Clinical profile and predictors of in-hospital outcome in patients with heart failure: The FADOI “CONFINE” Study

Biagi, Paolo; Gussoni, Gualberto; Iori, Ido; Nardi, Roberto; Mathieu, Giovanni; Mazzone, Antonino; Panuccio, Domenico; Scanelli, Giovanni; Cicatello, C.; Rinollo, Carmelina; Muriago, Michela; Galasso, Doménico; Bonizzoni, Erminio; Vescovo, Giorgio

doi:10.1016/j.ijcard.2011.02.025

Cited by 46 publications

(41 citation statements)

References 32 publications

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“…18 In our study the population is old, the mean age being over 82 years old, three female patients were over 100. Compared with precedent studies in Italy [21][22][23] we may notice that from 2002 the mean age of the patients with HF has increased over 5 years.…”

Section: Discussionmentioning

confidence: 79%

“…Our study was not retailed to define the prognostic impact of each comorbidity but it is well known that renal failure, anemia and cognitive deficit are the worse prognostic factors of HF in an elderly population. 21,23 Also BNP or NT pro-BNP are powerful prognostic markers: above all their discharge values are good predictors of hospital readmission, [33][34][35] but their determination was uncommon in our study.…”

Section: Discussionmentioning

confidence: 80%

“…According to the most recent guidelines, 16,24 echocardiography had a more wider use than that of previous surveys in IMD, 21,23 irrespective of the fact that the examination is performed from an internist or a cardiologist.…”

Section: Discussionmentioning

confidence: 99%

“…Note that percent is over one hundred since in many cases the etiology of heart failure is multiple. More patients than before 21,23 are treated b-blockers, especially the patients with reduced systolic function, in fact about three out of four patients with LVEF <40% are in b-blocker treatment. This is in good accord with the most recent suggestion of International guidelines: 24 taking into account the characteristics of our population this means that internist are now more trained to use these drugs in patients in which their safety (i.e., the therapeutic range) may be reduced.…”

Section: Discussionmentioning

confidence: 99%

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The heart failure in Internal Medicine in Tuscany: the SMIT Study

Verdiani

Panigada²,

Fortini³

et al. 2015

Ital J Med

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The incidence and prevalence associated with the growing age of population have made heart failure (HF) a new epidemic. In Italy most of HF patients are admitted to Internal Medicine Departments (IMD). We conducted a 30-day cross-sectional study involving patients with HF admitted to IMD of Tuscany. The aim of the study was to provide an updated snapshot of in-hospital management of HF in Tuscany and to analyze the differences in relation to the most recent guidelines. We have recruited 770 patients (M=45.4%) with a mean age of 82.5±8.9 years. Only 16.1% had a de novo HF. Most of them were re-admitted for decompensated HF. Hypertension and ischemic disease are the prevailing etiologies. HF alone was in less than 2%. 71.5% of patients had more than two comorbidities and 40.6% more than three concomitant diseases. The mean hospital stay (overall 8.6±5.5 days) correlated with the number of comorbidity. About 25% of patients had a creatinine clearance <30 mL/min. Nearly 50% of patients had atrial fibrillation but only the half was anti-coagulated. b-blockers, angiotensin converting enzyme-inhibitors (ACE-I) or angiotensin receptor blockers (ARB) were prescribed in about two-thirds of the subjects. Echocardiography was performed in 64.1% of patients. BNP or NT-pro BNP was tested in 67% at the hospital admission and in 18.3% at the discharge. At the discharge 50.1% of patients had loss of autonomy, 57% a polypharmacy prescription (≥8 classes of medicines) and 21.2% needed domiciliary oxygen therapy, but despite these critical points only 8% of the patients were transferred to long-term/intermediate care settings. In conclusion, the main characteristics of patients with HF admitted to IMD in Tuscany are the advanced age (the patients are old and very old) and the presence of multiple comorbidities (HF alone is a rarity indeed). The use of echocardiography and the pharmacological therapy with ACE-I, ARB, b-blocker and anti-aldosterone agents is wider than previous surveys, but some diagnostic, therapeutic and prognostic aspects are not similar to that recommended by the most recent HF guidelines. This survey underscores again some differences between HF trials world and HF real world, where the management is probably also driven by a clinical holistic approach. Correspondence: Valerio Verdiani, via Faccioli 15, 50145 Firenze, Italy. Tel.: +39.366.6581380 -Fax: +39.0564.48533. E-mail: verdiani@fastwebnet This work is licensed under a Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0).

