Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience

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dc.contributor.advisorMayosi, Bongani Men_ZA
dc.contributor.authorSzymanski, Patryk Zygmunten_ZA
dc.date.accessioned2017-01-19T12:23:49Z
dc.date.available2017-01-19T12:23:49Z
dc.date.issued2016en_ZA
dc.description.abstractBackground: There is limited information on acute heart failure (AHF) and the treatment thereof in sub-Saharan Africa. Therefore, the aim of this study was to describe the clinical characteristics, causes, adherence to heart failure (HF) treatment guidelines and mortality of patients presenting to Groote Schuur Hospital with acute heart failure (AHF). Methods: This is a sub-study of The Sub-Saharan Africa Survey of Heart Failure (THESUSHF). This sub-study is a prospective and observational survey that focused on the enrolment and follow-up of additional patients with AHF presenting to Groote Schuur Hospital entered into the existing registry, following the publication of the primary paper of THESUS-HF in 2012. The patients were classified into prevalent (or existing) or incident (or new) cases of heart failure. Results: Of the 119 patients included, 69 (58%) were female and the mean (SD) age was 49.9 (16.3) years. Prevalent cases were mostly of mixed ancestry (63.3%) with more hypertension (70%), diabetes mellitus (36.7%), hyperlipidaemia (33.3%) and ischaemic heart disease (36.7%) than incident cases. The main causes of heart failure were cardiomyopathy (20.2%), ischaemic heart disease (IHD) (19.3%) and rheumatic valvular heart disease (RHD) (18.5%). Most patients received renin-angiotensin system blockers and loop diuretics on discharge. There was a low rate of β-blocker, aldosterone antagonist and digoxin use. Rehospitalisation at 180 days occurred in 25.2%. In-hospital mortality was 8.4 % and the case fatality rate at six months was 26.1%. Conclusion: In Cape Town the main causes of AHF are cardiomyopathy, IHD and RHD. AHF affects a young population and is associated with a high rate of rehospitalisation and mortality. There is a serious under-use of β-blockers, aldosterone antagonists and digoxin. An emphasis on the rigorous application of treatment guidelines is needed in order to reduce re-admission and mortality.en_ZA
dc.identifier.apacitationSzymanski, P. Z. (2016). <i>Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/22820en_ZA
dc.identifier.chicagocitationSzymanski, Patryk Zygmunt. <i>"Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2016. http://hdl.handle.net/11427/22820en_ZA
dc.identifier.citationSzymanski, P. 2016. Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Szymanski, Patryk Zygmunt AB - Background: There is limited information on acute heart failure (AHF) and the treatment thereof in sub-Saharan Africa. Therefore, the aim of this study was to describe the clinical characteristics, causes, adherence to heart failure (HF) treatment guidelines and mortality of patients presenting to Groote Schuur Hospital with acute heart failure (AHF). Methods: This is a sub-study of The Sub-Saharan Africa Survey of Heart Failure (THESUSHF). This sub-study is a prospective and observational survey that focused on the enrolment and follow-up of additional patients with AHF presenting to Groote Schuur Hospital entered into the existing registry, following the publication of the primary paper of THESUS-HF in 2012. The patients were classified into prevalent (or existing) or incident (or new) cases of heart failure. Results: Of the 119 patients included, 69 (58%) were female and the mean (SD) age was 49.9 (16.3) years. Prevalent cases were mostly of mixed ancestry (63.3%) with more hypertension (70%), diabetes mellitus (36.7%), hyperlipidaemia (33.3%) and ischaemic heart disease (36.7%) than incident cases. The main causes of heart failure were cardiomyopathy (20.2%), ischaemic heart disease (IHD) (19.3%) and rheumatic valvular heart disease (RHD) (18.5%). Most patients received renin-angiotensin system blockers and loop diuretics on discharge. There was a low rate of β-blocker, aldosterone antagonist and digoxin use. Rehospitalisation at 180 days occurred in 25.2%. In-hospital mortality was 8.4 % and the case fatality rate at six months was 26.1%. Conclusion: In Cape Town the main causes of AHF are cardiomyopathy, IHD and RHD. AHF affects a young population and is associated with a high rate of rehospitalisation and mortality. There is a serious under-use of β-blockers, aldosterone antagonists and digoxin. An emphasis on the rigorous application of treatment guidelines is needed in order to reduce re-admission and mortality. DA - 2016 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience TI - Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience UR - http://hdl.handle.net/11427/22820 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/22820
dc.identifier.vancouvercitationSzymanski PZ. Clinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experience. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2016 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/22820en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherMedicineen_ZA
dc.titleClinical characteristics, causes, adherence to heart failure treatment guidelines and mortality of patients with acute heart failure: the Groote Schuur Hospital experienceen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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