Clinical characteristics, treatment patterns, & outcomes of heart failure: A comparative analysis across age groups from the heart failure registry in India

Background & objectives Heart failure is a major health burden globally. While the prevalence of heart failure is increasing, limited research has focused on the specific characteristics and outcomes of patients with heart failure belonging to different age groups in India. This study aimed to describe the clinical characteristics, treatment patterns and outcomes of patients with heart failure in India with a focus on comparing these aspects among young (16 to 40 yr), middle-aged (41-64 yr), and elderly (≥ 65 yr) individuals. Methods A multicentre, hospital-based study was conducted in five small- to medium-sized cities in India. Participants included admitted cases of heart failure between June 2018 and March 2022. Demographic and clinical information, including comorbidities, and data on aetiology, treatment, and outcomes, were collected using a standardised proforma. Statistical analyses were conducted to compare variables across age groups. Results Out of 6018 participants, 613 (10.2%) were young adults, 3207 (53.3%) were middle-aged, and 2198 (36.5%) belonged to the elderly age group. Most of the patients (>60%) were from rural areas. Ischemic heart disease (IHD) was the most common aetiology across all three age groups (52.4%, 75.1%, and 76.9%), and the 90-day mortalities for the three age groups were 12.6, 13.4 and 19 per cent, respectively. Young patients presented with milder symptoms, distinct aetiologies, and fewer comorbidities than older age groups. Treatment patterns varied across age groups. Young patients had longer hospital stays and higher in-hospital mortality rates. However, long-term mortality rates were higher among the older age groups. Interpretation & conclusions This study provides valuable insights into the clinical characteristics, treatment patterns and mortality rates of individuals with heart failure in India, particularly from rural areas. The findings highlight the need for tailored approaches for different age groups in the prevention and management of heart failure, with a special focus on the young and rural population.