Utilidad del score H2FPEF en el diagnóstico y pronóstico de las insuficiencia cardiaca con fracción de eyección preservada en atención primaria

Abstract

Objective

To determine, in a group of patients with a diagnosis of heart failure (HF) in primary care, the probability of presenting heart failure with preserved ejection fraction (HFpEF) according to the H₂FPEF score and its association with one-year morbidity and mortality.

Design

Cross-sectional descriptive study.

Setting

Seven primary care centres in Barcelona.

Participants

Patients with HF (ICD-10: I.50) and left ventricular ejection fraction ≥ 50%.

Interventions

analysis of electronic health record data from primary care and clinical interview with patients.

Main measurements

Clinical, laboratory and echocardiographic variables were collected. The H₂FPEF score was calculated and patients were classified accordingly. The association between the score and the composite outcome (all-cause mortality or HF hospitalisation) at one year was analysed.

Results

A total of 628 patients were included, of whom 169 had complete data for score calculation. Of these, 47.9% had a high probability of HFpEF. These patients were older, with more comorbidities and worse functional class. The incidence of the composite event was higher in the high-probability group (64.4%) compared to the low/intermediate group (35.6%; P=.011). In multivariate analysis, high probability showed a trend towards association with the composite outcome (OR: 2.06; 95% CI: 0.96-4.54; P=.066).

Conclusions

The H₂FPEF score is a useful and feasible tool in primary care for improving the diagnosis and risk stratification of morbidity and mortality in patients with suspected HF.