Predictors of one-year outcomes in chronic heart failure: the portrait of a middle income country

Autor: Alfredo José Mansur, Luciana Gioli-Pereira, José Eduardo Krieger, Fabiana G. Marcondes-Braga, Sabrina Bernardez-Pereira, Alexandre C. Pereira, Fernando Bacal, Fábio Fernandes
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
medicine.medical_treatment
Blood Pressure
030204 cardiovascular system & hematology
Ventricular Function
Left
Blood Urea Nitrogen
0302 clinical medicine
Risk Factors
Natriuretic Peptide
Brain
Medicine
Outpatient clinic
Prospective Studies
030212 general & internal medicine
Aged
80 and over
Heart transplantation
Ejection fraction
Middle Aged
Prognosis
Cardiac surgery
Hospitalization
Cohort
Disease Progression
Female
Cardiology and Cardiovascular Medicine
Brazil
Research Article
Adult
medicine.medical_specialty
Adolescent
Outcomes
Risk Assessment
Young Adult
03 medical and health sciences
Internal medicine
Humans
Aged
business.industry
Proportional hazards model
Stroke Volume
Mortality predictors
medicine.disease
Blood pressure
lcsh:RC666-701
Heart failure
Chronic Disease
business
Biomarkers
Heart Failure
Systolic
Systolic heart failure
Zdroj: BMC Cardiovascular Disorders, Vol 19, Iss 1, Pp 1-7 (2019)
BMC Cardiovascular Disorders
ISSN: 1471-2261
DOI: 10.1186/s12872-019-1226-9
Popis: Background Heart failure (HF) is a major public health problem with increasing prevalence worldwide. It is associated with high mortality and poor quality of life due to recurrent and costly hospital admissions. Several studies have been conducted to describe HF risk predictors in different races, countries and health systems. Nonetheless, understanding population-specific determinants of HF outcomes remains a great challenge. We aim to evaluate predictors of 1-year survival of individuals with systolic heart failure from the GENIUS-HF cohort. Methods We enrolled 700 consecutive patients with systolic heart failure from the SPA outpatient clinic of the Heart Institute, a tertiary health-center in Sao Paulo, Brazil. Inclusion criteria were age between 18 and 80 years old with heart failure diagnosis of different etiologies and left ventricular ejection fraction ≤50% in the previous 2 years of enrollment on the cohort. We recorded baseline demographic and clinical characteristics and followed-up patients at 6 months intervals by telephone interview. Study data were collected and data quality assurance by the Research Electronic Data Capture tools. Time to death was studied using Cox proportional hazards models adjusted for demographic, clinical and socioeconomic variables and medication use. Results We screened 2314 consecutive patients for eligibility and enrolled 700 participants. The overall mortality was 6.8% (47 patients); the composite outcome of death and hospitalization was 17.7% (123 patients) and 1% (7 patients) have been submitted to heart transplantation after one year of enrollment. After multivariate adjustment, baseline values of blood urea nitrogen (HR 1.017; CI 95% 1.008–1.027; p p = 0.008) were independently associated with death within 1 year. Kaplan Meier curves showed that ischemic patients have worse survival free of death and hospitalization compared to other etiologies. Conclusions High levels of BUN and BNP and low systolic blood pressure were independent predictors of one-year overall mortality in our sample. Trial registration Current Controlled Trials NTC02043431, retrospectively registered at in January 23, 2014.
Databáze: OpenAIRE
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