Heart Failure and Cardiovascular Disease Patterns in Sikkim: A 17-Month Hospital Registry

Background: Heart failure (HF) is a growing global health challenge, yet regional data from India’s northeastern states remain scarce. This study describes the spectrum, care patterns, and outcomes of cardiovascular diseases (CVDs), with a focus on HF, using data from a 17-month hospital-based registry in Sikkim. Methods: A prospective observational registry was conducted at the Central Referral Hospital, Sikkim Manipal Institute of Medical Sciences, from November 2022 to March 2024. Consecutive patients aged ≥16 years diagnosed with CVD were enrolled and followed. HF cases were categorized by ejection fraction (EF) (HF with preserved EF [HFpEF], HF with mildly reduced EF [HFmrEF], and HF with reduced EF) and followed up at 30, 90, and 180 days. Data were analyzed using SPSS (version 25.0) with descriptive statistics. Results: Among 793 CVD cases (mean age – 58.2 years), 130 had HF. Male and female patients were nearly equal. Predominant CVDs were hypertensive heart disease and other nonrheumatic structural heart diseases. HFpEF was most frequent (40.0%), followed by HFmrEF (32.3%) and reduced EF (27.7%). Most presented with acute decompensated HF (63.1%) and New York Heart Association Class IV symptoms (60.0%). Thirteen patients died during hospitalization. The HF readmission rate was 17.1% during follow-up, with no additional deaths. Conclusion: This registry provides prospective hospital-based insights into CVD and HF patterns from Sikkim. The predominance of HFpEF and advanced presentations highlights the need for early diagnosis, structured follow-up, and region-specific strategies within India’s noncommunicable disease framework. Strengthening regional HF registries can enhance evidence-based care and guide public health planning in resource-limited settings.