In a large Russian registry of outpatients with heart failure, patients were relatively young with a high comorbidity burden and suboptimal use of guideline-directed medical therapy, particularly quadruple therapy in HFrEF, leading to significant differences in 1-year mortality and hospitalization across ejection fraction phenotypes.
Aim . Geographic heterogeneity of phenotypes and prognosis in heart failure (HF) highlights the need for region-specific data. The aim of the study was to evaluate characteristics, therapy, and 1-year outcomes in a Russian large representative cohort of outpatients with HF. Material and methods. PRIORITY-HF is a prospective, observational, multicenter registry study. From 2020 to 2022, outpatients diagnosed with HF aged 18 years and older were included in 50 regions of the Russian Federation. R e sults . The study included 19,981 patients with HF (mean age 64.9 years; 63.5% men). HF with reduced ejection fraction (HFrEF) was diagnosed in 34.9% of patients, while HF with mildly reduced ejection fraction (HFmrEF) — in 24.7%, and HF with preserved ejection fraction (HFpEF) — in 40.4%. The most common comorbidities were hypertension (89.0%), coronary artery disease (73.4%), obesity (45.2%), chronic kidney disease (44.7%), and atrial fibrillation/flutter (42.5%). There was high prescription rate of individual classes of recommended HF therapy as follows: 92% of patients received renin-angiotensin-aldosterone system inhibitors, 86% — beta-blockers, 72% — mineralocorticoid receptor antagonists and 40% — sodium-glucose cotransporter-2 inhibitors, but only 46.6% of patients with HFrEF received quadruple therapy. After 12 months, all-cause mortality was 5.2% in the overall group (HFrEF: 8.1%; HFmrEF: 4.6%; HFpEF: 3.1%), while cumulative HF-related hospitalization rate — 6.3% (HFrEF: 10.4%; HFmrEF: 6.2%; HFpEF: 2.9%). Conclusion . The obtained data indicate a relatively young age of patients with HF in Russia with a high level of comorbidities and suboptimal therapy, especially in HFrEF. With relatively low mortality and rehospitalization rates, significant differences between the EF subgroups were revealed, which emphasizes the need for targeted interventions to improve the quality of care and prognosis.
Shlyakhto et al. (Fri,) studied this question.