Sinan Ümit Yaşar, Ekmekçi Ahmet, Özbay Benay, Akyıldız Akçay Filiz, Bekar Lütfü, Koza Yavuzer, Bolat İsmail, Kocabaş Umut, Zoghi Mehdi
Department of Cardiology, Faculty of Medicine, İstanbul University, Institute of Cardiology; İstanbul-Turkey.
Anatol J Cardiol. 2019 Jan;21(1):25-30. doi: 10.14744/AnatolJCardiol.2018.50880.
Acute heart failure (AHF) is a life-threatening clinical syndrome characterized by rapid onset of heart failure (HF) symptoms and signs and requires urgent therapy. The aim of the present study was to evaluate the overall clinical characteristics, management, and in-hospital outcomes of hospitalized patients with AHF in a large sample of Turkish population.
The Journey HF-TR study is a cross-sectional, multicenter, non-invasive and observational trial. Patients who were hospitalized with a diagnosis of AHF in the intensive care unit (ICU)/coronary care unit and cardiology wards between September 2015 and September 2016 were included in our study.
A total of 1606 (male: 57.2%, mean age: 67.8±13 years) patients who were diagnosed with AHF were enrolled in the study. Seventeen percent of the patients were admitted to the hospital with a diagnosis of new onset AHF. Hypertension (67%) and coronary artery disease (CAD) (59.6%) were the most frequent underlying diseases. Acute coronary syndrome accompanying HF (14.7%), infection (29.3%), arrhythmia (25.1%), renal dysfunction (23%), and non-compliance with medication (23.8%) were the precipitating factors. The median length of stay in the ICU was 3 days (interquartile range, IQR 1-72) and 7 days (IQR 1-72) for in-hospital journey. The guideline recommended medications were less likely used in our patient population (<73%) before admission and were similar to European and US registers at discharge. The in-hospital mortality rate was 7.6%. Hypertension and CAD were the most frequent underlying diseases in our population similar to other European surveys. Although our study population was younger than other registers, in-hospital mortality was high.
Analyses of such real-world data will help to prepare a national database and distinctive diagnosis and treatment algorithms and to provide observing compliance with the current European Society of Cardiology guidelines for more effective management of HF.
急性心力衰竭（AHF）是一种危及生命的临床综合征，其特征为心力衰竭（HF）症状和体征迅速出现，需要紧急治疗。本研究的目的是评估大量土耳其人群中住院的AHF患者的总体临床特征、治疗及住院结局。
“Journey HF-TR研究”是一项横断面、多中心、非侵入性观察性试验。2015年9月至2016年9月期间在重症监护病房（ICU）/冠心病监护病房及心内科病房因AHF诊断而住院的患者纳入本研究。
共有1606例（男性：57.2%，平均年龄：67.8±13岁）被诊断为AHF的患者纳入研究。17%的患者因新发AHF诊断入院。高血压（67%）和冠状动脉疾病（CAD）（59.6%）是最常见的基础疾病。HF伴发急性冠状动脉综合征（14.7%）、感染（29.3%）、心律失常（25.1%）、肾功能不全（23%）及药物治疗依从性差（23.8%）是诱发因素。ICU中位住院时间为3天（四分位间距，IQR 1 - 72），住院总时间为7天（IQR 1 - 72）。指南推荐药物在入院前在我们的患者群体中使用可能性较低（<73%），出院时与欧洲和美国登记数据相似。住院死亡率为7.6%。与其他欧洲调查相似，高血压和CAD是我们人群中最常见的基础疾病。尽管我们的研究人群比其他登记数据中的人群年轻，但住院死亡率较高。
对此类真实世界数据的分析将有助于建立国家数据库及独特的诊断和治疗算法，并有助于观察对当前欧洲心脏病学会HF管理指南的依从性，以实现更有效的HF管理。
