Abstract 13692: Gender, Process of Care and Mortality in Heart Failure Patients in India: Findings From the National Heart Failure Registry India

Abstract

Introduction: HF mortality rate vary by gender in high income countries. Process of care is often associated with differences in HF mortality. Hypothesis: We hypothesized that, HF process of care is associated with differential mortality in men and women. Methods: National Heart Failure Registry is a nationwide registry . Data from 10851 consecutive acute decompensated heart failure patients (ESC2016) criteria was analysed. At baseline we examined sociodemographic characteristics, clinical features , disease etiology and co-morbid conditions of patients. We assessed both in-hospital and 90-day mortality. Results: The mean age of study population was 59.9 (SD=13.5). More than two third (69%) participants were men. Sixty-five percent (Women = 58.6%, Men =68.2%, p value = p<0.001) and 13%( Women = 19.5%, Men =9.6%, p value = p<0.001) of patients had HF with reduced ejection fraction and HF with preserved ejection fraction, respectively. In this study, 71.2%(Women =74.2 %, Men = 69.8%, p value = p<0.001) of patients had New York Heart Association (NYHA) Class III or Class IV. In-hospital and 90-day mortality rate were 6.7%(Women = 7.6%, Men = 6.3%, p value = 0.010) and 14.2%(Women = 14.9%, Men = 13.9%, p value =0.160), respectively(Fig:1). Beta blockers (BB), angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) were prescribed in 75.7% (Women=74.2%, Men=76.4%, p value = 0.015), 61.2% (Women=60.6%, Men=61.4%, p value = 0.405) and 64.7% (Women=66.4%, Men=64.0%, p value = 0.016), respectively. The study population had very low usage of devices like the automatic implantable cardioverter-defibrillator 0.9% (Women=0.4%, Men=1.1%, p value =p<0.001), cardiac resynchronization therapy defibrillator 1.0% (Women=1.1%, Men=1.0%, p value =0.75). Conclusion: The HF process of care differences may partially explains the differences in mortality in men and women.