THESUS II –Study presented at ESC MADRID 2025 as Late Breaking Science and at the poster session

The Sub-Saharan Africa Survey of Heart Failure (THESUS II) is a large research project led by a team at the Cape Heart Institute (CHI), Cape Town, South Africa, under the umbrella of the Pan African Cardiac Society (PASCAR).

Principal Investigator, Prof K. Sliwa, had been invited to present the findings of this study as a Late Breaking Science lecture, Friday, 31 August 2025 at the European Society of Cardiology Congress in Madrid, Spain.
The study commenced in mid-2024 by researchers with expertise in cardiology and public health, across 17 African countries, gathering data from hospitals to provide insights into how acute HF is managed on the continent and the impact on patients. This ongoing observational study enrolled more than 1500 patients across 50 participating hospitals thus far. The findings of this study have important HF management implications for healthcare policy and practice in Africa. Understanding the current state of acute HF can help develop strategies to improve care, optimise resource use, and enhance patient outcomes.
Key findings from THESUS II for HF:

• Common patient characteristics at presentation were severe symptoms and a history of hypertension, diabetes, and smoking.

• Access to advanced diagnostic facilities such as cardiac catheterisation and cardiac MRI’s are limited. This poses a challenge for the majority of Africa to manage heart attacks optimally, leading to more patients with heart failure.

• Access to medical therapy has improved substantially over the last decade, with beta-blockers, ACE-inhibitors and mineralocorticoid receptor antagonists being largely supplied by hospitals. Advanced medical therapies, such as SGLT-2 inhibitors and sacubitril-valsartan, are largely available but purchased privately.

• Mortality rates are significant but are in line with international trials.

The complication and death rates associated with HF, as shown in the research, underscore the importance of addressing challenges in managing acute HF. Variability in healthcare resources across different regions in Africa impacts the management of acute HF. This emphasises that improving access to essential resources, enhancing healthcare provider training, and developing context-specific management guidelines are key steps toward better outcomes for patients. By working together through initiatives like PASCAR, we can access useful data to enhance patient care and inform better management strategies, ultimately improving outcomes for those affected by heart failure.