Etiology, clinical features, comorbidities and mortality in patients with acute heart failure. Experience of a tertiary public hospital in Angola

Abstract

This article aims to study the etiological and clinical profile of acute heart failure in Angola and to identify the predictors associated with in-hospital mortality. Methods: A descriptive, observational, cross-sectional study was carried out in a tertiary public hospital in Angola. Information on demographic and biological data was collected. The following variables were included: demographic, etiological, and clinical characteristics, cardiovascular risk factors, precipitating factors of cardiac decompensation, comorbidities, and complications. In the univariate analysis we evaluated absolute and relative frequency, in the bivariate analysis independent Mann-Whitney Test, T Student test, and Chi-Square, tests were used as appropriate. Results: The sample comprises 257 individuals, of which 114 (44.36%) are male. The mean age is 49.90 ± 15.95 years. Hospital mortality is 23%. Predictors of poor prognosis were male sex (56.67% vs 40.61%, p = 0.037), lower systolic, diastolic, and mean blood pressure ((mean = 115 mmHg vs 138 mmHg, p < 0.001; mean = 73 mmHg vs. 85 mmHg, p < 0.001 and mean = 87.55 mmHg vs 102.74 mmHg; p < 0.001, respectively), higher respiratory rate (mean = 26.48 vs 24.00, p = 0.013), New York Health Association (NYHA) Class IV (60.00% vs 35.03%, p < 0.001) and lower LVEF (mean = 34.90% vs 39.7%, p = 0.013) Infection as a precipitating cause of cardiac decompensation, a previous history of pulmonary TB and DCM were also associated with higher in-hospital mortality (61.66% vs 26.39%, p < 0.001; 33.33% vs 12.69 p < 0.001, and 45.00% vs 29.95%, p = 0.031; respectively). Conclusions: The results indicate that in Angola, heart failure affects young and middle-aged patients and is associated with high in-hospital mortality.

Additional value of the coronary calcium score to conventional cardiovascular risk factors in predicting significant coronary disease diagnosed by computed tomography angiography in Angola

“…In Angola, malaria, tuberculosis, and AIDS are the main causes of morbidity and mortality; however, cardiovascular diseases (CVD) have been gaining ground in recent decades due to economic and social changes, as well as rapid urbanization leading to the adoption of new lifestyles and the well-known epidemiological transition [3,4]. In Angola, the broad spectrum of CVD is led by heart failure associated with hypertension dilated cardiomyopathy [5] and toxic habits deeply rooted in the population (excessive alcohol consumption) [3]. However, in recent years CAD in all its variants has increased in prevalence, which has motivated the attention of many researchers regarding this issue [3,4,6].…”

“…However, in recent years CAD in all its variants has increased in prevalence, which has motivated the attention of many researchers regarding this issue [3,4,6]. Clinically, it may present as asymptomatic myocardial ischemia, stable angina, and the so-called acute coronary syndromes (ACS), which include acute unstable angina and acute myocardial infarction [3,5].…”