Five years Clinical characteristics and in hospital outcome of acute heart failure at tertiary care hospital in Ethiopia

  • Esubalew woldeyes Asfaw St Paul’s hospital millennium medical collage


Background:  Heart failure is a burgeoning problem worldwide, with more than 20 million people affected. This study was done with the aims to determine, etiology, clinical characteristics, management and in hospital outcome of heart failure patients.

Methods : Retrospective patient chart review was conducted at St Paul Hospital Millennium medical college Addis Ababa, Ethiopia .A data of 496 patients admitted with acute heart failure over five years from September 2010 –September 2015 was collected with a pretested data abstraction form and entered and analyzed by SPSS Version 20.

Results: We analyzed medical record of 496 patients admitted with acute heart failure to one of teaching hospital in Ethiopia. The mean age was 47.1±19.4 years, and 57.8% were male. The mean systolic blood pressure  were 107.5±33 mmHg .Rheumatic heart disease (30%) was the most frequent cause of HF. In total 428 of analyzed patients had Echocardiography 136(31.77%)  .ejection fraction  was 40% or less, and ECG result showed atrial fibrillation  in 27.5%. Angiotensin converting enzyme inhibitors , beta-blockers, and spironolactone prescribed 38.9%,27.9%, and 71% respectively at discharge. In-hospital mortality was 24.4%. The median duration of hospitalization was 11 days. CKD as comorbidity, female sex , and high heart rate at admission was predicators of lower in-hospital survival

Conclusions : In our patients acute heart failure affects  young age and associated with high mortality. Our patients are under investigated and treated. We recommend further large scale multi centered prospective study for better characterization of Ethiopian patients with acute heart failure.

Author Biography

Esubalew woldeyes Asfaw, St Paul’s hospital millennium medical collage

St Paul’s hospital millennium medical collage Department of intrenal medicine ,cardiologist

assistant proffesor


Ezzati M, Vander Hoorn S, Lawes CM et al. Rethinking the ‘diseases of affluence’ paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med 2005;2:e133.

Mensah GA. Ischaemic heart disease in Africa. Heart 2008;94:836–43.

Parkin DM, Sitas F, Chirenje M et al. Cancer in indigenous Africans—burden, distribution and trends. Lancet Oncol 2008;9:683–92. Connor MD, Walker R, Modi G, Warlow CP. Burden of stroke in black populations in sub-Saharan Africa. Lancet Neurol 2007;6:269–78.

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006;3:e442.

Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367:1747–57.

Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, MD, PhD ,Anthony S. Fauci, Joseph Loscalzo,Dan L. Longo, ,Harrison principles of internal medicine 2015

Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet 2007;370:1929–38

Andre Pascal Kengne Anastase Dzudie Eugene Sobngwi Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetesVascular Health and Risk Management 2008:4(1) 123–130

Albertino Damasceno,Gad Cotter ,Anastase Dzudie,Bongani,Karen Sliwa M,Myosi Heart failure in sub-Saharan africa ;time for action J Am coll Cardiolo octpbour 23,2007,50(17):1688-1693

Doust JA, Pietrzak E, Dobson A, Glasziou P. How well does Btype natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ 2005; 330(7492): 625.

Awoke Misganaw, Damen Haile Mariam, Ahmed Ali, Tekebash Araya Epidemiology of Major Non-communicable Diseases in Ethiopia: A Systematic Review J HEALTH POPUL NUTR 2014 Mar;32(1):1-13

World Health Organization. Noncommunicable diseases country profiles 2011. Geneva: World Health Organization, 2011. 207 p.

Maru M The changing pattern of cardiovascular diseases in Ethiopia East Afr Med J. 1993 Dec;70(12):772-6

E. H. O. Parry and C. G. I. Gordon Case-finding by mass miniature radiography Bull World Health Organ. 1968; 39(6): 859–871.

