Precipitating factors for acute decompensated heart failure in patients with stable chronic left ventricular systolic dysfunction

Abstract

Background: The burden of HF in India is high, with an estimated prevalence of about 5 million patients, an annual incidence of one million, an in hospital mortality as high as 30.8%, with postdischarge 6 month major adverse event and mortality rates at 39.5% and 26.3%. Acute decompensated HF is caused by a variety of precipitating factors and many are preventable. Methods: This 1 year study was a prospective study conducted on the patients admitted under a tertiary care unit in north India. Patients included in the study had chronic stable left ventricular systolic dysfunction and developed acute decompensated HF. Results: This study included 150 Patients with ADHF . Moderate to severe anemia was found to be the factor in 63.8% of the patients. New onset myocardial ischemia was the next most common factor leading to acute decompensated HF, Dietary indiscretion was seen in 45.3% of the patients. Noncompliance to drugs was also very common. The study revealed that higher rates of admissions with acute decompensated HF were seen in winters (October to December and January to March). Conclusion: Anemia and noncompliance with drugs were most common precipitating factors leading acute decompensated HF in North Indian population.Every patient needs a more intensive regular follow up and adequate diet pattern for prevention of acute decompensated HF. Systematic patient education and treatment can reduce the burden, risk of ADHF, and re hospitalization.

Keywords

• Acute decompensated heart failure
• anemia
• noncompliance
• precipitating factors