Clinical Epidemiology of Acute Heart Failure in Nigeria: Insights and Lessons from the Ibadan Heart Failure Project
Authors & Affiliations
Okechukwu S Ogah1,2,3, Olanike A Orimolade1,2,3,Omokorede Ademowo-Olusanya1,2,4, Chidinma M Ogah3 Oladimeji Adebayo1,4, Akinyemi Aje2, Abiodun M Adeoye1,2, Adewole A Adebiyi1,2, Olulola O Oladapo1,2, Okechukwu S Ogah1,2,3 Affiliations 1. Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria. 2. Cardiology Unit, Department of Medicine, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Oyo State, Nigeria. 3. Cardiomyopathies, Heart Failure and Atrial Fibrillation Research Projects, Cardiology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria 4. Institute of Cardiovascular Disease, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria. Correspondence Prof. Okechukwu S Ogah, Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, PMB 5116, Ibadan, Nigeria
📖 Abstract Content
Background Contemporary evidence and long-term outcomes are limited. The Ibadan acute heart failure project was set up in 2016 to address this gap
Methods The project is a real-life, prospective observational study that was conducted on patients with acute heart failure at the University College Hospital. Data were collected using a pretested case report form. Data on demographic, clinical, laboratory, electrocardiographic, echocardiographic, treatment, and outcome data were collected.
Results The mean age of the study participants was 55.9 ± 16.0 years, and 43.4% were female. The majority, 80.4% of patients, had de novo acute HF. 74.3% were in NYHA class III/IV. Hypertension, type 2 diabetes mellitus, and atrial fibrillation were present in 73.8%, 14.3%, and 12.7%, respectively. The mean LVEF was 37.7 ± 18.5% and TAPSE 16.1 ± 1.62 cm. About 77.2% had HFrEF, and over 2/3 had RV dysfunction. Mitral and tricuspid regurgitation were present in 72.2% and 21.5%. The mean hospital stay was 9.7 ± 5.7 (95% CI: 9- 10)days. The intrahospital mortality was 5.9%. At 12 months follow-up, 29.6% died, and 6.4% were readmitted.
Conclusion Acute HF is a disease of the young and middle-aged population. Presentation is often late with severe structural abnormalities. Heart failure with reduced EF is more common. Intrahospital mortality is similar to data from high-income countries, but 1-year mortality is high. The Project provides opportunities for initiatives to improve outcomes.
