Comparación del tratamiento ambulatorio frente al tratamiento hospitalario en el paciente con insuficiencia cardiaca aguda

Introduction and objectives

Heart failure is a highly prevalent disease with a high morbidity and mortality. Episodes of acute episodes of heart failure during its natural history leads to a deterioration in the quality of life of these patients, as well as a worsening of their prognosis and the increased health costs, given that these patients have a high frequency of hospital admissions. The development of multidisciplinary heart failure units provides an intensive treatment and follow-up of the decompensated patient that prevents them being admitted in many cases. However, there are no studies that have evaluated the efficacy and safety of outpatient management compared to conventional hospital treatment. For this reason, the aim of this work is to compare the treatment of decompensations due to heart failure in the hospital setting with that of their outpatient treatment.

Method

Patients with acute heart failure without severity criteria will be enrolled and then randomised to either hospital or outpatient management. This will be a non-inferiority study, in which the primary outcome of the analysis is the time until death of cardiovascular origin, or re-admission due to heart failure in the first month of follow-up. It is estimated that 54 patients per group will be needed. The secondary outcomes collected will be: time until the combined event of admissions due to heart failure or death of cardiovascular origin at 6 months follow-up, a change in the level of perceived dyspnoea, and a comparison of the costs of each strategy. The estimated time to complete the current project is 24 months.

Conclusions

The current study will determine the safety and efficacy of the outpatient treatment of patients with acute heart failure.