Clinical characteristics and outcomes of Yemeni patients with acute heart failure aged 50 years or younger. data from gulf acute heart failure registry (gulf CARE)

Aims: There is a shortage of data about acute heart failure (AHF) in the young, including its underlying causes, clinical presentation and outcomes. We aim to describe clinical characteristics, causes and outcomes of AHF in Yemeni patients aged 50 years or younger. Methods and results: we evaluated Yemeni patients with AHF enrolled in Gulf CARE registry. Patients were divided into two groups: young patients (≤50 years) and older patients N50 years). A total of 1536 patientswith AHF were enrolled, of whom635 (41.3%)were 50 years old or younger. Themean age for this groupwas 38.8 (±9.5) years; and 399 (62.8%) were males. Younger patients had a higher prevalence of non-ischemic cardiomyopathy (41% vs 11.1%, p b 0.001), primary valvular disease (27.9% vs 3.2%, p b 0.001), viral myocarditis (0.8% vs 0, p b 0.001). Ischemic heart disease (61.6% vs 25.5%, p b 0.001) and hypertensive heart disease (18.3% vs 6.3%, p b 0.001) were more frequent in the elderly group. Cardiogenic shock was more frequent among younger patients (13.7% vs 7.0, p b 0.001). In-hospital mortality was higher in patient aged ≤50 years (12% vs 7.6%, p = 0.002) while no difference in all-cause mortality was present at 3 months (17.8 vs 14.5, p = 0.089) and after 1 year (21.9% vs 20.6%, p = 0.56). Conclusion: This analysis of Gulf CARE registry represents the largest report of patients admitted with AHF in Yemen. There were differences among cause of HF and precipitating factors of AHF among younger and elderly patients. Younger patients had higher in-hospital mortality and more severe clinical condition at admission