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The heart failure in Internal Medicine in Tuscany: the SMIT Study

Verdiani

Panigada²,

Fortini³

et al. 2015

Ital J Med

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“…13 Considering specifically the Campania region, the rate of hospitalization because of HF was of 343.3/100,000 inhabitants, representing the leading cause of hospitalization in subjects over 65 years old (1369/100,000 inhabitants). 14,15 It is relatively common that patients admitted to hospital for any cause may suffer from HF as a coexisting medical problem, establishing a strong network of chronic diseases closely interrelated that greatly complicates diagnosis, management and outcome. 16 As a consequence the HF is no longer considered as an isolated syndrome but part of a larger framework of multi-morbidity requiring a holistic approach in order to improve prognosis and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Results of prospective multicenter study on heart failure on Campania Internal Medicine wards: the FASHION study

Gallucci¹,

Ronga²,

Fontanella

et al. 2017

Ital J Med

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Heart failure (HF) is characterized by a high prevalence and hospitalization rate with considerable health and social impact; the knowledge of its epidemiological features remains the mainstay to assess adequacy of the health care needs. The aim of this study was to evaluate the prevalence of HF in Internal Medicine Units of the Campania region (Italy) and patients' characteristics. We recruited all patients with HF admitted between April 1 and June 30, 2014, in 23 Units of Internal Medicine: 975 patients (19.5% of 5000 admissions), 518 women and 457 men, mean age 76.9±9.9 (range 34-100) with 741 (76%) older than 70 years. The mean age was higher in women than men; 35.8% of patients had atrial fibrillation, with higher prevalence in women than in men. Coronary artery disease represented the leading etiology while prevalence of non-ischemic heart failure was higher in women. New York Heart Association class was indicated in 926 patients. Left ventricular ejection fraction (LVEF) was measured in 503 patients; 18.4% of patients had a severely reduced LVEF<35%, mostly men (P=0.0001) and 67.4% presented a LVEF>40%. At least one hospital admission in the previous 12 months was registered in 39.6% of patients. One, two and more than two relevant comorbidities were present in 8.6%, 24.7% and 64.8% of patients, respectively. Arterial hypertension and coronary artery disease were more frequent in female. In conclusion, advanced age and clinical complexity were the main characteristics of HF patients hospitalized in the Internal Medicine Units in Campania. Gender differences also emerged from the analysis of demographic parameters and etiopathogenetic features. Some diagnostic and therapeutic aspects not in line with that recommended by the most recent HF international guidelines were registered.

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Regional expert opinion: Management of heart failure with preserved ejection fraction in the Middle East, North Africa and Turkey

Abdelhamid,

Al Ghalayini,

Al‐Humood

et al. 2023

ESC Heart Failure

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Although epidemiological data on heart failure (HF) with preserved ejection fraction (HFpEF) are scarce in the Middle East, North Africa and Turkey (MENAT) region, Lancet Global Burden of Disease estimated the prevalence of HF in the MENAT region in 2019 to be 0.78%, versus 0.71% globally. There is also a high incidence of HFpEF risk factors and co‐morbidities in the region, including coronary artery disease, diabetes, obesity, hypertension, anaemia and chronic kidney disease. For instance, 14.5–16.2% of adults in the region reportedly have diabetes, versus 7.0% in Europe. Together with increasing life expectancy, this may contribute towards a higher burden of HFpEF in the region than currently reported. This paper aims to describe the epidemiology and burden of HFpEF in the MENAT region, including unique risk factors and co‐morbidities. It highlights challenges with diagnosing HFpEF, such as the prioritization of HF with reduced ejection fraction (HFrEF), the specific profile of HFpEF patients in the region and barriers to effective management associated with the healthcare system. Guidance is given on the diagnosis, prevention and management of HFpEF, including the emerging role of sodium‐glucose co‐transporter‐2 inhibitors. Given the high burden of HFpEF coupled with the fact that its prevalence is likely to be underestimated, healthcare professionals need to be alert to its signs and symptoms and to manage patients accordingly. Historically, HFpEF treatments have focused on managing co‐morbidities and symptoms, but new agents are now available with proven effects on outcomes in patients with HFpEF.

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Clinical profile and predictors of in-hospital outcome in patients with heart failure: The FADOI “CONFINE” Study

Cited by 46 publications

References 32 publications

The heart failure in Internal Medicine in Tuscany: the SMIT Study

The heart failure in Internal Medicine in Tuscany: the SMIT Study

Results of prospective multicenter study on heart failure on Campania Internal Medicine wards: the FASHION study

Regional expert opinion: Management of heart failure with preserved ejection fraction in the Middle East, North Africa and Turkey

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