DOI: 10.1161/circ.148.suppl_1.13644 ISSN: 0009-7322

Abstract 13644: Management Patterns in Patients With Heart Failure: Insights From iCaReMe Global Registry

Mikhail N Kosiborod, Carolyn S Lam, Carol Pollock, Kamlesh Khunti, Hiddo Lambers Heerspink, Antonio Nicolucci, Shashank Joshi, Peter Fenici, Susana Goncalves, Hardik Vasnawala, Ahmed HADAOUI
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Heart failure (HF) is an increasing major case of morbidity and mortality, including in low and middle income countries (LMIC) due to the rising incidence of HTN, T2D and CKD. Little information is available on the management of HF in LMIC. iCaReMe is a unique ongoing registry collecting data from contemporary routine clinical practice in patients with HF, T2D, HTN and/or CKD.

Aims: Describe clinical characteristics, comorbidities and management of HF patients based on data from iCaReMe Registry.

Methods: iCaReMe Global Registry (NCT03549754) is a multinational, prospective, observational study to assess the management and quality of care in patients with HF, T2D, HTN and/or CKD. We present baseline descriptive analysis of the HF cohort enrolled from February 2018 to December 2022.

Results: A total of 3069 adults (mean age±SD 58.7±12.6 years, 59.2% males, 40.3% obese) with HF from 21 countries were evaluated in this initial report. Of the 2307 (75.2%) patients with available LVEF data; 63.4% had HFrEF, 14.3% HFmrEF, and 22.3% HFpEF. The median (IQR) LVEF was 36(30-47) % and 83% had NYHA class II-IV symptoms. Overall, 27.1% of patients reported history of hospitalization for HF. The comorbidities were common including T2D (60.4%), HTN (57.1%), CAD (45.4%), dyslipidemia (36.0%), and CKD (30.5%). In patients with available data, the mean UACR was 282.5 mg/g [reported in 666 (21.7%) patients] and mean eGFR was 70.3 ml/min/1.73m 2 [reported in 2325 (75.8%) patients]. The medications included ACEi or ARB in 66.6%, ARNI in 15.9%, b-blockers in 65%, MRA in 38.7%, and SGLT2i in 40.3%.

Conclusions: iCaReMe Registry provides a unique perspective on the characteristics and management of patients with HF in low and middle income countries and demonstrates substantial burden of multimorbidity. The data highlight gaps between guidelines and routine care and the need to identify and address barriers to the implementation of optimal management and evidence-based therapies.

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