NONCOMPLIANCE TO TREATMENT AND COMMON PRECIPITATING FACTORS IN STAGE C HEART FAILURE

Objectives: The objective of this study was to determine the frequency of non-compliance to treatment and common precipitating factors in stage C heart failure (HF) patients at a tertiary care cardiac hospital of Karachi, Pakistan. Methodology: This descriptive cross-sectional study was conducted at a tertiary care cardiac center of Karachi, Pakistan. Required number of consecutive patients of either gender between 18 to 75 years of age who were diagnosed with stage C HF were included in this study. Data for the study were collected on a pre-defined proforma consisted of demographic characteristics (gender, age), clinical factors, and precipitants of decompensation of HF (duration of disease, non-compliance to the treatment, infection, arrhythmias, uncontrolled hypertension, and anemia). Results: A total of 114 patients with stage C HF were included. Mean age was 56.7 ± 9.9 years with 34.2% (39) patients above 60 years of age. Male patients were 51.8% (59) of the total sample and median duration of disease was 36 [20 to 60] months. Non-compliance to the HF treatment was observed in 48.2% (55), while among other precipitants, infection was observed in 21.9% (25), arrhythmias in 20.2% (23), uncontrolled hypertension in 13.2% (15), and anemia in 18.4% (21). Conclusion: A significant proportion of stage C HF patients were found to be non-adherent to the prescribed treatment. The most commonly observed triggering factor was infection followed by arrhythmias. Routine practice must include an ongoing assessment of compliance to the treatment and lifestyle modifications among HF patients for the proper counseling of non-complying individuals.