Burden of Illness beyond Mortality and Heart Failure Hospitalizations in Patients Newly Diagnosed with Heart Failure in Spain According to Ejection Fraction

Abstract

Objective: The objective of this study was to describe the rates of adverse clinical outcomes, including all-cause mortality, heart failure (HF) hospitalization, myocardial infarction, and stroke, in patients newly diagnosed with HF to provide a comprehensive picture of HF burden. Methods: This was a retrospective and observational study, using the BIG-PAC database in Spain. Adults, newly diagnosed with HF between January 2013 and September 2019 with ≥1 HF-free year of enrolment prior to HF diagnosis, were included. Results: A total of 19,961 patients were newly diagnosed with HF (43.5% with reduced ejection fraction (EF), 26.3% with preserved EF, 5.1% with mildly reduced EF, and 25.1% with unknown EF). The mean age was 69.7 ± 19.0 years; 53.8% were men; and 41.0% and 41.5% of patients were in the New York Heart Association functional classes II and III, respectively. The baseline HF treatments included beta-blockers (70.1%), renin–angiotensin system inhibitors (56.3%), mineralocorticoid receptor antagonists (11.8%), and SGLT2 inhibitors (8.9%). The post-index incidence rates of all-cause mortality, HF hospitalization, and both combined were 102.2 (95% CI 99.9–104.5), 123.1 (95% CI 120.5–125.7), and 182 (95% CI 178.9–185.1) per 1000 person-years, respectively. The rates of myocardial infarction and stroke were lower (26.2 [95% CI 25.1–27.4] and 19.8 [95% CI 18.8–20.8] per 1000 person-years, respectively). Conclusions: In Spain, patients newly diagnosed with HF have a high risk of clinical outcomes. Specifically, the rates of all-cause mortality and HF hospitalization are high and substantially greater than the rates of myocardial infarction and stroke. Given the burden of adverse outcomes, these should be considered targets in the comprehensive management of HF. There is much room for improving the proportion of patients receiving disease-modifying therapies.

Clinical Characteristics and Incidence of Hemorrhagic Complications in Patients Taking Factor Xa Inhibitors in Spain: A Long-Term Observational Study

“…A retrospective and observational cohort study, which included secondary data from computerized health records of primary care centers and hospitals in seven Spanish Autonomous Communities since 2012, was conducted using the BIG-PAC ® database. This is an administrative database, representative of the Spanish population [ 18 , 19 , 20 ]. In this study, all adult patients with a prescription of either an oral direct FXai (i.e., apixaban, edoxaban, or rivaroxaban) or enoxaparin (only in active cancer patients) in therapeutic dose, and a previous recording (or on the same day) of any of the following diagnoses: VTE, AF, or non-mechanical cardiac–valve replacement, during the study period (i.e., between 1 January 2013 and 31 December 2022) were included.…”

Practical requirements for the development of an advanced cardiorenal unit

“…Chronic kidney disease (CKD) is one of the most prevalent comorbidities in HF. Recent studies in Spain show that up to 30% of patients with HF also have CKD [4].…”

“…Patients with HF are at significant risk of hospitalization and death. This risk is higher in patients who have recently experienced decompensation [4], thus generating high disease-associated costs [5]. In addition, patients with HF frequently have associated comorbidities, which not only increase the risk of complications but also hinder appropriate management.…”

The value of cardiopulmonary comorbidity in patients with acute large vessel occlusion stroke undergoing endovascular thrombectomy: a retrospective, observational cohort study

“…Recent data suggest that distinctive factors [ 6 – 9 ] may impact functional outcome in ALVOS patients. Chronic lung and heart diseases cause discomfort in activities of daily living (ADLs) or exercise [ 10 ] and are more likely to lead an intensive end point after stroke onset [ 11 , 12 ]. Previous studies have focused on the impact of comorbidity on stroke, but none have considered whether comorbidity affect endovascular therapy and it is uncertain whether EVT could help retard functional deterioration.…”