Perfil clínico y patrones de manejo en los pacientes con insuficiencia cardíaca atendidos ambulatoriamente en España: estudio INCA (Estudio Insuficiencia Cardíaca)

Abstract

Aim To assess clinical characteristics and treatment management of out-patients with chronic heart failure (CHF) in Spain. Design Cross-sectional study. Location Primary care (PC) centres and cardiology out-patient clinics. Patients CHF patients (all had an echocardiography performed). Methods Data were collected from consecutive patients who attended clinics (93 cardiologist and 415 PC physicians) with a diagnosis of CHF during June 2006. Results The study subjects were 2161 CHF patients (1412 PC; 749 Cardiology), with a mean age was 70.9±10.6 years and 55.62% were males. Patients followed up in cardiology were younger, the majority were male, had a better functional class, lower ejection fraction, and fewer co-morbidities than those followed up in PC. The most used treatments were drugs that block the renin-angiotensin system (ACEi or ARB) (89.4%) and diuretics (84.91%), followed by beta-blockers (43.96%). Blood pressure (< 130/80 mmHg) was controlled in 24.93% of the patients, and diabetes mellitus in 32.33% of the diabetics (HbA 1c<6.5%). Both risk factors were significantly better in PC. Conclusions The INCA results show different clinical characteristics between patients followed up in the two health care levels. The pharmacological treatment has improved since previous studies and is closer to that recommended in chronic heart failure guidelines. Nevertheless, blood pressure and diabetes mellitus control are still insufficient.