Characterization of 2,500 Patients with Heart Failure and Analysis of Their Optimal Medical Therapy: Insights from the AMERICCAASS Registry.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI:10.5334/gh.1418

Alex David Sotomayor-Julio, Sebastián Seni-Molina, Juliana María Gutiérrez-Posso, Juan Andrés Muñoz-Ordoñez, Valeria Azcárate-Rodríguez, Hoover O León-Giraldo, Eduardo R Perna, Víctor Rossel, Daniel Quesada-Chaves, Mario Speranza, Mark H Drazner, Walter Alarco, Alexander Romero-Guerra, Gabriel Frago, Daniela García Brasca, Álvaro Mauricio Quintero-Ossa, Javier Galeano Figueredo, Milton Lubeck Herrera, Antonella A Ferrer, Ruddy Miguel García-Safadit, Freddy Pow-Chon-Long, Felix Nunura Arrese, Kwame van der Hilst, Silvia Carolina Lazo-Majano, Elisabeth Ashley Hardin, Orlando David Fernández-Flores, Gabriela Ormaechea-Gorricho, Luis Felipe Anhuaman-Atoche, Annia María Carrero-Vásquez, Andrés Ulate Retana, Pablo Hurtado Nuñez, Emilio Samael Peralta-López, Juan Esteban Gómez-Mesa

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引用次数: 0

Abstract

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.

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2500例心力衰竭患者的特征分析及其最佳药物治疗：来自AMERICCAASS注册的见解

心衰（HF）是世界范围内住院和死亡的主要原因，强调了最佳药物治疗（OMT）在改善患者预后方面的关键作用。尽管进行了广泛的研究，但大多数关于心衰的科学证据是在发达国家收集和研究的，在拉丁美洲和加勒比地区留下了关于心衰的大量知识空白。目的：研究美洲HF患者的社会人口学特征和临床特征，并评估他们对OMT的依从性。方法：AMERICCAASS注册是一项前瞻性、观察性、多中心研究，包括18岁及以上、住院和门诊诊断为心衰的患者。收集了前2500名患者的社会人口学和临床数据，以确定研究人群的特征。随后根据左室射血分数（LVEF）评估OMT的依从性。结果：在研究的2500例患者中，36%住院，64%门诊。患者的中位年龄为66.9岁（住院）和66.3岁（门诊）。男性占住院患者的60.8%，占门诊患者的59.3%。大多数HF患者LVEF降低（≤40%）：住院患者为60.7%，门诊患者为58.5%。纽约心脏协会（NYHA）功能等级II在门诊患者中占主导地位（67.9%），而NYHA功能等级III在住院患者中占主导地位（46.6%）。只有21%的LVEF降低患者接受了四联治疗，而12.3%的LVEF轻度降低患者（41-49%）接受了这种治疗。结论：研究结果表明，美洲HF患者的社会人口学和临床概况与国际报道大致一致。然而，在这一人群中观察到的低使用率强调了在遵守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果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.