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Rev. Soc. Bras. Clín. Méd ; 19(2): 89-96, abr.-jun. 2021. tab.
Article in Portuguese | LILACS | ID: biblio-1379254


Objetivo: Elaborar um perfil clínico e epidemiológico de pacientes com insuficiência cardíaca descompensada, de acordo com a etiologia da descompensação, e analisar o desfecho clínico dentre os diferentes grupos etiológicos encontrados. Métodos: Estudo retrospectivo e observacional. Os pacientes foram reunidos em seis grupos, conforme etiologia de descompensação, e comparados de acordo com dados coletados. Realizaram-se verificação por meio da análise de variância e teste exato de Fisher. Obteve-se significância estatística por meio do valor de p <0,10. Resultados: Foram analisados 123 prontuários de pacientes admitidos entre 2016 e 2018. A maior causa de descompensação da doença foi a má aderência ao tratamento (32,5%). Além disso, a doença foi responsável por maior tempo de internação (13,5 dias) e número de óbitos (seis). Conclusão: Otimizando-se os cuidados e o acompanhamento desses pacientes, pode haver um importante impacto sobre a incidência, as complicações e a frequência de descompensações. (AU)

Objective: To develop a clinical and epidemiological profile of patients with decompensated heart failure according to the etiology of decompensation and to analyze the clinical outcome among the different etiological groups found. Methods: This is a retrospective, observational study. Patients were divided in six groups according to etiology of decompensation and were compared according to data collected. Variance analysis and Fisher's exact test were performed. Statistical significance was obtained by means of p-value <0.10. Results: We analyzed 123 medical records of patients admitted between 2016 and 2018. The greatest cause of decompensation was the poor adherence to treatment (32.5%). In addition, the disease was responsible for longer hospitalization time (13.5 days) and number of deaths (six). Conclusion: Optimizing care and follow-up of these patients can have an important impact on the incidence, complications, and frequency of decompensation. (AU)

Humans , Male , Female , Middle Aged , Aged , Health Profile , Heart Failure/epidemiology , Hospitals, Teaching , Arrhythmias, Cardiac/complications , Stroke Volume , Blood Pressure Determination/statistics & numerical data , C-Reactive Protein/analysis , Epidemiology, Descriptive , Retrospective Studies , Sex Distribution , Age Distribution , Erythrocyte Count , Acute Coronary Syndrome/complications , Medication Adherence/statistics & numerical data , Electronic Health Records , Heart Rate Determination/statistics & numerical data , Heart Failure/diagnosis , Heart Failure/etiology , Heart Failure/blood , Hospitalization , Hypertension/complications , Infections/complications
Int. j. cardiovasc. sci. (Impr.) ; 33(6): 673-685, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1143116


Abstract Background Heart failure is an important cause of morbidity and mortality in children. Objective To determine the clinical characteristics of children with acute heart failure syndrome in the emergency ward of River state university teaching hospital, Nigeria and identify factors associated with poor outcomes. Methods This was an 18month retrospective review of the acute heart failure register. Poor outcome measures were defined as the persistence of heart failure after 4 days on admission or death. Results Ninety-two (4.1%) of 2,244 children admitted were in heart failure, Non-cardiac disorders [bronchopneumonia 32(36%), sepsis 21(24%), severe malaria 10(11%), sickle cell anaemia 8(9%) and tuberculosis 3(3%)] contributed to 74(83%) while congenital heart disease(CHD) was 15(17%). Seventy-four (83%) were discharged, 10(11%) died and 4(5%) left against medical advice. The median time to resolution of heart failure was significantly 24 hours longer for malnourished children than those with normal-nutritional status, 72Vs48hrs, log rank:0.001. Those with modified Ross score of >7 and sepsis were more likely to die, OR,8.8(95% CI,1.2 to 72.5,p = 0.02) and 3.9(95% CI,1.01 to 15.2;p =0.04). Age <2yrs(OR,3.1,CI,1.2 to 8.5,p = 0.02), and CHD (OR 3.6,95% CI,1.1 to 12,P=0.02) were associated with a higher likelihood of having a poor outcome. Each unit increase in weight for age Z score of 1, decreased the odds of having a poor outcome, OR,0.77 (95% CI,0.63 to 0.95)p=0.016. Conclusion Heart failure in our setting is predominantly caused by non-cardiac disorders. Modified Ross score of >7 and sepsis are risk factors for mortality in children with heart failure. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Malnutrition/complications , Heart Failure/complications , Heart Failure/mortality , Retrospective Studies , Sepsis/complications , Sepsis/mortality , Emergency Service, Hospital , Heart Disease Risk Factors , Heart Failure/epidemiology , Nigeria
Int. j. cardiovasc. sci. (Impr.) ; 33(1): 45-54, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090641


