Serrano José Antonio Magaña, López José Angel Cigarroa, Mendoza Adolfo Chávez, Ivey-Miranda Juan Betuel, Zavala Genaro Hiram Mendoza, Domínguez Luis Olmos, Leal Sergio Armando Chávez, Bartelt José Ernesto Pombo, Herrera-Garza Eduardo Heberto, Leal Gerardo Mercado, Michel Rodolfo Parra, Mora Luisa Fernanda Aguilera, Escobar Patricia Lenny Nuriulu
División de Insuficiencia Cardiaca y Trasplante, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Clínica de Insuficiencia Cardiaca Avanzada y Trasplantes de la UMAE Hospital de Cardiología, Centro Médico Nacional Siglo XXI, IMSS (Instituto Mexicano del Seguro Social), Ciudad de México, México.
Drugs Context. 2024 Jan 16;13. doi: 10.7573/dic.2023-8-1. eCollection 2024.
Acute heart failure (HF) is associated with poor prognosis. After the acute event, there is a vulnerable period during which the patient has a marked risk of readmission or death. Therefore, early optimization of treatment is mandatory during the vulnerable period. The objective of this article is to provide recommendations to address the management of patients with HF during the vulnerable period from a practical point of view. A group of Mexican experts met to prepare a consensus document. The vulnerable period, with a duration of up to 6 months after the acute event - either hospitalization, visit to the emergency department or the outpatient clinic/day hospital - represents a real window of opportunity to improve outcomes for these patients. To best individualize the recommendations, the management strategies were divided into three periods (early, intermediate and late vulnerable period), including not only therapeutic options but also evaluation and education. Importantly, the recommendations are addressed to the entire cardiology team, including physicians and nurses, but also other specialists implicated in the management of these patients. In conclusion, this document represents an opportunity to improve the management of this population at high risk, with the aim of reducing the burden of HF.
急性心力衰竭(HF)与不良预后相关。急性事件发生后,存在一个易损期,在此期间患者有再次入院或死亡的显著风险。因此,在易损期尽早优化治疗是必需的。本文的目的是从实际角度为易损期心力衰竭患者的管理提供建议。一组墨西哥专家开会编写了一份共识文件。易损期在急性事件(住院、就诊于急诊科或门诊/日间医院)后持续长达6个月,这是改善这些患者预后的真正机会窗口。为了使建议最佳个体化,管理策略分为三个阶段(早期、中期和晚期易损期),不仅包括治疗选择,还包括评估和教育。重要的是,这些建议针对整个心脏病学团队,包括医生和护士,也包括参与这些患者管理的其他专科医生。总之,本文档是改善这一高危人群管理的契机,旨在减轻心力衰竭负担。