{"id":9099,"date":"2025-10-27T21:46:58","date_gmt":"2025-10-27T18:46:58","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9099"},"modified":"2025-10-27T21:46:58","modified_gmt":"2025-10-27T18:46:58","slug":"jordan-heart-failure-registry-johfr-key-insights-and-clinical-implications","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/jordan-heart-failure-registry-johfr-key-insights-and-clinical-implications\/","title":{"rendered":"Jordan Heart Failure Registry (JoHFR): Key Insights and Clinical Implications"},"content":{"rendered":"
Jordan Heart Failure Registry (JoHFR): Key Insights and Clinical Implications<\/div>\n
<\/div>\n
Presented by:<\/div>\n
Dr. Hadi Abu-Hantash<\/div>\n
Heart Failure Manager, Working Group (JCS)<\/div>\n
Source: JCS Heart Failure Conference 2025 \u2013 JoHFR Final Slides<\/div>\n
<\/div>\n
Keynotes:<\/div>\n
\u20071.\u2060 \u2060Study Design and Scope<\/div>\n
\u2022 First national, multicenter registry capturing real-world data from 21 healthcare centers (university, public, and private).<\/span><\/div>\n
\u2022 Study period: July 2021 \u2013 February 2023.<\/span><\/div>\n
\u2022 Patients enrolled: 2,151 (1,531 chronic HF; 387 acute-on-chronic; 233 de novo HF).<\/span><\/div>\n
\u2022 Represents the largest structured effort to characterize heart failure and benchmark it against ESC-HF Pilot and AHA\/ACC GWTG-HF registries.<\/span><\/div>\n
<\/div>\n
\u20072.\u2060 \u2060Clinical Profile of Patients<\/div>\n
\u2022 Mean LVEF: 38.1 \u00b1 12.7 %; approximately 59 % had LVEF \u2264 40 %.<\/span><\/div>\n
\u2022 Hypertension: 80.7 %.<\/span><\/div>\n
\u2022 Atherosclerotic CVD: 80.6 %.<\/span><\/div>\n
\u2022 Diabetes: 69.2 %.<\/span><\/div>\n
\u2022 Obesity: 36.6 %.<\/span><\/div>\n
\u2022 Smoking: 31 %.<\/span><\/div>\n
\u2022 Mean age: 66 years (27 % below 60 years).<\/span><\/div>\n
<\/div>\n
Comparative Context:<\/div>\n
\u2022 ESC-HF Pilot: mean age 67\u201370 years; diabetes 29\u201335 %; ischemic etiology \u2248 45\u201350 %.<\/span><\/div>\n
\u2022 AHA\/ACC GWTG-HF: mean age \u2248 70\u201372 years; diabetes \u2248 40\u201345 %; ischemic etiology \u2248 55\u201360 %.<\/span><\/div>\n
\u2192 Jordanian patients are younger with heavier comorbidity burden, especially diabetes and ischemic disease.<\/div>\n
<\/div>\n
\u20073.\u2060 \u2060Symptomatology and Presentation<\/div>\n
\u2022 Dyspnea: 85.9 %.<\/span><\/div>\n
\u2022 Orthopnea: 39.5 % (over 60 % in acute cases).<\/span><\/div>\n
\u2022 Chest Pain: 32.8 %.<\/span><\/div>\n
\u2022 Paroxysmal Nocturnal Dyspnea (PND): 30.6 %.<\/span><\/div>\n
\u2022 Acute-on-chronic presentations showed greater congestion and symptom severity.<\/span><\/div>\n
<\/div>\n
Comparative Context:<\/div>\n
\u2022 ESC-HF Pilot and AHA\/ACC datasets report similar predominant symptoms, but with slightly lower congestion rates at admission due to earlier presentation and stronger outpatient management systems.<\/span><\/div>\n
<\/div>\n
\u20074.\u2060 \u2060Key Laboratory Findings<\/div>\n
<\/div>\n
JoHFR Summary (First 24 Hours):<\/div>\n
\u2022 Elevated BNP\/NT-proBNP: \u2248 95 %.<\/span><\/div>\n
\u2022 eGFR < 60 mL\/min\/1.73 m\u00b2: 42.6 %.<\/span><\/div>\n
\u2022 Anemia (Hb < 10 g\/dL): 16 %, mean ferritin \u2248 10.8 ng\/mL.<\/span><\/div>\n
\u2022 Hyponatremia (<130): 6 %.<\/span><\/div>\n
\u2022 Hyperkalemia (>5): 13 %.<\/span><\/div>\n
<\/div>\n
Comparative Context:<\/div>\n
\u2022 ESC-HF Pilot: median BNP\/NT-proBNP elevation \u2248 85\u201390 %; renal dysfunction \u2248 35 %.<\/span><\/div>\n
