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Mackay Heart Failure Study: Examining the Root Causes, Compliance With Guideline-Based Therapy and Prognosis - 04/08/21

Doi : 10.1016/j.hlc.2021.03.273 
Pyi Naing, MBBS, MPhil, FRACP a, b, c, , Michael Zhang, MBBS, FRACP a, d, Aye Myat Thandar Khine, MBBS a, Hnin Sabai Aung, MBBS, MRCP a, Li Ning Chean, MBBS a, Jacqueline Liaw, MBChB a, Margaret Bazley, CN a, Shantisagar Vaidya, MD, DNB, FRACP a, Muntaser D. Musameh, MD, PhD, FRACP a, Ahmed Khan, MBBS, FRACP a, e, f
a Mackay Base Hospital, Mackay, Qld, Australia 
b The Prince Charles Hospital, Brisbane, Qld, Australia 
c University of Notre Dame, Fremantle, WA, Australia 
d James Cook University, Townsville, Qld, Australia 
e University of Melbourne, Melbourne, Vic, Australia 
f Monash University, Melbourne, Vic, Australia 

Corresponding author at: University of Notre Dame, School of Medicine, Henry Street, Fremantle, WA, AustraliaUniversity of Notre DameSchool of MedicineHenry StreetFremantleWAAustralia

Abstract

Introduction

Heart failure patients have poor outcomes comparable to some malignancies; however, the modern guideline directed medical therapy (GDMT) has improved its outcomes. The clinical characteristics and prescribers’ compliance with GDMT for heart failure patients have not been studied in the Mackay region.

Methods

A retrospective cohort study of 115 consecutive adult heart failure patients was conducted at our institution.

Results

The study cohort consisted of 80% (n=92) males. Ischaemia was the leading cause accounting for 54% (n=62) of the cohort, followed by idiopathic cardiomyopathy at 32% (n=37). Drug-induced and Takotsubo cardiomyopathies were responsible for 11% and 1% respectively. Two (2) patients (2%) had valvular heart disease. Hypertension was present in 57% while diabetes and atrial fibrillation were present in 32% and 43% of patients. Fifty-nine per cent (59%) had a smoking history. All, except four patients, had reduced left ventricular ejection fraction (LVEF <50%) at diagnosis. Among patients with coronary ischaemia, 37% and 31% were revascularised with percutaneous coronary interventions and bypass graft surgeries, respectively. Renin-angiotensin-aldosterone system inhibitors and beta blockers were prescribed in 94% and 95% of the patients, respectively. Mineralocorticoid inhibitors were used in 25% while ivabradine was given to 8% of patients. Nine per cent (9%) of patients received cardiac resynchronisation therapy. Most patients had improvement in functional class and LVEF during follow-up. There were very few mortalities at 3% (n=3) at the median follow-up of 403 (IQR 239–896) days.

Conclusion

Our study has shed light on heart failure epidemiology in the Mackay region. We found excellent compliance with GDMT and good prognosis for most patients in terms of both symptom and survival.

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Keywords : Heart failure, Guideline directed medical therapy, Revascularisation


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Vol 30 - N° 9

P. 1302-1308 - settembre 2021 Ritorno al numero
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