Clinical Presentation and Prognosis in Heart Failure Patients with Reduced Ejection Fraction: A Prospective One-Year Follow Up Study in National Cardiovascular Center Harapan Kita, Indonesia
Abstract
Rarsari Soerarso, Hansen Angkasa, Gladys Kusumowidagdo, Catherine J Josephine, Mohammad Risandi P, Bambang B Siswanto
Background: Systolic heart failure (HFrEF) is characterized by ejection fraction of <40% and causes significant mortality and morbidity rate. We seek to characterize Indonesian patients’ clinical presentation (low to middle income country), oneyear outcome and prognostic factors of HFrEF patients.
Methods and Results: Prospective cohort with consecutive sampling method was done in National Cardiovascular Center Harapan Kita (NCCHK), Jakarta from October 2013 to March 2014. NCCHK is a national heart referral center for 34 provinces in Indonesia. Data was obtained from medical records of HFrEF patients enrolled in ASIAN-HF study. Oneyear follow up was done via medical record or phone interview. Data was analyzed using SPSS version 23. Ninety HFrEF subjects (57.3±1.17 years) were obtained. Angina was more commonly seen in higher EF group (21-40%; p=0.016). At one-year, 22.2% died. Lower EF group had higher rate of death (p>0.05). Age, rales and elevated JVP were predictive of death regardless of EF (p<0.05).
Conclusions: Angina was more commonly seen in higher EF group. Signs of congestion are associated with poorer prognosis. Low EF (<20% vs 21-40%) had clinically high rate of death (26.7% vs 13.3%, p>0.05).