Factors determining survival in Heart failure patients with reduced ejection fraction

Abstract

Background:Heart failure (HF) is one of the major NCDs, which has become a public health burden in recent years. Heart failure is increasing in prevalence, especially in the developing countries. The mortality rate of heart failure patients with reduced ejection fraction is higher compared with HFpEF patients. Having a reduced left ventricular ejection fraction is associated with increased risk of death commonly due to cardiovascular causes. There are limited studies that have addressed trends in the mortality and survival of HF patients with reduced ejection fraction in Ethiopia. This study aims to assess the factors associated with the survival of patients after the diagnosis of heart failure with systolic dysfunction. Objectives: The objective of this study is to assess the factors associated with longer survival of heart failure patients with reduced ejection fraction. It will identify the demographic factors, the primary cardiac abnormality, and pharmacological and interventional therapies linked with increased survival after the diagnosis of heart failure with compromised left ventricular function. Methods: A cardiac facility-based case-control study was conducted on cases (41) and controls (89) with; a confidence interval of 95%, power of 80%, and taking cases to controls 1:2. All consecutive cases were included in the study and controls were selected randomly. Data was collected through a chart review using a structured format by trained healthcare professionals. Epi-info version 7.2 and STATA version 17 were used for data entry and analysis respectively. Descriptive analyses, Chi-square testand multivariable logistic regression were used to assess a statistically significant association. The Kaplan–Meier survival curve and the log-rank test were done. Results:The result of the multivariable binary logistic regression shows that diagnosis of atrial fibrillation (AOR=0.387 95% CI=0.16, 0.92, p-value=0.032), aldosterone antagonist (AOR=0.16 95% CI=0.03, 0.76, p-value=0.021) and Interventional/surgical procedure (AOR=11.97 95% CI=1.51, 94.49, p-value=0.019) were found to be significant factors that determine survival in HFrEF. Conclusion & recommendation: Guideline recommended drugs and procedures should be utilized and optimized effectively in heart failure patients with compromised systolic function for favorable outcome