Clinical Presentation, Management and Outcome of Heart Failure Patients.

Coronary artery disease was the most common etiology of heart failure in this cohort, affecting nearly two-thirds of patients.

• Coronary artery disease accounted for 65.8% of cases.
• Idiopathic dilated cardiomyopathy was the second most common etiology at 15.0%.
• Rheumatic heart disease was the third most common etiology at 7.2%.
• Study included 1,523 admitted heart failure patients at a tertiary cardiac center in Nepal.

Acute coronary syndrome was the primary aggravating factor for heart failure admissions.

• Acute coronary syndrome was identified as the primary aggravating factor in 39.9% of patients.
• Data were collected via structured interviews, chart review, clinical observation, phone calls, and follow-up.
• The study was prospective and observational, conducted over six months.

The overall mortality rate was 12.7%, comprising both in-hospital and post-discharge deaths within 90 days.

• In-hospital mortality was 4.7%.
• 90-day mortality was 7.9%.
• Overall mortality across both periods was 12.7%.
• Outcomes were tracked via phone calls and follow-up after discharge.

Guideline-directed medical therapy was used in a majority of patients, though SGLT-2 inhibitor use was notably low.

• ACE inhibitors or angiotensin receptor blockers were prescribed to 68.5% of patients and represented the most common pharmacological treatment.
• Beta-blockers were used in 66.1% of patients.
• Mineralocorticoid receptor antagonists were used in 61.2% of patients.
• Sodium-glucose cotransporter-2 (SGLT-2) inhibitor use was low at only 15.2%.

Device therapy for heart failure was extremely rare in this cohort.

• Device therapy was used in only 0.26% of patients.
• The study was conducted at a tertiary cardiac center in Nepal.
• This finding likely reflects resource and access limitations in the low-to-middle income country context.

The study population was predominantly male and middle-to-older aged.

• 62.0% of the 1,523 patients were male.
• The mean age of the cohort was 61.5 ± 14.9 years.
• All patients were aged 18 years and above.
• The study was conducted over a six-month period at a single tertiary cardiac center in Nepal.