Argentine Registry of Acute Heart Failure (ARGEN-IC). Evaluation of a Partial Cohort at 30 Days

2020 
espanolIntroduccion: La insuficiencia cardiaca aguda es una problematica epidemiologica actual, en correlacion con el incremento dela edad poblacional y la mayor sobrevida de los pacientes con enfermedades cardiovasculares.Objetivos: Evaluar el perfil clinico, las estrategias diagnosticas y terapeuticas y las complicaciones durante la internacion yel seguimiento a 30 dias del registro ARGEN-IC.Materiales y Metodos: Se efectuo un estudio prospectivo multicentrico nacional, basado en los datos suministrados por 50instituciones de salud (periodo: agosto 2018 a marzo 2019) referidos a pacientes con diagnostico primario de insuficienciacardiaca aguda, con un seguimiento de 12 meses.Resultados: Se incluyeron los datos de 909 pacientes aportados por 74 investigadores de 18 provincias. La media y el desvioestandar de la edad de los pacientes fue 72,2 (+-14) anos y el 60,5% era de sexo masculino. Entre las caracteristicas basales deesta cohorte, se destacaron las siguientes (prevalencia): diabetes (33%); IAM previo (17%); fibrilacion auricular (31%); coberturamedica de prepagas (38%). Entre los factores desencadenantes, predominaron las causas desconocidas (28.5%), seguidas de lasinfecciosas (15,7%) y de transgresion alimentaria (13,5%). Se destaca la etiologia isquemico-necrotica (26%), la presentacioncomo congestion mixta (48%) y el grupo con fraccion de eyeccion (Fey) deteriorada EnglishIntroduction: Acute Heart Failure is currently an epidemiological problem, with a close correlation with the increase in thepopulation age and the greater survival of patients with cardiovascular diseases.Objectives: Evaluate the clinical profile, the diagnostic and therapeutic strategies and the complications during hospitalizationand the 12-month follow up of the ARGEN IC Registry.Materials and Methods: It’s a prospective, multicenter, national Registry which included 50 health centers (August 2018-March 2019) and included patients with a confirmed diagnosis of acute heart failure with a 12-month follow-up.Results: A total of 909 patients were included, corresponding to 18 provinces and 73 active researchers. The mean age was 72.2(SD 14) years, 60.5% of the patients were males. Baseline characteristics include a prevalence of diabetes of 33%, previousAMI 17%, and Atrial Fibrillation 31% and a predominant private security medical coverage (38%) Among the trigger factorsof decompensation, 28.5% were associated with unknown causes, 15.7% infectious causes, and 13.5% with food transgression.The ischemic-necrotic etiology (26%), the presentation as mixed congestion (48%) and the impaired ejection fraction (EF)group stand out. 77.6% of the patients were admitted to the critical care unit, with a median overall hospital stay of 8 daysand overall mortality of 7.9%. The pharmacological treatment at discharge, including the group with reduced EF: Beta Blockers(BB) 78.7%, ACEI, ARA II or ARNI 70.9% and anti aldosteronic 56.3% and the referral to cardiovascular rehabilitationin 17%. The 30-day follow-up showed a rehopitalization rate of 16.7%, mortality of 5.5% and combined events of 18%. Only47% accessed the medical consultation.Conclusions: The ARGEN-IC Registry represents a heterogeneous population, with high middle ages and comorbidities. Thediagnostic and therapeutic strategies are underutilized during hospitalization and in the first 30 days, with poor access tothe health system. The overall combined rate of in-hospital events and at 30 days remains high.
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