In-Hospital Management and Long-term Clinical Outcomes and Adherence in Patients With Acute Decompensated Heart Failure: Primary Results of the First Brazilian Registry of Heart Failure (BREATHE).

Autor: DE Albuquerque DC; Departamento de Insuficiência Cardíaca-DEIC-SBC, Rio de Janeiro, Brazil; Hospital Copa D'Or, Rio de Janeiro, Brazil., DE Barros E Silva PGM; Hcor-Hospital do Coração, São Paulo, Brazil; Hospital Samaritano Paulista, São Paulo, Brazil; Brazilian Clinical Research Institute, São Paulo, Brazil., Lopes RD; Brazilian Clinical Research Institute, São Paulo, Brazil; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Centro de Pesquisa da Clínica Médica e Cardiologia da UNIFESP, São Paulo, Brazil. Electronic address: renato.lopes@dm.duke.edu., Hoffmann-Filho CR; Hospital Regional Hans Dieter Schmidt, Santa Catarina, Brazil., Nogueira PR; Fundação Faculdade Regional de Medicina de São José do Rio Preto, São Paulo, Brazil., Reis H; Hospital de Clínicas Gaspar Viana, Paró, Brazil., Nishijuka FA; Hospital Naval Marcílio Dias, Rio de Janeiro, Brazil., Martins SM; Real Hospital Português de Beneficência em Pernambuco, Pernambucado, Brazil., DE Figueiredo Neto JA; Centro de Pesquisa Clínica do Hospital Universitório da Universidade Federal do Maranhão (CEPEC-HUUFMA), Maranhão, Brazil., Pavanello R; Hcor-Hospital do Coração, São Paulo, Brazil., DE Souza Neto JD; Hospital de Messejana, Cearó, Brazil., Danzmann LC; Hospital São Lucas-PUCRS, Rio Grande do Sul, Brazil; Universidade Luterana do Brasil-Hospital Universitório de Canoas (RS), Rio Grande do Sul, Brazil., Gemelli JR; Clínica Gemelli, Rondônia, Brazil., Rohde LEP; Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil; Hospital Moinhos de Vento-HMV, Rio Grande do Sul, Brazil., Hernandes ME; Santa Casa de Votuporanga, São Paulo, Brazil., Rivera MAM; Hospital Universitório Prof. Alberto Antunes-Universidade Federal de Alagoas; Alagoas, Brazil., Simões MV; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, São Paulo, Brazil., Dos Santos ES; Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil., Canesin MF; Hospital Universitório do Norte do Paranó/ UEL, Paranó, Brazil., Zilli AC; Hospital de Caridade São Vicente de Paulo, São Paulo, Brazil., Santos RHN; Hcor-Hospital do Coração, São Paulo, Brazil., Jesuino IA; Hcor-Hospital do Coração, São Paulo, Brazil., Mourilhe-Rocha R; Hospital Universitório Pedro Ernesto, Rio de Janeiro, Brazil; Complexo Hospitalar Américas- Vitória e Samaritano Barra, Rio de Janeiro, Brazil., Moura LZ; Irmandade Santa Casa de Misericórdia de Curitiba, Paranó, Brazil., Marcondes-Braga FG; Departamento de Insuficiência Cardíaca-DEIC-SBC, Rio de Janeiro, Brazil; Instituto do Coração (inCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Mesquita ET; Departamento de Insuficiência Cardíaca-DEIC-SBC, Rio de Janeiro, Brazil; Universidade Federal Fluminense, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2024 May; Vol. 30 (5), pp. 639-650. Date of Electronic Publication: 2023 Aug 28.
DOI: 10.1016/j.cardfail.2023.08.014
Abstrakt: Background: Heart failure (HF), a common cause of hospitalization, is associated with poor short-term clinical outcomes. Little is known about the long-term prognoses of patients with HF in Latin America.
Methods: BREATHE was the first nationwide prospective observational study in Brazil that included patients hospitalized due to acute heart failure (HF). Patients were included during 2 time periods: February 2011-December 2012 and June 2016-July 2018 In-hospital management, 12-month clinical outcomes and adherence to evidence-based therapies were evaluated.
Results: A total of 3013 patients were enrolled at 71 centers in Brazil. At hospital admission, 83.8% had clear signs of pulmonary congestion. The main cause of decompensation was poor adherence to HF medications (27.8%). Among patients with reduced ejection fraction, concomitant use of beta-blockers, renin-angiotensin-aldosterone inhibitors and spironolactone decreased from 44.5% at hospital discharge to 35.2% at 3 months. The cumulative incidence of mortality at 12 months was 27.7%, with 24.3% readmission at 90 days and 44.4% at 12 months.
Conclusions: In this large national prospective registry of patients hospitalized with acute HF, rates of mortality and readmission were higher than those reported globally. Poor adherence to evidence-based therapies was common at hospital discharge and at 12 months of follow-up.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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