\u2022 AHA\/ACC GWTG-HF: similar renal dysfunction (\u2248 40 %) but lower anemia rates (\u2248 10\u201312 %).<\/span><\/div>\n
\u2192 Cardiorenal interaction and iron deficiency are more pronounced in JoHFR.<\/div>\n
<\/div>\n
\u20075.\u2060 \u2060Treatment Patterns (Guideline-Directed Medical Therapy \u2013 GDMT)<\/div>\n
<\/div>\n
JoHFR Medication Use:<\/div>\n
\u2022 Beta-blockers: 67 %.<\/span><\/div>\n
\u2022 ACEI: 18 %; ARB: 25 %; ARNI: 10.8 %.<\/span><\/div>\n
\u2022 SGLT2 inhibitors: \u2248 9 %.<\/span><\/div>\n
\u2022 MRAs: 20\u201328 % (depending on HF type).<\/span><\/div>\n
<\/div>\n
Comparative Context:<\/div>\n
\u2022 ESC-HF Pilot: beta-blockers \u2248 90 %, ACEI\/ARB\/ARNI \u2248 80 %, MRA \u2248 65 %.<\/span><\/div>\n
\u2022 AHA\/ACC GWTG-HF: beta-blockers \u2248 92 %, RAAS inhibitors 80\u201385 %, SGLT2i \u2248 30\u201335 %.<\/span><\/div>\n
\u2192 GDMT utilization in Jordan remains far below global standards, indicating major opportunity for system-level improvement.<\/div>\n
<\/div>\n
\u20076.\u2060 \u2060Device Therapy<\/div>\n
\u2022 ICD\/CRT use: 4 % overall.<\/span><\/div>\n
\u2022 ESC-HF Pilot: ICD \u2248 25\u201330 %, CRT \u2248 20 %.<\/span><\/div>\n
\u2022 AHA\/ACC: ICD\/CRT \u2248 35\u201340 %.<\/span><\/div>\n
\u2192 Device therapy is markedly underutilized due to financial constraints and access inequity.<\/div>\n
<\/div>\n
\u20077.\u2060 \u2060Outcomes<\/div>\n
\u2022 In-hospital mortality: 9.6 %.<\/span><\/div>\n
\u2022 Median hospital stay: 6.2 days.<\/span><\/div>\n
\u2022 Mortality correlates strongly with renal dysfunction and delayed therapy initiation.<\/span><\/div>\n
<\/div>\n
Comparative Context:<\/div>\n
\u2022 ESC-HF Pilot: mortality < 5 %, mean LOS \u2248 5 days.<\/span><\/div>\n
\u2022 AHA\/ACC: mortality \u2248 2.5\u20133.5 %, mean LOS \u2248 4.4 days.<\/span><\/div>\n
\u2192 Jordan\u2019s mortality is two- to three-fold higher, underscoring gaps in acute management and transitional care.<\/div>\n
<\/div>\n
\u20078.\u2060 \u2060Comparison With International Registries<\/div>\n
<\/div>\n
Mean Age<\/div>\n
JoHFR \u2013 66 years<\/div>\n
ESC-HF Pilot \u2013 67 to 70 years<\/div>\n
AHA\/ACC \u2013 \u2248 70 to 72 years<\/div>\n
\u2192 Jordanian patients present 4\u20136 years earlier on average.<\/div>\n
<\/div>\n
Diabetes Prevalence<\/div>\n
JoHFR \u2013 69 %<\/div>\n
ESC-HF Pilot \u2013 29\u201335 %<\/div>\n
AHA\/ACC \u2013 \u2248 40\u201345 %<\/div>\n
\u2192 Diabetes is nearly twice as common in Jordanian patients.<\/div>\n
<\/div>\n
Hypertension Prevalence<\/div>\n
JoHFR \u2013 80.7 %<\/div>\n
ESC-HF Pilot \u2013 variable (lower range)<\/div>\n
AHA\/ACC \u2013 \u2248 75 %<\/div>\n
\u2192 Hypertension is highly prevalent in all registries, highest in Jordan.<\/div>\n
<\/div>\n
Ischemic Etiology<\/div>\n
JoHFR \u2013 80.6 %<\/div>\n
ESC-HF Pilot \u2013 40\u201350 %<\/div>\n
AHA\/ACC \u2013 \u2248 55\u201360 %<\/div>\n
\u2192 Heart failure in Jordan is predominantly ischemic, reflecting a very high ASCVD burden.<\/div>\n
<\/div>\n
In-Hospital Mortality<\/div>\n
JoHFR \u2013 9.6 %<\/div>\n
ESC-HF Pilot \u2013 < 5 %<\/div>\n
AHA\/ACC \u2013 \u2248 2.5\u20133.5 %<\/div>\n
\u2192 Hospital mortality in Jordan is roughly two- to three-fold higher than in Western registries.<\/div>\n
<\/div>\n
Insight:<\/div>\n
