Abstract
OBJECTIVES: No previous studies have specifically examined the effects of ethnicity on factors precipitating hospital admissions for heart Failure (HF). The aim of the current study was to identify factors precipitating HF hospitalizations peculiar to Middle-Eastern Arab and South Asian ethnicities using a large multinational multicenter Middle-Eastern HF registry in which these two ethnicities are most prevalent. METHODS: From February 2012 to November 2013, consecutive patients hospitalized with HF were enrolled from 47 hospitals in 7 Middle East countries. Identifiable factors contributing to HF hospitalization were pre-specified and captured at admission. Patients were divided into 2 groups according to ethnicity, Arabs and South Asians (referred to as Asians) and the 2 groups were compared. RESULTS: During the study period 5005 patients with HF were enrolled of whom 4989 patients were from the 2 ethnicities under study; 4516 Arabs (90.5%) and 473(9.5%) Asians with the mean age of 60 years for Arabs and 55 years for Asians. The mean left ventricular ejection fraction was 37 % for Arabs compared to 33.8 % for Asians, P=0.001. Among the precipitating factors studied, nonadherence to medications and infections were significantly more prevalent in Arabs compared to Asians (19.9% vs. 13.5% and 15.3% vs.8.5%, both P=0.001) whereas myocardial ischemia and uncontrolled hypertension were significantly more prevalent in Asians (40.4% vs. 25.9% and 11.6% vs.7.8%, both P=0.001). In both groups, however, myocardial ischemia and nonadherence to medications were the commonest two factors precipitating hospital admissions for HF (table). CONCLUSIONS: Our study identifies for the first time important ethnic related differences in precipitating factors for HF hospitalizations among Arabs and Asians living in the Middle-East. The current study underscores the need to consider ethnicity in studies of HF hospitalizations and HF outcomes.
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