Title:Adherence to Congestive Heart Failure Guidelines and Outcome in the
Middle East
Volume: 20
Issue: 3
Author(s): Raed Aqel*, Tareq Alzughayyar, Jihad Zalloum, Qais Salah, Qutaiba Qafisheh and Mahmoud Izraiq
Affiliation:
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
Keywords:
Congestive, heart failure, guidelines, Middle East, socioeconomical, ejection fraction, morbidity and mortality rates.
Abstract:
Background: Adherence to Congestive Heart Failure with reduced Ejection Fraction
(CHFrEF) guidelines is not easily attainable everywhere, particularly in countries with a high
prevalence of low socioeconomic status, which includes many Middle Eastern countries. However,
it is well-established that adherence to the guidelines is associated with lower mortality and
morbidity rates.
Objective: Our objective is to investigate the adherence to the degree of treatment guideline in
CHFrEF within a patient population in the Middle East and correlate the level of compliance
both fully and partially with morbidity and mortality outcomes.
Methods and Statistics: We conducted a retrospective study on patients with CHFrEF in the
Middle East region who were maintained on Sacubitril/Valsartan for up to 4 years (190 patients).
This study included follow-up assessments for morbidity and mortality rates and their
correlation with the level of adherence to guidelines.
Results: Statistical analysis was performed using IBM SPSS® 27th version. In both the partial
adherence group and the full adherence group, there was a statistically significant improvement
in NYHA (pretreatment and post-treatment) and Ejection fraction (pretreatment and posttreatment).
This means that regardless of the level of adherence to the use of Sacubitril/Valsartan
in CHFrEF, there was an overall improvement in the morbidity and mortality rates over the four
years of follow-up.
Conclusion: While we fully support the idea of achieving full CHFrEF guideline adherence, we
recognize the difficulty of this task. Nevertheless, this study reinforces the notion that any degree
of adherence to guideline is correlated with better morbidity and mortality rates over a
long-term follow-up.
