Demographics and Clinical Characteristics of Indian Patients with Heart Failure Visiting Outpatient Clinics: A Cross-Sectional Observational Study.

Background

Data on heart failure (HF) phenotypes in India remain limited. We examined clinical characteristics and factors associated with HF phenotype defined according to ejection fraction (EF) in a large multicentre outpatient cohort.

Methods

We performed a retrospective cross-sectional analysis of adult HF outpatients with documented EF at centres across India (April 2021-March 2023). Patients were classified as HFrEF (EF ≤40%), HFmrEF (41-49%), or HFpEF (≥50%); multivariable logistic regression identified factors associated with phenotype.

Results

Among 1,207 patients (62 ± 10 years; 73% male), HFrEF was present in 822 (68.1%), HFmrEF in 89 (7.4%), and HFpEF in 296 (24.5%). Patients with HFpEF had higher systolic blood pressure (153 ± 26 vs 122 ± 25 mmHg), higher body mass index (BMI; 27.5 ± 4.9 vs 26.4 ± 4.4 kg/m2), and more chronic kidney disease (45% vs 23%) and stroke (27% vs 6.2%) than those with HFrEF (all p ≤ 0.003). Ischaemic heart disease (66% vs 56%; p = 0.002) and higher NT-proBNP (median 3,705 [481-6,232] vs 140 [121-521] pg/mL; p < 0.001) were more common in HFrEF. In multivariable analysis, higher BMI (OR 1.35 per 5 kg/m2, 95% CI 1.10-1.65), higher systolic blood pressure (OR 1.48 per 10 mmHg, 95% CI 1.37-1.60), and stroke (OR 1.99, 95% CI 1.11-3.54) were associated with higher odds of HFpEF, whereas higher NT-proBNP (OR 0.46, 95% CI 0.40-0.53) and diabetes (OR 0.56, 95% CI 0.38-0.83) were associated with lower odds of HFpEF.

Conclusions

Higher BMI and blood pressure were associated with HFpEF, whereas elevated NT-proBNP and diabetes were associated with HFrEF. These cross-sectional associations may support phenotype-specific management of HF.