title: Clinical characteristics and outcomes of Yemeni patients with acute heart failure aged 50years or younger: Data from Gulf Acute Heart Failure Registry (Gulf CARE).
abstract: OBJECTIVE
  There is a shortage of data about acute heart failure (AHF) in the young, including its underlying causes, clinical presentation and outcomes. We aim to describe clinical characteristics, causes and outcomes of AHF in Yemeni patients aged 50years or younger.
  
  
  RESULTS
  we evaluated Yemeni patients with AHF enrolled in Gulf CARE registry. Patients were divided into two groups: young patients (≤50years) and older patients (>50years). A total of 1536 patients with AHF were enrolled, of whom 635 (41.3%) were 50years old or younger. The mean age for this group was 38.8 (±9.5) years; and 399 (62.8%) were males. Younger patients had a higher prevalence of non-ischemic cardiomyopathy (41% vs 11.1%, p<0.001), primary valvular disease (27.9% vs 3.2%, p<0.001), viral myocarditis (0.8% vs 0, p<0.001). Ischemic heart disease (61.6% vs 25.5%, p<0.001) and hypertensive heart disease (18.3% vs 6.3%, p<0.001) were more frequent in the elderly group. Cardiogenic shock was more frequent among younger patients (13.7% vs 7.0, p<0.001). In-hospital mortality was higher in patient aged ≤50years (12% vs 7.6%, p=0.002) while no difference in all-cause mortality was present at 3months (17.8 vs 14.5, p=0.089) and after 1year (21.9% vs 20.6%, p=0.56).
  
  
  CONCLUSIONS
  This analysis of Gulf CARE registry represents the largest report of patients admitted with AHF in Yemen. There were differences among cause of HF and precipitating factors of AHF among younger and elderly patients. Younger patients had higher in-hospital mortality and more severe clinical condition at admission.
authors.affiliation: Medical Department, Faculty of Medicine and Health Sciences, Sanaa University, Yemen.
authors.forename: A-Nasser
authors.initials: AN
authors.lastname: Munibari
authors.affiliation: Medical Department, Faculty of Medicine and Health Sciences, Sanaa University, Yemen.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Motarreb
authors.affiliation: Medical Department, Faculty of Medicine and Health Sciences, Sanaa University, Yemen.
authors.forename: Nora
authors.initials: N
authors.lastname: Al-Sagheer
authors.affiliation: Medical Department, Al-Thawarah Hospital, Sanaa, Yemen.
authors.forename: Hana Abu
authors.initials: HA
authors.lastname: Hadi
authors.affiliation: Medical Department, Al-Thawarah Hospital, Sanaa, Yemen.
authors.forename: Ali
authors.initials: A
authors.lastname: Othman
authors.affiliation: Medical Department, Al-Thawarah Hospital, Sanaa, Yemen.
authors.forename: Nawar
authors.initials: N
authors.lastname: Al-Wather
authors.affiliation: Medical Department, Al-Jomhory Hospital, Sanaa, Yemen.
authors.forename: Abdu
authors.initials: A
authors.lastname: Hamoud
authors.affiliation: Cardiac Centre, Al-Dhalea, Yemen.
authors.forename: Mutae
authors.initials: M
authors.lastname: Alawlagy
authors.affiliation: Medical Department, AL-Gomhorya Hospital, Aden, Yemen.
authors.forename: Salem
authors.initials: S
authors.lastname: Almehdar
authors.affiliation: Medical Department, Al-Gomhory Hospital, Taiz, Yemen.
authors.forename: Abdulkarim
authors.initials: A
authors.lastname: Alhammadi
authors.affiliation: Medical Department, Yemen - German Hospital, Sanaa, Yemen.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Almogayed
authors.affiliation: Division of Cardiology, S. Andrea Hospital, ASL 5 Regione Liguria, La Spezia, Italy. Electronic address: giorgio.caretta@gmail.com.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Caretta
authors.affiliation: Division of Cardiology, S. Andrea Hospital, ASL 5 Regione Liguria, La Spezia, Italy.
authors.forename: Anees
authors.initials: A
authors.lastname: Al Jabri
authors.affiliation: Department of Cardiology, Policlinico Umberto I, "La Sapienza" University of Rome, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Agati
mesh_terms: D000208:Acute Disease; D000328:Adult; D019468:Disease Management; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D015006:Yemen / Q000453:epidemiology
keywords: Acute heart failure; Congestive heart failure; Gulf Acute Heart Failure Registry (Gulf CARE); Yemen