Clinical Profile and Management of Heart Failure in a Cardiac Center.

Heart failure is a progressive and serious disease. In the future this syndrome is likely to become a major public health problem in a developing country like Indonesia because of an aging population and increasing frequency of some major coronary heart disease risk factors. At the moment there is no systematically collected information on the clinical profile and the pattern of management of heart failure in Indonesia. The present study sought to examine some important demographics and clinical characteristics of patients hospitalized for heart failure and the pattern of anti failure treatment as performed by cardiologist in a National Cardiac Center. All consequtive patients who were admitted because of heart failure in 2000 were included in this survey. Information was abstracted from medical records by trained personel using standardized froms. There were 397 patients (male 68%, mean age 58.14 ± 13.57 years) included in the present study. Heart failure was due to coronary artery disease in 47% of patients, hypertensive heart disease 27%, valvular heart disease 15%, cardiomyopathy 8% and others 3%. During hospitalization (mean length of stay 8.69 ± 6.61 days) 5% of the patients died, 8% complicated by stroke, and 2% developed thromboembolism. Recurrent admission rate was 39%. The results of this study showed that standard treatment for heart failure were not given equally well to all patients: ACE inhibitors 62%, beta blockers 31%, angiotensin II receptor blockers 10%, and digitalis 66%. Symptomatic treatment were given as follow: furosemid 80% HCT 6%, spirolactone 44% and nirate 66%. In summary, the present survey highlighted some important clinical characteristics patients of hospitalized for heart failure. Despite advances in the management of heart failure, patients currently hospitalized for this syndrome still have high mortality and morbidity and high readmission rate. There is still room for improvement of evidence-based therapy.