2500例心力衰竭患者的特征分析及其最佳药物治疗方案：来自AMERICCAASS注册研究的见解
Characterization of 2,500 Patients with Heart Failure and Analysis of Their Optimal Medical Therapy: Insights from the AMERICCAASS Registry.
作者信息
Sotomayor-Julio Alex David, Seni-Molina Sebastián, Gutiérrez-Posso Juliana María, Muñoz-Ordoñez Juan Andrés, Azcárate-Rodríguez Valeria, León-Giraldo Hoover O, Perna Eduardo R, Rossel Víctor, Quesada-Chaves Daniel, Speranza Mario, Drazner Mark H, Alarco Walter, Romero-Guerra Alexander, Frago Gabriel, Brasca Daniela García, Quintero-Ossa Álvaro Mauricio, Figueredo Javier Galeano, Herrera Milton Lubeck, Ferrer Antonella A, García-Safadit Ruddy Miguel, Pow-Chon-Long Freddy, Arrese Felix Nunura, van der Hilst Kwame, Lazo-Majano Silvia Carolina, Hardin Elisabeth Ashley, Fernández-Flores Orlando David, Ormaechea-Gorricho Gabriela, Anhuaman-Atoche Luis Felipe, Carrero-Vásquez Annia María, Retana Andrés Ulate, Nuñez Pablo Hurtado, Peralta-López Emilio Samael, Gómez-Mesa Juan Esteban
机构信息
Servicio de Cardiología, Fundación Valle del Lili, Cali, Colombia.
Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia.
出版信息
Glob Heart. 2025 Mar 11;20(1):27. doi: 10.5334/gh.1418. eCollection 2025.
INTRODUCTION
Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, emphasizing the critical role of optimal medical therapy (OMT) in improving patient outcomes. Despite extensive research, most scientific evidence regarding HF is gathered and studied in developed countries, leaving substantial knowledge gaps regarding HF in Latin America and the Caribbean.
OBJECTIVE
To characterize the sociodemographic and clinical profiles of HF patients and to assess their adherence to OMT in the Americas.
METHODS
The AMERICCAASS Registry is a prospective, observational, multicenter study, including patients aged 18 and older, both hospitalized and ambulatory, and diagnosed with HF. Sociodemographic and clinical data were collected from the first 2,500 patients to characterize the study population. Adherence to OMT was subsequently evaluated according to left ventricular ejection fraction (LVEF).
RESULTS
Among the 2,500 patients in the study, 36% were hospitalized and 64% were ambulatory. The median ages of the patients were 66.9 (hospitalized) and 66.3 years (ambulatory). Males made up 60.8% of hospitalized and 59.3% of ambulatory patients. The majority had HF with reduced LVEF (≤40%): 60.7% for hospitalized and 58.5% for ambulatory. The New York Heart Association (NYHA) functional class II predominated among ambulatory patients (67.9%), while NYHA functional class III predominated among hospitalized patients (46.6%). Only 21% of patients with reduced LVEF were receiving quadruple therapy, whereas 12.3% of patients with mildly reduced LVEF (41-49%) were on this treatment.
CONCLUSION
The findings demonstrate that the sociodemographic and clinical profiles of HF patients in the Americas are broadly consistent with international reports. However, the low use of OMT observed in this population underscores gaps in adherence to current guidelines. These results highlight the need for targeted strategies to improve pharmacological treatment adherence to optimize health outcomes in this region.
引言
心力衰竭（HF）是全球住院和死亡的主要原因，这凸显了优化药物治疗（OMT）在改善患者预后方面的关键作用。尽管进行了广泛研究，但大多数关于HF的科学证据是在发达国家收集和研究的，拉丁美洲和加勒比地区在HF方面仍存在大量知识空白。
目的
描述美洲HF患者的社会人口统计学和临床特征，并评估他们对OMT的依从性。
方法
AMERICCAASS注册研究是一项前瞻性、观察性、多中心研究，纳入年龄在18岁及以上、住院和门诊的HF患者。收集前2500例患者的社会人口统计学和临床数据以描述研究人群。随后根据左心室射血分数（LVEF）评估对OMT的依从性。
结果
在该研究的2500例患者中，36%为住院患者，64%为门诊患者。患者的中位年龄分别为66.9岁（住院患者）和66.3岁（门诊患者）。男性占住院患者的60.8%，占门诊患者的59.3%。大多数患者的LVEF降低（≤40%）：住院患者中占60.7%，门诊患者中占58.5%。纽约心脏协会（NYHA）功能分级II级在门诊患者中占主导（67.9%），而NYHA功能分级III级在住院患者中占主导（46.6%）。LVEF降低的患者中只有21%接受四联疗法，而LVEF轻度降低（41-49%）的患者中有12.3%接受这种治疗。
结论
研究结果表明，美洲HF患者的社会人口统计学和临床特征与国际报告大致一致。然而，该人群中OMT的低使用率凸显了在遵循现行指南方面的差距。这些结果强调需要有针对性的策略来提高药物治疗依从性，以优化该地区的健康结局。
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