Abstract Background: Recently, a new HF entity, with LVEF between 40-49%, was presented to comprehend and seek better therapy for HF with preserved LVEF (HFpEF) and borderline, in the means that HF with reduced LVEF (HFrEF) already has well-defined therapy in the literature. Objective: To compare the clinical-therapeutic profile of patients with HF with mid-range LVEF (HFmrEF) with HFpEF and HFrEF and to verify predictors of hospital mortality. Method: Historical cohort of patients admitted with decompensated HF at a supplementary hospital in Recife/PE between April/2007 - August/2017, stratified by LVEF (< 40%/40 - 49/≥ 50%), based on the guideline of the European Society of Cardiology (ESC) 2016. The groups were compared and Logistic Regression was used to identify predictors of independent risk for in-hospital death. Results: A sample of 493 patients, most with HFrEF (43%), HFpEF (30%) and HFmrEF (26%). Average age of 73 (± 14) years, 59% men. Hospital mortality 14%, readmission within 30 days 19%. In therapeutics, it presented statistical significance among the 3 groups, spironolactone, in HFrEF patients. Hospital death and readmission within 30 days did not make difference. In the HFmrEF group, factors independently associated with death were: valve disease (OR: 4.17, CI: 1.01-9.13), altered urea at admission (OR: 6.18, CI: 1.78-11.45) and beta-blocker hospitalization (OR: 0.29, CI: 0.08-0.97). In HFrEF, predictors were: prior renal disease (OR: 2.84, CI: 1.19-6.79), beta-blocker at admission (OR: 0.29, CI: 0.12-0.72) and ACEI/ ARB (OR: 0.21, CI: 0.09-0.49). In HFpEF, only valve disease (OR: 4.61, CI: 1.33-15.96) and kidney disease (OR: 5.18, CI: 1.68-11.98) were relevant. Conclusion: In general, HFmrEF presented intermediate characteristics between HFrEF and HFpEF. Independent predictors of mortality may support risk stratification and management of this group.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Heart Failure/physiopathology , Heart Failure/mortality , Stroke Volume/physiology , Retrospective Studies , Hospital Mortality , Heart Failure/epidemiology
Arch. cardiol. Méx ; 89(4): 360-368, Oct.-Dec. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1149094


Resumen La insuficiencia cardíaca (IC) es un problema de salud pública global con más de 37 millones de individuos afectados en el mundo. La insuficiencia cardíaca con fracción de expulsión preservada (ICFEp) representa una categoría cada vez más frecuente en la práctica clínica, constituye hasta el 60% de los casos y presenta diferencias importantes en el diagnóstico y tratamiento en comparación con la insuficiencia cardíaca y la fracción de expulsión reducida. Esta revisión de ICFEp expone la epidemiología, delimita los principales factores de riesgo y mecanismos fisiopatológicos, identifica las características clínicas/paraclínicas y los criterios diagnósticos, y finaliza con un llamado para realizar investigación en este país.

Abstract Heart failure is a global public health problem, with more than 37 million patients living with heart failure around the world. Heart failure with preserved ejection fraction is an increasingly common category (approximately 60% of the cases) and shows remarkable differences in diagnosis and treatment when compared with heart failure with reduced ejection fraction. The current review covers epidemiology, risk factors, pathophysiologic mechanisms, clinical and paraclinical characteristics and diagnostic criteria of heart failure with preserved ejection fraction and concludes with a plea for original research in our country.

