Six Month Outcomes of Heart Failure Patients Followed at a Newly Established Multidisciplinary Program in the Middle East

Background Patients with heart failure (HF) are best managed within specialized programs in order to improve clinical outcomes and quality of life. Such programs are very rare in the Middle East. The objective of this observational study is to describe the experience at our centre following the establishment of an advanced HF program in October 2015. Methods A retrospective chart review was conducted on patients first seen at our HF clinic between Oct 2015 and Nov 2016. Patients included were adults with HF and reduced ejection fraction (HFrEF) defined as LVEF ≤ 40%. Patients were excluded if no 6-month follow up data were available. Data collected included clinical characteristics, LVEF, and pharmacotherapy both at baseline and at 6 months. In addition, survival and hospital re-admission rates were captured. Chi-square and paired t-test comparisons were performed to compare changes from baseline to the 6-month follow up point. Results Out of a total of 174 patients screened, 95 met the inclusion/exclusion criteria. Six patients expired prior to the follow up (6-month survival rate of 93.7%). Most (69.5%) were males with an average age of 57.8 ± 14.5 years and 61.8% had an ischemic etiology. More than half (56.8%) had an improvement in their LVEF (mean increased from 26.5 ± 7.7% to 34.5 ± 13.1; p figure 1 ). 25.8% of patients had an HF-related admission during the 6-months, with a subsequent 30-day re-admission occurring in 17.4% of them ( Table 1 ). More patients were on target doses of beta blockers and ACEI/ARBs, although this did not reach statistical significance. A significant proportion of patients were switched to sacubitril/valsartan at 6-months follow up compared to baseline (36% vs. 11.6% p Conclusion Close follow up of patients with HFrEF was associated with symptomatic improvement, low 6-month HF hospitalizations, and higher doses of HF pharmacotherapy. These findings warrant more studies comparing patients followed in advanced HF programs to those followed by general cardiology and internal medicine providers, especially in developing countries.