1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Hospital Universitario A Coruna, CIBERCV, La Coruna, Spain
Pol Arch Intern Med. 2019 Feb 28;129(2):106-116. doi: 10.20452/pamw.4418. Epub 2019 Jan 16.
INTRODUCTION The management of heart failure (HF) has changed significantly in recent decades. OBJECTIVES We analyzed the clinical profile, 1‑year outcomes, predictors of mortality, and hospital readmissions in hospitalized patients enrolled in the European Society of Cardiology Heart Failure Pilot Survey (ESC‑HF Pilot) and Heart Failure Long‑Term Registry (ESC‑HF‑LT). PATIENTS AND METHODS The analysis included hospitalized Polish patients from both registries. The primary endpoint was all‑cause death at 1 year, while the secondary endpoint was all‑cause death or hospitalization for worsening HF at 1 year. RESULTS The study included a total of 1415 hospitalized patients (650 from ESC‑HF Pilot; 765 from ESC‑HF‑LT). The primary endpoint occurred in 89 of the 650 patients (13.7%) and in 120 of the 711 patients (16.9%) from ESC‑HF Pilot and ESC‑HF‑LT, respectively (P = 0.11). The secondary endpoint was more frequent in ESC‑HF Pilot than in ESC‑HF‑LT (201 of 509 [39.5%] vs 222 of 663 [33.5%]; P = 0.04). Compared with ESC‑HF Pilot, patients from the ESC‑HF‑LT registry were older and more often had hypertension, atrial fibrillation, peripheral artery disease, and chronic kidney disease, while the incidence of chronic obstructive pulmonary disease was lower. The percentage of patients receiving drugs for HF (diuretics, angiotensin‑converting enzyme inhibitors, angiotensin receptor blockers, β‑blockers, mineralocorticoid receptor antagonists), anticoagulants, cardiac resynchronization therapy, and implantable cardioverter‑defibrillator were higher in the ESC‑HF‑LT group in comparison with the ESC‑HF Pilot group. CONCLUSIONS Patients from the ESC‑HF‑LT registry had a lower risk of death or hospitalization for worsening HF despite the fact that they were older and had more comorbidities. The results might suggest an improvement in physicians' adherence to the guidelines on the management of HF in the ESC‑HF‑LT registry.
简介 近几十年来,心力衰竭(HF)的管理发生了重大变化。 目的 我们分析了欧洲心脏病学会心力衰竭试点调查(ESC-HF Pilot)和心力衰竭长期登记处(ESC-HF-LT)中入组的住院患者的临床特征、1 年结局、死亡率预测因素和再住院情况。 患者和方法 该分析包括来自这两个登记处的住院波兰患者。主要终点是 1 年时的全因死亡,次要终点是 1 年时的全因死亡或因 HF 恶化再次住院。 结果 研究共纳入 1415 例住院患者(ESC-HF Pilot 组 650 例,ESC-HF-LT 组 765 例)。ESC-HF Pilot 组和 ESC-HF-LT 组的 650 例患者中有 89 例(13.7%)和 711 例患者中有 120 例(16.9%)发生主要终点事件(P=0.11)。ESC-HF Pilot 组的次要终点事件发生率高于 ESC-HF-LT 组(509 例患者中有 201 例[39.5%],663 例患者中有 222 例[33.5%];P=0.04)。与 ESC-HF Pilot 组相比,ESC-HF-LT 组的患者年龄更大,更常患有高血压、心房颤动、外周动脉疾病和慢性肾脏病,而慢性阻塞性肺疾病的发病率更低。ESC-HF-LT 组患者接受心力衰竭药物(利尿剂、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、β受体阻滞剂、盐皮质激素受体拮抗剂)、抗凝剂、心脏再同步治疗和植入式心脏复律除颤器的比例高于 ESC-HF Pilot 组。 结论 尽管 ESC-HF-LT 组的患者年龄更大且合并症更多,但死亡或因 HF 恶化再次住院的风险较低。结果可能表明 ESC-HF-LT 登记处的医生在 HF 管理方面对指南的依从性有所提高。