Humans , Stroke Volume/physiology , Heart Failure/physiopathology , Public Health , Global Health , Risk Factors , Heart Failure/diagnosis , Heart Failure/epidemiology
Arch. cardiol. Méx ; 89(4): 339-347, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1149092


Abstract Heart failure (HF) is a syndrome characterized basically by a circulatory deficit to cover the metabolic and energetic demands of the body. This condition has a broad spectrum in its clinical presentation, affects the quality of life significantly, impacts the family/social environment, and generates a great demand for health services. The purpose of this research is to report the situational diagnose of patients with HF in Mexico. We evaluated 292 patients, 70.2% were men. Average age was 56.7 +- 14.3 years. Ischemic heart disease is the main etiology (98 patients, 33.9%) followed by hypertensive (22.6%) and idiopathic (23.3%) heart disease. The associated clinical background was obesity (31.1%), systemic hypertension (36.7%), myocardial infarction (26.4%), and dyslipidemia (15.1%). The most common symptom was stress dyspnea (41.4%) and jugular vein engorgement at physical examination (32.5%). Anemia was observed in 1% of patients. The average left ventricular ejection fraction was 29.2 +- 10.6%. Sinus rhythm was the most frequently detected in 84.9%. 19.9% of patients had an implantable cardioverter-defibrillator or cardiac resynchronization therapy. 13.7% of patients with QRS > 130 ms. In our population, the meta-analysis global group in chronic heart failure risk score calculated was 16.8 +- 5.7 and for EMPHASIS 3.3 +- 1.5. We observed that age at presentation in HF in this analysis is at least 10 years younger than in other reports. The grade of obesity takes relevance in our group. The association of anemia and HF in Mexico is rare.

Resumen La insuficiencia cardiaca es un síndrome caracterizado fundamentalmente por un déficit circulatorio para cubrir las demandas metabólicas y energéticas del organismo. Esta entidad tiene un amplio espectro en su presentación clínica, afecta de manera significativa la calidad de vida, impacta en el entorno familiar/social y genera una gran demanda de los servicios de salud. El propósito de esta investigación es reportar el diagnóstico situacional de pacientes con insuficiencia cardiaca (IC) en México. Evaluamos 292 enfermos, 70.2% eran hombres. Con edad promedio 56.7 +- 14.3 años. La principal etiología es la cardiopatía isquémica (33.9%), seguida de la hipertensiva (22.6%) e idiopática (23.3%). Los antecedentes clínicos asociados fueron: obesidad (31.1%), hipertensión arterial sistémica (36.7%), infarto al miocardio (26.4%) y dislipidemia (15.1%). El síntoma con mayor presentación fue la disnea de esfuerzos (41.4%) y a la exploración física la ingurgitación yugular (32.5%). Se observó anemia en 1% de los enfermos. La fracción de expulsión del ventrículo izquierdo (FEVI) promedio fue de 29.2 + 10.6%. El ritmo sinusal fue el más frecuentemente detectado en 84.9%. El 19.9% de los pacientes tenían instalado un desfibrilador automático implantable (DAI) o tratamiento de resincronización cardiaca (TRC). El 13.7% de los enfermos con QRS mayor de 130 ms. El riesgo (MAGGIC) calculado en nuestro grupo poblacional fue de 16.8 +- 5.7 y para EMPHASIS 3.3 +- 1.5. Observamos que la edad de presentación de la IC en el presente análisis es menor por 10 años en comparación con otros reportes. El grado de obesidad toma relevancia en nuestro grupo. La asociación de anemia e IC en México es poco frecuente.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Quality of Life , Heart Failure/epidemiology , Stroke Volume , Defibrillators, Implantable/statistics & numerical data , Cardiac Resynchronization Therapy/statistics & numerical data , Heart Failure/physiopathology , Heart Failure/therapy , Anemia/epidemiology , Mexico/epidemiology , Obesity/epidemiology
Int. j. cardiovasc. sci. (Impr.) ; 32(6): 596-604, Nov.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1056378


