Pronóstico al año en pacientes con insuficiencia cardiaca en España. Registro ESC-EORP-HFA Heart Failure Long-Term

Abstract

Introduction and objectivesHeart failure (HF) is a growing health problem that constitutes an important burden to society. In spite of this, its importance is frequently underestimated, particularly regarding prognosis. This study estimates one-year prognosis among acute and chronic heart failure patients in Spain and the rest of Europe. Methods2829 HF patients (589 acute HF and 2240 chronic HF) treated by cardiologists were recruited in 27 Spanish hospitals that participate in the ESC-EORP-HFA Heart Failure Long-Term Registry (that includes a total of 12 440 patients from 211 hospitals) and followed-up for one year to monitor hospital admissions and death. ResultsAmong patients with acute HF, one-year mortality rate was 29.3% in Spain (95%CI, 25.6-33.2) and 27.7% in the rest of Europe (P=.4303). Among patients with chronic HF the corresponding figures were 6.4% (95%CI, 5.4-7.5) and 9.5% (P <.0001). One-year hospitalization cumulative incidence among acute HF patients was 46.2% (95%CI, 41.8-50.7) in Spain and 44.6% in Europe (P=.4977); 22.3% (95%CI, 20.6-24.1) and 30.0% respectively among chronic HF patients (P <.0001). ConclusionsThis study highlights the severity of HF, in particular when admission to hospitals is already needed, even in centers that adhere well to guidelines recommendations. Among patients admitted to hospital for HF, almost one third will die within a year of admission (including the 5.9% that die during the index admission) and almost half of them will either die or will need to be readmitted due to HF. The favorable comparison with Europe in chronic HF should be interpreted with caution due to limited control of potential confounders.