097 Clinical Characteristics of Heart Failure Patients in Mackay

Abstract

Heart failure has poor outcomes comparable to some malignancies; however, the modern guideline directed medical therapy (GDMT) has improved its outcomes. A retrospective cohort study of 115 consecutive adult heart failure patients was conducted at our institution. Medical records were reviewed to document the demographics, aetiology, risk factors, treatments and outcomes. The study cohort consisted of 80%(N=92) males. Ischaemia was the leading cause accounting for 56% (n=64) of the cohort, followed by idiopathic cardiomyopathy at 30% (n=35). Drug induced and Takotsubo cardiomyopathies were responsible for 11% and 1%. Two patients (2%) had valvular heart disease. Hypertension was present in 57% while diabetes and atrial fibrillation were present in 32% and 43% of patients. 59% had history of smoking. All except 4 patients had reduced ejection fraction (EF <50%) at diagnosis. 44% and 31% of ischemic patients were revascularized with percutaneous coronary interventions and bypass graft surgeries, respectively. Angiotensin Receptor-Neprilysin Inhibitors (ARNi) were prescribed in 62% while Angiotensin Converting Enzyme inhibitors and Angiotensin Receptor Blockers were prescribed in 23% and 10% of patients. Bisoprolol was the preferred betablocker and prescribed in 80%. Mineralocorticoid inhibitors and ivabradine were underutilised at 25% and 8% of patients. Cardiac Resynchronisation Therapy was used in 9%. There were very few mortalities at 3% (n=3) at the median follow-up of 403 (IQR 239-896) days. Most first line medications from GDMT were prescribed in our patients. Underuse of mineralocorticoid inhibitors may be explained by the concern of hyperkalaemia and renal dysfunction from ARNi use.