Benefits of a comprehensive care model in patients with heart failure and preserved ejection fraction: The UMIPIC program

González, J.M. Cerqueiro; González-Franco, Álvaro; Carrascosa-García, Sara; Rangel, Llanos Soler; Laiglesia, Fernando José Ruiz; Epelde-Gonzalo, F.; Dávila‐Ramos, Melitón Francisco; Casado, Jesús; Casariego-Vales, Emilio; Manzano, Luís

doi:10.1016/j.rceng.2021.11.006

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Most of them have HFpEF (>50%). This profile is similar to the one identified in other studies developed in Spain and different HF units [ 14 , 16 , 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 89%

“…The following paper presents a study carried out in a Heart Failure Unit, included in the UMIPIC program of the Spanish Society of Internal Medicine, based on the comprehensive care of elderly patients with HF and other comorbidities [ 14 , 15 , 16 ]. This program, made for managing patients with HF and other comorbidities, is extended throughout Spain.…”

Section: Introductionmentioning

confidence: 99%

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Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

et al. 2022

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(1) Background: Heart failure (HF) is a chronic and complex pathology requiring continuous patient management due to clinical instability, associated comorbidity, and extensive pharmacological treatment. Its unpredictable course makes the advanced stages challenging to recognize and raises the need for palliative care. This study aims to identify palliative care needs in HF patients and describe clinical features related to short-term mortality. (2) Methods: A descriptive, observational, cross-sectional, and retrospective study was carried out in an HF unit of a Spanish tertiary hospital. Patients’ socio-demographic and clinical data were collected from clinical records, and different instruments were used to establish mortality risks and patients’ needs for palliative care. Subsequently, univariate and bivariate descriptive analyses were performed. A binary logistic regression model helped to determine variables that could influence mortality 12 months after admission to the Unit. (3) Results: The studied population, sixty-five percent women, had an average age of 83.27 years. Among other clinical characteristics predominated preserved ejection fraction (pEF) and dyspnea NYHA (New York Heart Association) class II. The most prevalent comorbidities were hypertension and coronary heart disease. Forty-nine percent had a low–intermediate mortality risk in the following year, according to the PROFUND index. The NECPAL CCOMS-ICO© instrument identified subjects who meet the criteria for palliative care. This predictive model identified NECPAL CCOMS-ICO© results, using beta-blockers (BB) or AIIRA (Angiotensin II receptor antagonists) and low glomerular filtration rate (GFR) as explanatory variables of patients’ mortality in the following year. (4) Conclusions: The analysis of the characteristics of the population with HF allows us to identify patients in need of palliative care. The NECPAL CCOMS-ICO© instrument and the PROFUND have helped identify the characteristics of people with HF who would benefit from palliative management.

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“…Most of them have HFpEF (>50%). This profile is similar to the one identified in other studies developed in Spain and different HF units [ 14 , 16 , 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

et al. 2022

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“…In fact, ischemic heart disease and hypertension are the most common causes of HFrEF and HFpEF, respectively [ 1 ]. Nevertheless, comorbidities are very common in both conditions, and only through a comprehensive approach can the maximum benefit be obtained [ 37 ]. In addition, we analyzed the group of patients with HFpEF in 2 subgroups (EF 50 to <60% vs. ≥60%), as some clinical trials have suggested a different efficacy of some drugs according to EF [ 17 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Characteristics, Management and Outcomes of Patients with Heart Failure with Preserved, Mildly Reduced, and Reduced Ejection Fraction in Spain

Cervantes

Palacios

Varela

et al. 2022

JCM

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Objective: To estimate the prevalence, incidence, and describe the characteristics and management of patients with heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF) in Spain. Methods: Adults with ≥1 inpatient or outpatient HF diagnosis between 1 January 2013 and 30 September 2019 were identified through the BIG-PAC database. Annual incidence and prevalence by EF phenotype were estimated. Characteristics by EF phenotype were described in the 2016 and 2019 HF prevalent cohorts and outcomes in the 2016 HF prevalent cohort. Results: Overall, HF incidence and prevalence were 0.32/100 person-years and 2.34%, respectively, but increased every year. In 2019, 49.3% had HFrEF, 38.1% had HFpEF, and 4.3% had HFmrEF (in 8.3%, EF was not available). Compared with HFrEF, patients with HFpEF were largely female, older, and had more atrial fibrillation but less atherosclerotic cardiovascular disease. Among patients with HFrEF, 76.3% were taking renin-angiotensin system inhibitors, 69.5% beta-blockers, 36.8% aldosterone antagonists, 12.5% sacubitril/valsartan and 6.7% SGLT2 inhibitors. Patients with HFpEF and HFmrEF took fewer HF drugs compared to HFrEF. Overall, the event rates of HF hospitalization were 231.6/1000 person-years, which is more common in HFrEF patients. No clinically relevant differences were found in patients with HFpEF, regardless EF (50- < 60% vs. ≥60%). Conclusions: >2% of patients have HF, of which around 50% have HFrEF and 40% have HFpEF. The prevalence of HF is increasing over time. Clinical characteristics by EF phenotype are consistent with previous studies. The risk of outcomes, particularly HF hospitalization, remains high, likely related to insufficient HF treatment.

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Peritoneal ultrafiltration in older adult patients with advanced heart failure

Rodríguez-Álvarez,

Piñeiro-Fernández,

Guerrero-Sande

et al. 2023

Intern Emerg Med

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Benefits of a comprehensive care model in patients with heart failure and preserved ejection fraction: The UMIPIC program

Cited by 3 publications

References 29 publications

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

Prevalence, Characteristics, Management and Outcomes of Patients with Heart Failure with Preserved, Mildly Reduced, and Reduced Ejection Fraction in Spain

Peritoneal ultrafiltration in older adult patients with advanced heart failure

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