[Clinical characteristics, treatment and short-term morbidity and mortality of patients with heart failure followed in heart failure clinics. Results of the BADAPIC Registry].
ABSTRACT Despite recent improvements in therapy, heart failure is still associated with high mortality and hospitalization rates. New management strategies such as heart failure clinics could help to improve this situation.
We analyzed the clinical features, treatment, morbidity and mortality of 3909 patients with heart failure followed at 62 heart failure clinics in Spain in the last 3 years (BADAPIC Registry). Mean follow-up time was 13 +/- 4 months.
Mean age was 66 +/- 12 years (40% of the patients were older than 70 years), and 67% were male. Etiology was ischemic heart disease in 41% of the cases, systemic hypertension in 19%, idiopathic dilated cardiomyopathy in 17%, valvular disease in 17% and other in the remaining 6%. Left ventricular ejection fraction was < 45% in 68% of the patients. After inclusion in the BADAPIC Registry, 86% of the patients received diuretics, 37% received digoxin, 87% were given angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists, 32% received spironolactone, 59% received beta blockers and 28% were given nitrates. Actuarial survival at 24 months was 87%, admission-free survival was 80% and event-free survival was 76%. Survival was similar in men and women, higher in patients younger than 70 years (P<.05), and slightly higher in those with left ventricular ejection fraction > 45% (P=.08).
The treatment received by patients included in the BADAPIC Registry closely approached the recommended standards. Their short-term survival rate was very high.
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ABSTRACT: To determine the clinical and prognostic differences between patients with heart failure who had preserved or deteriorated systolic function, defined as a left ventricular ejection fraction of > 50% or < 50%, respectively, within two weeks of admission to hospital. The records of 229 patients with congestive heart failure were studied. There were 95 women and 134 men, mean (SD) age 66.7 (11.7) years, who had been admitted to a cardiology department for congestive heart failure in the period 1991 to 1994, and whose left ventricular systolic function had been evaluated echocardiographically within two weeks of admission. Data were collected on the main clinical findings, supplementary investigations, treatment, and duration of hospital admission. Follow up information was obtained in the spring of 1998 by searching the general archives of the hospital and by a telephone survey. Left ventricular systolic function was preserved in 29% of the patients. The preserved and deteriorated groups differed significantly in the sex ratio (more women in the preserved group) and in the presence of a third heart sound, cardiomegaly, alveolar oedema, ischaemic cardiomyopathy, and treatment with angiotensin converting enzyme (ACE) inhibitors (all more in the deteriorated group). There were no significant differences in age, New York Heart Association functional class, rhythm disturbances, left ventricular hypertrophy, treatment with drugs other than ACE inhibitors, or survival. In the group as a whole, the survival rates after three months, one year, and five years were 92.6%, 80%, and 48.4%, respectively. In view of the unexpectedly poor prognosis of patients with congestive heart failure and preserved left ventricular systolic function, controlled clinical trials should be carried out to optimise their treatment.Heart (British Cardiac Society) 09/2002; 88(3):249-54. · 5.01 Impact Factor
- The Journal of Heart and Lung Transplantation 03/2002; 21(2):189-203. · 5.11 Impact Factor