Epidemiology and outcomes of chronic heart failure among Moroccan individuals: A multicentric study

Abstract

Heart failure (HF) is nowadays an important health problem. However, epidemiology and outcomes of HF is not well established in Morocco despite the prevalent socioeconomic impact on health system. We conducted a nationwide register-based study to investigate demographics, risk factors, comorbid conditions and outcomes associated with heart failure in adults in Morocco. To our knowledge, this is the first epidemiological study aiming to address the profile of chronic heart failure in Moroccan individuals. A cross-sectional, retrospective, descriptive, multicentric study including patients beyond 14 years old with HF was conducted in Cardiology departments of 4 University Hospitals: University Hospital IbnRochd in Casablanca [May 2006 to June 2019], University Hospital Arrazi and Avicenne Military Hospital for Instruction in Marrakesh [January 2012 to June 2019] and University Hospital IbnSina in Rabat [March 2018 to June 2019] Prevalence of cardiovascular risk factors was: hypertension (41.73%), diabetes (36.73%), smoking (36%), dyslipidemia (12.5%), and obesity (41.73%). An important proportion of patients has experienced a previous cardiovascular event: acute myocardial infarction (36.73%) or stroke (12.5%). End-stage chronic kidney disease was associated to HF in 5.25% of cases. Etiologies were as follows: ischemic heart disease (59%), non-ischemic dilated cardiomyopathy (26%), valvular heart disease (10%). Atrial fibrillation (paroxysmal or permanent) was represented in 18.36% of cases. HF was classified HFrEF in 68% of cases, HFmrEF in 19% of cases and HFpEF in 13% of cases. Mean LVEF was 33.3 ± 10.83%. Optimal medical therapy was reached in 74% of cases.Mortality rate was 8.4% and re-hospitalization for HF rate was 39.08%. People living with HF require services that meet their changing needs.In order to develop appropriate care, it is imperative to generate evidence to inform policy and practice.