Epidemiología de la insuficiencia cardiaca con fracción de eyección preservada: resultados del Registro RICA

Trullàs, Joan Carles; Pérez-Calvo, Juan Ignacio; Conde-Martel, Alicia; Iborra, Pau Llàcer; Pedreira, Iván Suárez; Ormaechea, Gabriela; Rangel, Llanos Soler; Franco, Álvaro González; Cepeda, José María; Montero-Pérez-Barquero, Manuel

doi:10.1016/j.medcli.2020.05.059

Cited by 15 publications

(2 citation statements)

References 32 publications

(34 reference statements)

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“…A recent analysis of the RICA registry, which included 4752 patients hospitalised for HF in Spanish Internal Medicine departments between 2008 and 2018 showed a prevalence of HFpEF of 62.2%. 4 The HF patient profile represented in our study is that in which, a priori, we could expect greater prognostic benefit from a specialised therapeutic approach that includes aggressive dose titration of disease-modifying drugs, implantation of intracardiac devices and, in the case of refractory disease, advanced measures like heart transplant and mechanical ventricular assistance. 5 Nevertheless, it is worth noting that the selection of patients seen in our specialized consultation unit is a reflection of the clinical criteria of the doctors of reference, as the sole requirement that had to be met for their referral was the presence of a prior confirmed diagnosis of HF.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and causes of death according to ejection fraction in patients with heart failure cared for in a specialized Cardiology unit

Barge‐Caballero

Montero-Fole

Barge‐Caballero

et al. 2022

Revista Clínica Española (English Edition)

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Section: Discussionmentioning

confidence: 99%

Clinical profile and causes of death according to ejection fraction in patients with heart failure cared for in a specialized Cardiology unit

Barge‐Caballero

Montero-Fole

Barge‐Caballero

et al. 2022

Revista Clínica Española (English Edition)

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“…As individuals are living longer, it is essential to evaluate the risk of HF, including cardiovascular-related events. Outcomes of clinical HF have been adequately explored (9)(10)(11); nevertheless, there are few data regarding outcomes in elderly inpatients at various HF stages.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Prognostic Value of Heart Failure Stages: An Elderly Inpatient Based Cohort Study

et al. 2021

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Background: The prevalence and prognostic value of heart failure (HF) stages among elderly hospitalized patients is unclear.Methods: We conducted a prospective, observational, multi-center, cohort study, including hospitalized patients with the sample size of 1,068; patients were age 65 years or more, able to cooperate with the assessment and to complete the echocardiogram. Two cardiologists classified all participants in various HF stages according to 2013 ACC/AHA HF staging guidelines. The outcome was rate of 1-year major adverse cardiovascular events (MACE). The Kaplan–Meier method and Cox proportional hazards models were used for survival analyses. Survival classification and regression tree analysis were used to determine the optimal cutoff of N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict MACE.Results: Participants' mean age was 75.3 ± 6.88 years. Of them, 4.7% were healthy and without HF risk factors, 21.0% were stage A, 58.7% were stage B, and 15.6% were stage C/D. HF stages were associated with worsening 1-year survival without MACE (log-rank χ2 = 69.62, P < 0.001). Deterioration from stage B to C/D was related to significant increases in HR (3.636, 95% CI, 2.174–6.098, P < 0.001). Patients with NT-proBNP levels over 280.45 pg/mL in stage B (HR 2; 95% CI 1.112–3.597; P = 0.021) and 11,111.5 pg/ml in stage C/D (HR 2.603, 95% CI 1.014–6.682; P = 0.047) experienced a high incidence of MACE adjusted for age, sex, and glomerular filtration rate.Conclusions : HF stage B, rather than stage A, was most common in elderly inpatients. NT-proBNP may help predict MACE in stage B.Trial Registration: ChiCTR1800017204; 07/18/2018.

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Multinational cost‐effectiveness analysis of empagliflozin for heart failure patients with ejection fraction >40%

Kolovos,

Bellanca,

Groyer

et al. 2023

ESC Heart Failure

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AimsHeart failure is a chronic progressive condition, with considerable burden on patients' quality of life and economic burden for the healthcare systems. Before the approval of empagliflozin, there were no proven effective treatments for patients with heart failure with left ventricular ejection fraction (HF LVEF) > 40%. The aim of this study was to evaluate the cost‐effectiveness of empagliflozin + standard of care (SoC) compared with SoC alone for patients with HF LVEF > 40%, from the perspective of the healthcare systems of the United Kingdom (UK), Spain, and France, and to quantify the healthcare costs for these patients.Methods and resultsA lifetime Markov cohort state‐transition model was developed based on discrete health states defined by Kansas City Cardiomyopathy Questionnaire‐Clinical Summary Score quartiles to track disease severity. Model inputs relied primarily on the EMPEROR‐Preserved trial data or obtained from published literature or country‐specific databases, as well as local guidelines for the requirements for the conduct of the economic evaluation of healthcare technologies. The total lifetime cost of receiving SoC per patient was £10 092, €15 765, and €14 958 in the UK, Spain, and France, respectively, which increased by £1407, €1148, and €1485, respectively, with the addition of empagliflozin to the SoC. Empagliflozin + SoC was associated with significantly reduced number of hospitalization for HF or cardiovascular death compared with SoC alone, which was a key driver offsetting its drug acquisition costs. The incremental cost‐effectiveness ratio per quality‐adjusted life year (QALY) gained was consistently favourable at £14 851, €11 706, and €15 447 in the UK, Spain, and France, respectively. Scenario analysis using the New York Heart Association functional class showed similar results. Probabilistic sensitivity analyses showed more than 50% probability for cost‐effectiveness for a willingness‐to‐pay (WTP) threshold of £/€20 000/QALY for the three countries.ConclusionsEmpagliflozin was found to be the first targeted treatment option that is clinically effective and cost‐effective for patients with HF LVEF > 40%. Prescribing empagliflozin with SoC to patients with HF LVEF > 40% is expected to improve clinical outcomes and patients' quality of life and substantially below accepted WTP threshold for the healthcare systems in the UK, Spain, and France.

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Epidemiología de la insuficiencia cardiaca con fracción de eyección preservada: resultados del Registro RICA

Abstract: J.C. Trullàs).♦ Más información sobre los componentes de los investigadores del registro RICA está disponible en el anexo 1.

Cited by 15 publications

References 32 publications

Clinical profile and causes of death according to ejection fraction in patients with heart failure cared for in a specialized Cardiology unit

Clinical profile and causes of death according to ejection fraction in patients with heart failure cared for in a specialized Cardiology unit

Prevalence and Prognostic Value of Heart Failure Stages: An Elderly Inpatient Based Cohort Study

Multinational cost‐effectiveness analysis of empagliflozin for heart failure patients with ejection fraction >40%

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