title: Demographics, Clinical Characteristics, Management, and Outcomes of Acute Heart Failure Patients: Observations from the Oman Acute Heart Failure Registry.
abstract: OBJECTIVE
  We sought to describe the demographics, clinical characteristics, management and outcomes of patients in Oman with acute heart failure (AHF) as part of the Gulf aCute heArt failuRe rEgistry (CARE) project.
  
  
  METHODS
  Data were analyzed from 988 consecutive patients admitted with AHF to 12 hospitals in Oman between 14 February and 14 November 2012.
  
  
  RESULTS
  The mean age of our patients was 63±12 years. Over half (57%) were male and 95% were Omani citizens. Fifty-seven percent of patients presented with acute decompensated chronic heart failure (ADCHF) while 43% had new-onset AHF. The primary comorbid conditions were hypertension (72%), coronary artery disease (55%), and diabetes mellitus (53%). Ischemic heart disease (IHD), hypertensive heart disease, and idiopathic cardiomyopathy were the most common etiologies of AHF in Oman. The median left ventricular ejection fraction of the cohort was 36% (27-45%) with 56% of the patients having heart failure with reduced ejection fraction (< 40%). Atrial fibrillation was seen in 15% of patients. Acute coronary syndrome (ACS) and non-compliance with medications were the most common precipitating factors. At discharge, angiotensin converting enzyme inhibitors and beta-blockers were prescribed adequately, but aldosterone antagonists were under prescribed. Within 12-months follow-up, one in two patients were rehospitalized for AHF. In-hospital mortality was 7.1%, which doubled to 15.7% at three months and reached 26.4% at one-year post discharge.
  
  
  CONCLUSIONS
  Oman CARE was the first prospective multicenter registry of AHF in Oman and showed that heart failure (HF) patients present at a younger age with recurrent ADCHF and HF with reduced ejection fraction. IHD was the most common etiology of HF with a low prevalence of AHF, but a high prevalence of acute coronary syndrome and non-compliance with medications precipitating HF. A quarter of patients died at one-year follow-up even though at discharge medical therapy was nearly optimal. Our study indicates an urgent need for prevention, early diagnosis, and treatment of AHF in Oman.
authors.affiliation: Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Panduranga
authors.affiliation: Ministry of Health, Muscat, Oman.
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.affiliation: Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman; Gulf Health Research, Muscat, Oman.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.affiliation: Department of Cardiology, Sohar Hospital, Sohar, Oman.
authors.forename: Aouf AbdlRahman
authors.initials: AA
authors.lastname: Alazzawi
authors.affiliation: Department of Medicine, Ibri Hospital, Ibri, Oman.
authors.forename: Abraham
authors.initials: A
authors.lastname: Abraham
authors.affiliation: Department of Cardiology, Sultan Qaboos Hospital, Salalah, Oman.
authors.forename: Prit Pal
authors.initials: PP
authors.lastname: Singh
authors.affiliation: Department of Medicine, Ibra Hospital, Ibra, Oman.
authors.forename: Narayan Anantha
authors.initials: NA
authors.lastname: Narayan
authors.affiliation: Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Mamatha Punjee
authors.initials: MP
authors.lastname: Rajarao
authors.affiliation: Department of Cardiology, Sur Hospital, Sur, Oman.
authors.forename: Mohammed Ahmed
authors.initials: MA
authors.lastname: Khdir
authors.affiliation: Department of Cardiology, Sohar Hospital, Sohar, Oman.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Abdlraheem
authors.affiliation: Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Aftab Ahmed
authors.initials: AA
authors.lastname: Siddiqui
authors.affiliation: Department of Cardiology, Rustaq Hospital, Rustaq, Oman.
authors.forename: Hisham
authors.initials: H
authors.lastname: Soliman
authors.affiliation: Department of Cardiology, Rustaq Hospital, Rustaq, Oman.
authors.forename: Osama Abdellatif
authors.initials: OA
authors.lastname: Elkadi
authors.affiliation: Department of Cardiology, Armed Forces Hospital, Muscat, Oman.
authors.forename: Ruchir Kumar
authors.initials: RK
authors.lastname: Bichu
authors.affiliation: Department of Medicine, Al Nahdha Hospital, Muscat, Oman.
authors.forename: Kumayl Hasan
authors.initials: KH
authors.lastname: Al Lawati
keywords: Heart Failure; Oman; Registries