ICC - National Heart Failure Registry

Indian College of Cardiology – National Heart Failure Registry

The Indian College of Cardiology, National Heart Failure Registry (ICC-NHFR) was initiated in 2018 to study the demographics, comorbid conditions, aetiology, and outcome of acute decompensated heart failure (ADHF) in India.

This was done in two phases. The first phase of this study was from 2018-2019 across 22 hospitals in the country. All major cardiac centers were invited to participate, and those with institutional ethical clearance were included. In the first phase,5269 consecutive ADHF patients were enrolled. The design and rationale were already publishedin JICC1. Theaetiology, comorbid conditions, prescription pattern, and mortality at discharge and in the hospital were analyzed.The30-day outcomes and follow-up for one year were done.

The interim study results of 1230 patientswere presented in the ESC – HF meeting in 2019 at Athens2.

The clinical characteristics and 30-day outcomes in patients with ADHF of this registry were published in 2022 in the International College of Cardiology3.  This registry showed a high proportion of diabetes and hypertension 51.53% and 52.27%).CKD was seen in 14.81% of ADHF patients. Ischemic heart disease was the predominant aetiology (75.44%).Beta-blockers, Renin-angiotensin inhibitors, and mineralocorticoid receptor blockers were used only in 24.99% of discharged patients.The in-hospital mortality was 6.98%, and 30-day mortality was 12.02%.Increasing age, lower echo ejection fraction, and higher creatinine values accounted for higher mortality.30-day mortality. These patients were followed up for one year. The one-year mortality was 20.82%.

The study's second phase from 2019-2021 was over.The study was registered under (CTRI/2019/08/020972). 17 centers participated, and overall, 5182 patients were enrolled. Similar data and follow-ups were completed and completed for one year. There was a slow down in ADHF during COVID times. The comparative data of the pre-COVID4. The second part of ADHF admissions has been analysed and is being sent for publication

The total enrollment of 10451 makes it one of the largest ADHF databases in the country. It provides information on demographics, aetiology, and outcomes, which would serve as baseline data for implementation measures to improve HF care in the country.


  1. Jayagopal P. B, C. N. Manjunath, T. R. Raghu, et. al., Rationale, Methodology, and Design of Indian College of Cardiology National Heart Failure Registry. J Indian CollCardiol 2020; 10:75-8.
  2. Jayagopal P. B, C. N. Manjunath, S. Sridhar, et. al., Prognostic impact of comorbidities on mortality and re-hospitalization in acute decompensated heart failure in real-world clinical settings: Interim results from a multi-centre longitudinal registry. ESC Heart Failure 2019.
  3. P B Jayagopal, Sridhar L Sastry, VeenaNanjappa, et. al., Clinical characteristics and 30-day outcomes in patients with acute decompensated heart failure: Results from Indian College of Cardiology National Heart Failure Registry (ICCNHFR). Int J Cardiol. 2022 Jun 1:356:73-78.
  4. P.B. Jayagopal, Jabir Abdullakutty, L. Sridhar, et. al., Acute decompensated heart failure (ADHF) during COVID-19 pandemic insights from South India. Indian Heart Journal 73 (2021) 464-469.