Heart Failure Patient Profiles, Management and Outcome: Results from a Heart Failure Clinic Registry

Background: Heart failure (HF) is a global pandemic, but data from South Asia, particularly Bangladesh, are scarce. Understanding regional patient characteristics and risk factors is critical for improving outcomes. Therefore, this study aimed to characterize the clinical profile of patients with HF at a tertiary care center in Bangladesh and to identify the independent predictors of 1-year all-cause mortality. Methods: We conducted a retrospective cohort study using data from a heart failure registry at a single tertiary care hospital in Bangladesh. Data were collected from the medical records of 1,536 patients registered between 2020 and 2024. The primary outcome was all-cause mortality at 1 year. Multivariable logistic regression analysis was performed to identify independent predictors of mortality. Results: A total of 1,536 patients were included (mean age 53.2±6.5 years; 84% male). The majority of patients had HF with reduced Ejection Fraction (73%) and were in NYHA class II (85%) at their first visit. The most prevalent comorbidities were coronary artery disease (59%) and diabetes (55%). Guidelinedirected medical therapy was common, with 88% of patients on beta-blockers and 49% on Angiotensin Receptor-Neprilysin Inhibitor. The crude 1-year mortality rate was 15%. After multivariable adjustment, key independent predictors of mortality included the presence of renal failure and advanced NYHA classes at follow-up. Conclusions: In this large, single-center Bangladeshi cohort, patients with HF presented at a relatively young age with a high burden of comorbidities. The 1-year mortality rate was substantial. These findings highlight the need for targeted interventions focusing on high-risk subgroups to improve patient outcomes in this region.