Abstract Background: Heart failure (HF) is the final pathway of most cardiac diseases. Although the prevalence of HF has increased, due to the ageing of the population, more comprehensive data have shown a reduction in the percentage of HF hospital admissions over the last years. Objective: Assess the morbidity and mortality of HF patients in Brazil, Rio Grande do Sul and Porto Alegre. Method: The study is a retrospective analysis of data from the Brazilian Unified Health System's (Sistema Único de Saúde [SUS]) Department of Informatics (DataSUS). We evaluated the incidence of HF hospital admissions, the average length of stay, hospital costs and sex ratio, during a ten-year period (2007 to 2016). Due to availability of the system, mortality rate and age range, the total duration of the study was nine years. Results: Within this period, the percentage of hospitalizations for HF decreased. On the other hand, the length of stay increased in all regions studied. Mortality rates were in decline in all regions. Hospital costs showed an increase of 110.8%. HF was more prevalent in patients between the seventh and eighth decades of life, with men being more affected than women, except in Rio Grande do Sul. Conclusion: We conclude that, in spite of the high costs of HF to healthcare providers, hospitalizations and mortality rates have shown a significant decline over the last years, which results from the advances in the treatment of this disease, through initiatives to improve patient education, engagement and planning in health care and self-care.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Hospital Costs , Heart Failure/mortality , Heart Failure/epidemiology , Length of Stay , Unified Health System , Aging , Prevalence , Retrospective Studies , Morbidity , Heart Failure/physiopathology , Heart Failure/prevention & control , Hospitalization
Arq. bras. cardiol ; 112(6): 784-790, Jun. 2019. graf
Article in English, Portuguese | LILACS | ID: biblio-1011208


Abstract In 2016, the European Society of Cardiology (ESC) recognized heart failure (HF) with ejection fraction between 40 and 49% as a new HF phenotype, HF with mid-range ejection fraction (HFmrEF), with the main purpose of encouraging studies on this new category. In 2018, the Brazilian Society of Cardiology adhered to this classification and introduced HFmrEF in Brazil. This paper presents a narrative review of what the literature has described about HFmrEF. The prevalence of patients with HFmrEF ranged from 13 to 24% of patients with HF. Analyzing the clinical characteristics, HFmrEF shows intermediate characteristics or is either similar to HF with preserved ejection fraction (HFpEF) or to HF with reduced fraction (HFrEF). Regarding the prognosis, HFmrEF's all-cause mortality is similar to HFpEF's and lower than HFrEF's. Studies that analyzed cardiac mortality concluded that there was no significant difference between HFmrEF and HFrEF, both of which were lower than HFpEF. Despite the significant increase of publications on HFmrEF, there is a great scarcity of prospective studies and clinical trials that allow delineating specific therapies for this new phenotype. To better treat HFmrEF patients, it is fundamental that cardiologists and internists understand the differences and similarities of this new phenotype.

Resumo Em 2016, a Sociedade Europeia de Cardiologia (ESC) reconheceu a insuficiência cardíaca (IC) com fração de ejeção do ventrículo esquerdo entre 40% e 49% como um novo fenótipo de IC, a IC com fração de ejeção intermediária (ICFEI), tendo como principal intuito, incentivar estudos sobre essa nova categoria. Em 2018, a Sociedade Brasileira de Cardiologia aderiu a essa classificação e introduziu a ICFEI no Brasil. O presente trabalho traz uma revisão narrativa sobre o que a literatura descreve até o momento sobre ICFEI. A prevalência de pacientes com ICFEI variou de 13-24% dos pacientes com IC. Quando avaliadas as características clínicas, a ICFEI apresenta um caráter intermediário ou se assemelha algumas vezes com a IC de fração de ejeção preservada (ICFEP) e outras com a IC de fração reduzida (ICFER). Quanto ao prognóstico, a ICFEI apresenta mortalidade por todas as causas semelhante a ICFEP e menor que a ICFER. Os estudos que analisaram a mortalidade por causa cardíaca concluíram que não houve diferença significativa entre ICFEI e ICFER, sendo ambas menores que a ICFEP. Apesar do considerável aumento de publicações sobre a ICFEI, ainda existe uma grande carência de estudos prospectivos e ensaios clínicos que possibilitem delinear terapias específicas para esse novo fenótipo. O conhecimento das particularidades da ICFEI por cardiologistas e internistas é fundamental para o melhor manejo desses pacientes.