Abdissa SG, Oli K, Feleke Y, Goshu DY, Begna DM, Tafese A Spectrum of cardiovascular diseases among Ethiopian patients at Tikur Anbessa Specialized University Teaching Hospital, Addis Ababa Ethiop Med J. 2014 Jan;52(1):9-17

Zühlke L, Engel ME, Karthikeyan G, Rangarajan S, Mackie P, Cupido B, Mauff K, Islam S, Joachim A, Daniels R, Francis V, Ogendo S, Gitura B,Mondo C, Okello E, Lwabi P, Al-Kebsi MM, Hugo-Hamman C, Sheta SS, Haileamlak A, Daniel W13, Goshu DY14, Abdissa SG14, Desta AG14,Shasho BA14, Begna DM14, ElSayed A15, Ibrahim AS, Musuku J, Bode-Thomas F, Okeahialam BN, Ige O, Sutton C, Misra R, Abul Fadl A,Kennedy N, Damasceno A, Sani M, Ogah OS, Olunuga T, Elhassan HH, Mocumbi AO, Adeoye AM, Mntla P, Ojji D, Mucumbitsi J, Teo K, Yusuf S, Mayosi BM. Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study) Eur Heart J. 2015 May 7;36(18):1115-22a. doi: 10.1093/eurheartj/ehu449. Epub 2014 Nov 25

Oli K, Asmera J Rheumatic heart disease in Ethiopia: could it be more malignant? Ethiop Med J. 2004 Jan;42(1):1-8

Adams KF Jr, Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, Berkowitz RL, Galvao M, Horton DP; ADHERE Scientific Advisory Committee and Investigators. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE).Am Heart J2005;149:209–216

Fonarow GC1, Abraham WT, Albert NM, Gattis WA, Gheorghiade M, Greenberg B, O’Connor CM, Yancy CW, Young J. Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF):rationale and design.Am Heart J2004;148:43–51

Damasceno A, Mayosi BM, Sani M, Ogah OS, Mondo C, Ojji D, Dzudie A,Kouam CK, Suliman A, Schrueder N, Yonga G, Ba SA, Maru F, Alemayehu B, Edwards C, Davison BA, Cotter G, Sliwa K. The causes, treatment, and outcome of acute heart failure in1006 Africans from 9 countries.Arch Intern Med2012;172:1386–1394

Kadhim Sulaiman, Prashanth Panduranga,Ibrahim Al-Zakwani,Alawi A.Alsheikh-Ali3, Khalid F. AlHabib, Jassim Al-Suwaidi,WaelAl-Mahmeed6, Hussam AlFaleh, Abdelfatah Elasfar, Ahmed Al-Motarreb,Mustafa Ridha, Bassam Bulbanat10, Mohammed Al-Jarallah, Nooshin Bazargani, Nidal Asaad,and Haitham AminClinical characteristics, management, and outcomes of acute heart failure patients:observations from the Gulf acute heart failure registry (Gulf CARE), European Journal of Heart Failure (2015)17, 374–384

Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP,Hochadel M, Komajda M, Lassus J, Lopez-Sendon JL, Ponikowski P, Tavazzi L;EuroHeart Survey Investigators, Heart Failure Association, European Society of Cardiology. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population.Eur Heart J2006;27:2725-2736

Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC; OPTIMIZE-HF Investigators and Coordinators. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA 2006;296:2217–2226

Follath F, Yilmaz MB, Delgado JF, Parissis JT, Porcher R, Gayat E, Burrows N,McLean A, Vilas-Boas F, Mebazaa A. Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment(ALARM-HF).Intensive Care Med 2011;37:619–626

Maggioni AP, Dahlström U, Filippatos G, Chioncel O, Crespo Leiro M, Drozdz J, Fruhwald F, Gullestad L, Logeart D, Fabbri G, Urso R, Metra M, Parissis J, Persson H, Ponikowski P, Rauchhaus M, Voors AA, Nielsen OW, Zannad F, Tavazzi L; Heart Failure Association of the European Society of Cardiology (HFA). EURObservational Research Programme: regional differences and1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail 2013;15:808–817.

Original Article