Acute heart failure in yemen

Few data are available on epidemiology, natural history, and outcome of patients with acute heart failure (AHF) in Yemen. Aim of this study was to describe main characteristics of AHF in Yemeni patients. From February to November 2012, 1536 consecutive patients with AHF were enrolled from 8 Yemeni hospitals in the Gulf Acute Heart Failure Registry (Gulf-CARE). Patients were predominantly males (64%), mean age was 54+15 years. New onset HF was detected in 51% of patients, while 49% had previous episodes of HF. Co-morbid conditions were: hypertension (36%), diabetes mellitus (22%), coronary artery disease (35%), rheumatic heart disease (13%) and hyperlipidemia (10%). Smoking and khat chewing were reported in 34% and 56% of patients, respectively. The most common etiology was ischemic heart disease (47%) followed by idiopathic cardiomyopathy (21%), hypertensive heart disease (13%) and rheumatic heart disease (13%). Rheumatic heart disease and idiopathic cardiomyopathy were more common in young ages (range 18-39 years) while hypertension and ischemic disease were more common among older ages. The in-hospital mortality rate for AHF patients in Yemen was 9.2%. In conclusion, heart failure is a common health problem in Yemen. Patients arrive late with advanced disease, at younger age and with higher mortality rate than patients in other Gulf regions and in European countries. Main etiology was ischemic heart disease followed by idiopathic cardiomyopathy, hypertensive heart disease and rheumatic heart disease.