Humans , Stroke Volume/physiology , Heart Failure/diagnosis , Heart Failure/physiopathology , Heart Failure/drug therapy , Heart Failure/epidemiology , Prognosis , Prevalence , Hospitalization
Rev. chil. cardiol ; 38(1): 54-63, abr. 2019. graf
Article in Spanish | LILACS | ID: biblio-1003638


Resumen: Las enfermedades cardiovasculares y el cáncer son enfermedades crónicas transmisibles culturalmente, y las dos causas principales de mortalidad en el mundo. Además del gran impacto sobre la mortalidad y morbilidad, estas enfermedades han mostrado un alto grado de relación entre ellas debido, entre otras razones, a que comparten factores de riesgo y mecanismos biológicos. La alta incidencia de enfermedad cardiovascular en pacientes con cáncer es un fenómeno conocido que ha orientado el desarrollo del campo interdisciplinario de la cardio-oncología. Sin embargo, en la última década han surgido evidencias que muestran el papel que desempeñan las enfermedades cardiovasculares en el desarrollo de cáncer. Un estudio reciente publicado por Meijers y cols, en agosto de 2018 en Circulation, mostró que la insuficiencia cardiaca post-infarto del miocardio contribuye significativamente al desarrollo del cáncer de colón, apoyando lo obtenido en estudios epidemiológicos anteriores. Este estudio también sugiere que el crecimiento tumoral podría producirse por factores secretados por el corazón insuficiente abriendo un amplio grupo de posibilidades de investigación en lo que sería un nuevo campo de la medicina cuyo propósito sería el desarrollo de nuevas estrategias para el seguimiento y tratamiento del cáncer en pacientes con enfermedades cardiovasculares. El presente artículo revisa los factores de riesgo, y mecanismos celulares y moleculares, que son comunes en las enfermedades cardiovasculares y el cáncer, la contribución del trabajo de Meijers y cols hacia un mayor entendimiento de la interrelación entre estas patologías y las perspectivas futuras con respecto a los nuevos hallazgos.

Abstracts: Cardiovascular diseases and cancer are culturally transmitted chronic diseases and the two main causes of death globally. In addition to their high morbidity and mortality, these diseases are closely related, due to their common risk factors and biological mechanisms. The high incidence of cardiovascular diseases in cancer patients is widely known phenomenon, which has oriented the development of the interdisciplinary field of cardio-oncology Nonetheless, there is emerging evidence in the last decade suggesting a potential role for cardiovascular diseases in the onset of cancer. A recent publication by Meijers et al in the scientific cardiovascular journal Circulation showed that heart failure significantly contributes to tumor growth, confirming previous epidemiological findings suggesting this hypothesis. Moreover, this study indicates that tumor growth may be stimulated by the secretion of factors from the failing heart, opening a wide spectrum of research areas in what may be suggested as a new field in medicine that would seek to develop new strategies to treat and prevent cancer in patients with cardiovascular diseases. This article will review shared risk factor and common cellular and molecular pathways in cardiovascular diseases and cancer, the contribution of Meijers et al to a better understanding of the connection of these diseases and future perspectives in light of the new evidence.

Humans , Cardiovascular Diseases/epidemiology , Neoplasms/epidemiology , Risk Factors , Heart Failure/epidemiology
Rev. latinoam. enferm. (Online) ; 27: e3137, 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1004258


Objetivo identificar quais características clínicas da insuficiência cardíaca estão associadas à maior chance de dependência funcional admissional para as atividades básicas de vida diária em idosos hospitalizados. Método estudo transversal realizado com idosos hospitalizados. As características clínicas da insuficiência cardíaca foram avaliadas por meio do autorrelato, prontuário e aplicação de escalas. A dependência foi avaliada pelo Índice de Katz. Realizou-se o Teste Exato de Fisher para análise das associações entre as variáveis nominais e regressão logística para identificação de fatores associados à dependência. Resultados a amostra foi composta por 191 casos. A prevalência de dependência funcional admissional foi 70,2%. Grande parte dos idosos era parcialmente dependente (66,6%). As características clínicas associadas à dependência admissional foram: dispneia (Odds Ratio 8,5; Intervalo de confiança 95% 2,668-27,664; p<0,001), edema de membros inferiores (Odds Ratio 5,7; Intervalo de confiança 95% 2,148-15,571; p<0,001); tosse (Odds Ratio 9,0; Intervalo de confiança 95% 1,053-76,938; p<0,045); precordialgia (Odds Ratio 4,5; Intervalo de confiança 95% 1,125-18,023; p<0,033) e crepitação pulmonar (Odds Ratio 4,9; Intervalo de confiança 95% 1,704-14,094; p<0,003). Conclusão observou-se que a dependência funcional admissional em idosos com insuficiência cardíaca está mais associada com sinais e sintomas congestivos.

