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Albuquerque DC, Barros E Silva PG, Lopes RD, Hoffmann C, Nogueira PR, Reis H, Nishijuka FA, De Figueiredo Neto JA, De Souza Neto JD, Rohde LEP, Simoes MV, Rocha RM, Moura LZ, Marcondes-Braga FG, Mesquita ET. Main results of the first Brazilian Registry of Heart Failure (BREATHE). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure represents a common cause of hospitalization associated with poor short-term clinical outcomes. Little is known about the long-term prognosis of these patients in Latin America.
Methods
The rationale and design of the study were previously published (1). Briefly, BREATHE was the first nation-wide prospective observational study that included patients hospitalized due to acute heart failure in Brazil. In-hospital management as well as 12-month clinical outcomes were assessed. Patients were included during two time periods: from February 2011 to December 2012 (BREATHE I) and from June 2016 to July 2018 (BREATHE Extension). Adherence to evidence-based therapies was also evaluated.
Results
A total of 3,013 patients were included in 71 centers in Brazil. The median follow-up was 346 days. The BREATHE population included 39.3% of women, had a mean age of 65.2 (± 15.6) with a mean ejection fraction of 39.7% (± 17.5). Among the comorbidities, systemic arterial hypertension was the most common, present in almost 75% of the sample. At hospital admission, 83.8% of patients had clear signs of pulmonary congestion and the main cause of decompensation was poor adherence to heart failure medications, representing 27.8% of cases. Among patients with reduced ejection fraction, the concomitant use of renin-angiotensin-aldosterone inhibitors, beta-blocker and spironolactone at hospital discharge was 44.5% and decreased to 35.2% after 3 months (p<0.01). Mortality rate at 12 months was 28.9 for every 100 patient years with 26.2% readmission at 90 days and 46.4% at 365 days. The most common etiology of heart failure was ischemic disease (Figure 1) but the worst prognosis was associated with Chagas disease (Figure 2) including an analysis of a composite outcome encompassing death, myocardial infarction, stroke or cardiac arrest after discharge.
Conclusions
In this large national prospective registry of patients hospitalized with acute heart failure, mortality and readmission were higher than what have been reported globally. Poor adherence to evidence-based therapies was a common both at hospital discharge and 1-year of follow-up.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Brazilian Society of Cardiology
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Affiliation(s)
- D C Albuquerque
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
| | | | - R D Lopes
- Duke Clinical Research Institute , Durham , United States of America
| | - C Hoffmann
- Hospital Regional Hans Dieter Schmidt , Joinville , Brazil
| | - P R Nogueira
- Fundação Faculdade Regional de Medicina de São José do Rio Preto , São José do Rio Preto , Brazil
| | - H Reis
- Hospital de Clinicas Gaspar Viana , Belem , Brazil
| | - F A Nishijuka
- Hospital Naval Marcilio Dias , Rio de Janeiro , Brazil
| | - J A De Figueiredo Neto
- Centro de Pesquisa Clínica do Hospital Universitário da Universidade Federal do Maranhão (CEPEC-HUUF , Sao Luis , Brazil
| | | | - L E P Rohde
- Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - M V Simoes
- Hospital Das Clinicas Fmrp-Usp , Ribeirao Preto , Brazil
| | - R M Rocha
- Pedro Ernesto University Hospital , Rio de Janeiro , Brazil
| | | | - F G Marcondes-Braga
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
| | - E T Mesquita
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
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