Tromp J, Bamadhaj S, Cleland JGF, et al. - The study was carried out to assess differences in 1-year post-discharge mortality according to region, country income, and income inequality. Individuals were included during hospitalisation for acute heart failure from 358 centres in 44 countries on six continents. Countries were stratified according to a modified WHO regional classification (Latin America, North America, Western Europe, Eastern Europe, eastern Mediterranean, and Africa, Southeast Asia, and western Pacific), country income (low, middle, high) and income inequality (according to tertiles of Gini index). They distinguished risk factors on the basis of expert opinion and knowledge of the literature. Of 18 102 patients discharged, 3461 (20%) died within 1 year. It was demonstrated that important predictors of 1-year mortality were old age, anemia, chronic kidney disease, presence of valvular heart disease, left ventricular ejection fraction phenotype (heart failure with decreased ejection fraction [HFrEF] vs preserved ejection fraction [HFpEF]), and being on guideline-directed medical treatment (GDMT) at discharge. Acute heart failure is correlated with high post-discharge mortality, especially in individuals with HFrEF from low-income regions with high-income inequality. The study revealed that regional variations exist in the proportion of eligible patients discharged on GDMT, which was strongly associated with mortality and might reflect a lack of access to post-discharge care and the prescribing of GDMT.