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Abstract

Objectives: To describe the clinical characteristics, etiologies, management patterns, and outcomes of hospitalized heart failure patients in a tertiary care military hospital in United Arab Emirates (UAE), and to benchmark guideline directed medical therapy (GDMT) uptake and care models against regional and international registries.

Methods: We retrospectively reviewed all consecutive patients admitted with a primary diagnosis of heart failure between January and December 2024, at Zayed Military Hospital, UAE. Clinical data were extracted from electronic medical records. The GDMT adherence was assessed according to the 2022 American Heart Association (AHA)/ American College of Cardiology (ACC) and 2023 European Society of Cardiology (ESC) heart failure guidelines, and outcomes were compared between cardiology-led and non-cardiology services.

Results: Among 152 patients (69% male; mean age 68.5 years), 57% had heart failure with reduced ejection fraction (HFrEF), 24% mildly reduced, and 19% preserved ejection fraction. Ischemic heart disease was the most common etiology (58.6%). Compared with published Gulf registries, GDMT uptake in HFrEF was high: angiotensin converting enzyme inhibitors (ACEi)/ angiotensin receptor blocker (ARB)/ angiotensin receptor-neprilysin inhibitors (ARNI) (82.8%), beta-blockers (94.3%), and sodium-glucose co-transporter 2 (SGLT2) inhibitors (74.7%). In contrast, mineralocorticoid receptor antagonists were markedly underused (21.8%). HFpEF patients had the highest 180-day readmission rate (41.4%). Cardiology-led care was associated with higher GDMT uptake, shorter length of stay, and improved follow-up and readmission outcomes.

Conclusion: This cohort demonstrates improved adoption of evidence-based heart failure therapies compared with regional data, but highlights a persistent mineralocorticoid receptor antagonists (MRA) treatment gap. Cardiology-led inpatient management is associated with superior GDMT implementation and clinical outcomes, underscoring the importance of specialist-driven care pathways.

Article Type

Original Study

First Page

1168

Last Page

1174

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