Jordanian heart-failure patients are younger, more diabetic, and more often ischemic, with higher in-hospital mortality and lower uptake of guideline-directed therapy than their European and U.S. counterparts \u2014 underscoring the need for a national standardized registry and care pathway such as the NHFR-JO initiative.<\/div>\n
<\/div>\n
\u20079.\u2060 \u2060Implications for Clinical Practice<\/div>\n
\u2022 Strengthen adherence to the four pillars of heart-failure therapy (RAAS inhibitors, beta-blockers, MRAs, SGLT2 inhibitors).<\/span><\/div>\n
\u2022 Improve management of diabetes, hypertension, and ischemic disease.<\/span><\/div>\n
\u2022 Expand access to device therapy and structured post-discharge programs.<\/span><\/div>\n
\u2022 Establish dedicated multidisciplinary Heart Failure Clinics for continuity of care.<\/span><\/div>\n
<\/div>\n
10.\u2060 \u2060Implications for Health Policy<\/div>\n
\u2022 Develop national HF protocols aligned with ESC and AHA guidelines.<\/span><\/div>\n
\u2022 Ensure medication coverage for ARNI and SGLT2 inhibitors.<\/span><\/div>\n
\u2022 Establish sustainable funding for device therapies.<\/span><\/div>\n
\u2022 Launch primary-prevention initiatives addressing hypertension, diabetes, and smoking.<\/span><\/div>\n
<\/div>\n
11.\u2060 \u2060Future Directions<\/div>\n
\u2022 Longitudinal follow-up to assess outcomes and predictors of readmission.<\/span><\/div>\n
\u2022 Evaluation of cost-effectiveness for advanced therapies.<\/span><\/div>\n
\u2022 Implementation of national performance indicators and Heart Failure Centers of Excellence.<\/span><\/div>\n
\u2022 Training programs to enhance clinical adoption of evidence-based practice.<\/span><\/div>\n
<\/div>\n
12.\u2060 \u2060Regional and Strategic Impact<\/div>\n
\u2022 The JoHFR model provides a foundation for Middle Eastern collaboration and comparative data.<\/span><\/div>\n
\u2022 Aligns national metrics with ESC-EORP and AHA\/ACC standards.<\/span><\/div>\n
\u2022 Facilitates regional quality improvement and shared learning frameworks.<\/span><\/div>\n
<\/div>\n
13.\u2060 \u2060Conclusion<\/div>\n
<\/div>\n
The Jordan Heart Failure Registry (JoHFR) reveals that patients present younger, with a heavier metabolic and ischemic burden, and face significantly higher mortality than Western populations.<\/div>\n
These findings support the creation of the National Heart Failure Registry \u2013 Jordan (NHFR-JO), designed to unify data collection, standardize care, and bridge the treatment and outcome gaps between Jordan and global benchmarks.<\/div>\n","protected":false},"excerpt":{"rendered":"

Jordan Heart Failure Registry (JoHFR): Key Insights and Clinical Implications Presented by: Dr. Hadi Abu-Hantash Heart Failure Manager, Working Group (JCS) Source: JCS Heart Failure Conference 2025 \u2013 JoHFR Final Slides Keynotes: \u20071.\u2060 \u2060Study Design and Scope \u2022 First national, multicenter registry capturing real-world data from 21 healthcare centers (university, public, and private). \u2022 Study […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9099","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9099","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9099"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9099\/revisions"}],"predecessor-version":[{"id":9100,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9099\/revisions\/9100"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9099"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9099"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9099"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}