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Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction

Objective: The objective of this study was to describe the rates of adverse clinical outcomes, including all-cause mortality, heart failure (HF) hospitalization, myocardial infarction, and stroke, in patients newly diagnosed with HF to provide a comprehensive picture of HF burden. Methods: This was...

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Autores principales: Escobar, Carlos, Palacios, Beatriz, Gonzalez, Victoria, Gutiérrez, Martín, Duong, Mai, Chen, Hungta, Justo, Nahila, Cid-Ruzafa, Javier, Hernández, Ignacio, Hunt, Phillip R., Delgado, Juan F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054096/
https://www.ncbi.nlm.nih.gov/pubmed/36983410
http://dx.doi.org/10.3390/jcm12062410
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author Escobar, Carlos
Palacios, Beatriz
Gonzalez, Victoria
Gutiérrez, Martín
Duong, Mai
Chen, Hungta
Justo, Nahila
Cid-Ruzafa, Javier
Hernández, Ignacio
Hunt, Phillip R.
Delgado, Juan F.
author_facet Escobar, Carlos
Palacios, Beatriz
Gonzalez, Victoria
Gutiérrez, Martín
Duong, Mai
Chen, Hungta
Justo, Nahila
Cid-Ruzafa, Javier
Hernández, Ignacio
Hunt, Phillip R.
Delgado, Juan F.
author_sort Escobar, Carlos
collection PubMed
description Objective: The objective of this study was to describe the rates of adverse clinical outcomes, including all-cause mortality, heart failure (HF) hospitalization, myocardial infarction, and stroke, in patients newly diagnosed with HF to provide a comprehensive picture of HF burden. Methods: This was a retrospective and observational study, using the BIG-PAC database in Spain. Adults, newly diagnosed with HF between January 2013 and September 2019 with ≥1 HF-free year of enrolment prior to HF diagnosis, were included. Results: A total of 19,961 patients were newly diagnosed with HF (43.5% with reduced ejection fraction (EF), 26.3% with preserved EF, 5.1% with mildly reduced EF, and 25.1% with unknown EF). The mean age was 69.7 ± 19.0 years; 53.8% were men; and 41.0% and 41.5% of patients were in the New York Heart Association functional classes II and III, respectively. The baseline HF treatments included beta-blockers (70.1%), renin–angiotensin system inhibitors (56.3%), mineralocorticoid receptor antagonists (11.8%), and SGLT2 inhibitors (8.9%). The post-index incidence rates of all-cause mortality, HF hospitalization, and both combined were 102.2 (95% CI 99.9–104.5), 123.1 (95% CI 120.5–125.7), and 182 (95% CI 178.9–185.1) per 1000 person-years, respectively. The rates of myocardial infarction and stroke were lower (26.2 [95% CI 25.1–27.4] and 19.8 [95% CI 18.8–20.8] per 1000 person-years, respectively). Conclusions: In Spain, patients newly diagnosed with HF have a high risk of clinical outcomes. Specifically, the rates of all-cause mortality and HF hospitalization are high and substantially greater than the rates of myocardial infarction and stroke. Given the burden of adverse outcomes, these should be considered targets in the comprehensive management of HF. There is much room for improving the proportion of patients receiving disease-modifying therapies.
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spelling pubmed-100540962023-03-30 Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction Escobar, Carlos Palacios, Beatriz Gonzalez, Victoria Gutiérrez, Martín Duong, Mai Chen, Hungta Justo, Nahila Cid-Ruzafa, Javier Hernández, Ignacio Hunt, Phillip R. Delgado, Juan F. J Clin Med Article Objective: The objective of this study was to describe the rates of adverse clinical outcomes, including all-cause mortality, heart failure (HF) hospitalization, myocardial infarction, and stroke, in patients newly diagnosed with HF to provide a comprehensive picture of HF burden. Methods: This was a retrospective and observational study, using the BIG-PAC database in Spain. Adults, newly diagnosed with HF between January 2013 and September 2019 with ≥1 HF-free year of enrolment prior to HF diagnosis, were included. Results: A total of 19,961 patients were newly diagnosed with HF (43.5% with reduced ejection fraction (EF), 26.3% with preserved EF, 5.1% with mildly reduced EF, and 25.1% with unknown EF). The mean age was 69.7 ± 19.0 years; 53.8% were men; and 41.0% and 41.5% of patients were in the New York Heart Association functional classes II and III, respectively. The baseline HF treatments included beta-blockers (70.1%), renin–angiotensin system inhibitors (56.3%), mineralocorticoid receptor antagonists (11.8%), and SGLT2 inhibitors (8.9%). The post-index incidence rates of all-cause mortality, HF hospitalization, and both combined were 102.2 (95% CI 99.9–104.5), 123.1 (95% CI 120.5–125.7), and 182 (95% CI 178.9–185.1) per 1000 person-years, respectively. The rates of myocardial infarction and stroke were lower (26.2 [95% CI 25.1–27.4] and 19.8 [95% CI 18.8–20.8] per 1000 person-years, respectively). Conclusions: In Spain, patients newly diagnosed with HF have a high risk of clinical outcomes. Specifically, the rates of all-cause mortality and HF hospitalization are high and substantially greater than the rates of myocardial infarction and stroke. Given the burden of adverse outcomes, these should be considered targets in the comprehensive management of HF. There is much room for improving the proportion of patients receiving disease-modifying therapies. MDPI 2023-03-21 /pmc/articles/PMC10054096/ /pubmed/36983410 http://dx.doi.org/10.3390/jcm12062410 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Escobar, Carlos
Palacios, Beatriz
Gonzalez, Victoria
Gutiérrez, Martín
Duong, Mai
Chen, Hungta
Justo, Nahila
Cid-Ruzafa, Javier
Hernández, Ignacio
Hunt, Phillip R.
Delgado, Juan F.
Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction
title Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction
title_full Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction
title_fullStr Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction
title_full_unstemmed Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction
title_short Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction
title_sort burden of illness beyond mortality and heart failure hospitalizations in patients newly diagnosed with heart failure in spain according to ejection fraction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054096/
https://www.ncbi.nlm.nih.gov/pubmed/36983410
http://dx.doi.org/10.3390/jcm12062410
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