Heart failure & cardiomyopathiesCohort study
Aetiology, management, and outcomes of acute heart failure in 17 African countries (THESUS-HF II): a prospective, multicentre, observational cohort study
- Prospective observational cohort study
- multicentre
- 50 hospitals in 17 African countries
Authors' conclusion
Compared with THESUS-HF, THESUS-HF II suggests an evolving aetiological profile of acute heart failure in Africa, although differences in ascertainment and diagnostic capability might have contributed to the apparent aetiological shift.
Study context
- Population
- Adults (≥18 years) with acute HF in Africa, enrolled during seven 24 h surveillance periods within an 8-week site-specific window, 2024–20251,741 assessed
- Participants
- 1,578 adults
- Outcome
- Acute HF aetiology, treatment patterns, presentation rates, readmission and all-cause mortality
- Follow-up
- 180 days
Main finding
As reported in the abstract
- Weekly acute HF presentation rate, overall (per 10 000 people)
- 0.03 (95% CI 0.02-0.05)
- Weekly de novo acute HF presentation rate (per 10 000 people)
- 0.02 (0.01-0.04)
- De novo acute HF
- 1007 (64.2%) of 1568
- Aetiology: hypertensive heart disease
- 576 [36.5%] of 1578
- Aetiology: cardiomyopathy
- 370 [23.4%]
- Aetiology: ischaemic heart disease
- 367 [23.3%]
- In-hospital mortality
- 8.7% (95% CI 7.3-10.2; 134 of 1542)
- All-cause mortality at 30 days
- 11.1% (95% CI 9.6-12.9; 160 deaths)
- All-cause mortality at 180 days
- 20.6% (18.4-23.0; 255 deaths)
Observational data: associations, not effects.
Further findings
Discharge medication
- RAAS inhibitors
- 1014 (73.9%) of 1373
- β blockers
- 1053 (76.9%) of 1369
- MRA
- 982 (71.9%) of 1366
- SGLT2 inhibitors
- 743 (54.7%) of 1359
- Target doses reached in fewer than half of patients
Hospital ward stay
- Median hospital ward stay (days)
- 6.0 (IQR 4.0-10.0)
All-cause mortality by aetiological group
- No difference over 30 days (log-rank)
- P = 0.39
- Differed over 180 days
- P = 0.019
Original publication
Aetiology, management, and outcomes of acute heart failure in 17 African countries (THESUS-HF II): a prospective, multicentre, observational cohort study. Lancet. Published 30 August 2026. doi:10.1016/s0140-6736(26)01657-0
Summarised from the published abstract; every number is checked against it