Acute heart failure is a major and increasing cause of hospital admissions and
associated with significant morbidity and mortality. Aim: to describe the clinical
characteristics, management and in-hospital mortality in patients admitted with acute heart
failure to a single cardiology centre during one-year period. Methods: a retrospective study
of patients hospitalized to Tajoura National Heart Center during the period from January
to December 2005, medical records of all patients with a primary discharge diagnosis of
acute heart failure were revised and relevant data extracted and analyzed. Results: 103
patients were included (mean age of 66 years and 67% were men). Out of them, 10.7% had
a previous history of heart failure and presented with acute decompensation. The most
common concurrent diseases were; diabetes (59.2 %), arterial hypertension (47.6%), renal
impairment (29.1%) and chronic obstructive pulmonary disease (22.3%). Their mean
presenting systolic blood pressure was 120 ± 25 mmHg, 36.9% had hyponatremia (< 135
mEq/L and according to the WHO criteria, 42.7% were anemic. The mean left ventricular
ejection fraction was 56%, 74.8% had dilated cardiomyopathy and 46.6% had ischemic
heart disease. The mean hospital stay was 8.6 days and the in-hospital mortality was 18.4%.
Mortality was statistically associated with female gender, renal impairment, acute
decompensation and low presenting systolic blood pressure. On discharge 71.4% of the
patients were prescribed renin-angiotensin system blockers, 44% beta-blockers and 59.5%
mineralocorticoid antagonists. Compared with European and American patients, our
patients were of younger age and higher ratio of males and more De Novo presentation.
The in-hospital mortality was higher and could be due to the high prevalence of known
mortality risk factors (diabetes, low systolic BP, anemia, hyponatremia). Up on discharge,
there was less prescription of renin-angiotensin system and beta-blockers, and more
prescription of statins, anti-platelet drugs and amiodarone. In conclusion, we need to have
a higher awareness of heart failure and its risk factors at the primary care level as well as
local guidelines for the proper management of acute heart failure.
Keywords: Heart failure, mortality, hospitalized patients, risk factors, Libya