Objective to identify which clinical features of heart failure are associated with a greater chance of functional dependence for the basic activities of daily living in hospitalized elderly. Method cross-sectional study conducted with elderly hospitalized patients. The clinical characteristics of heart failure were assessed by self-report, medical records and scales. Dependency was assessed by the Katz Index. The Fisher's Exact Test was used to analyze associations between the nominal variables, and logistic regression to identify factors associated with dependence. Results the sample consisted of 191 cases. The prevalence of functional dependence was 70.2%. Most of the elderly were partially dependent (66.6%). Clinical characteristics associated with dependence at admission were dyspnea (Odds Ratio 8.5, Confidence Interval 95% 2.668-27.664, p <0.001), lower limb edema (Odds Ratio 5.7, 95% Confidence Interval 2.148-15.571, p <0.001); cough (Odds Ratio 9.0, 95% confidence interval 1.053-76.938, p <0.045); precordial pain (Odds Ratio 4.5, 95% confidence interval 1.125-18.023, p <0.033), and pulmonary crackling (Odds Ratio 4.9, 95% Confidence Interval 1.704-14.094, p <0.003). Conclusion functional dependence in admitted elderly patients with heart failure is more associated with congestive signs and symptoms.

Objetivo identificar cuáles son las características clínicas de la insuficiencia cardíaca que están asociadas a la mayor chance de dependencia funcional en el proceso de admisión para las actividades básicas de vida diaria en adultos mayores hospitalizados. Método estudio transversal realizado con adultos mayores hospitalizados. Las características clínicas de la insuficiencia cardíaca fueron evaluadas por medio del auto relato, prontuario y aplicación de escalas. La dependencia fue evaluada por el Índice de Katz. Se realizó el Test Exacto de Fisher para análisis de las asociaciones entre las variables nominales y regresión logística para la identificación de factores asociados a la dependencia. Resultados la muestra fue compuesta por 191 casos. La prevalencia de dependencia funcional en el proceso de admisión fue 70,2%. Gran parte de los adultos mayores eran parcialmente dependientes (66,6%). Las características clínicas asociadas a la dependencia fueron: disnea (Odds Ratio 8,5; Intervalo de confianza 95% 2,668-27,664; p<0,001), edema de miembros inferiores (Odds Ratio 5,7; Intervalo de confianza 95% 2,148-15,571; p<0,001); tos (Odds Ratio 9,0; Intervalo de confianza 95% 1,053-76,938; p<0,045); precordialgia (Odds Ratio 4,5; Intervalo de confianza 95% 1,125-18,023; p<0,033) y crepitación pulmonar (Odds Ratio 4,9; Intervalo de confianza 95% 1,704-14,094; p<0,003). Conclusión se observó que la dependencia funcional de los adultos mayores con insuficiencia cardíaca está más asociada con señales y síntomas congestivos.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Heart Failure/nursing , Heart Failure/therapy , Heart Failure/epidemiology , Brazil/epidemiology , Activities of Daily Living , Hospitalization/statistics & numerical data
Epidemiol. serv. saúde ; 28(1): e2018110, 2019. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1001958


Objetivo: analisar a tendência das taxas de internação por condições cardiovasculares sensíveis à atenção primária à saúde (CCSAP). Métodos: estudo ecológico das séries temporais das taxas de internação por CCSAP pelo Sistema Único de Saúde (SUS) no município de Senador Canedo, GO, em 2001-2016; utilizaram-se dados do Sistema de Informações Hospitalares e estimativas populacionais da Rede Interagencial de Informações para a Saúde (RIPSA) e da Fundação IBGE; utilizou-se o método de Prais-Winsten para análise de tendência. Resultados: utilizaram-se dados de 3.244 internações por CCSAP; verificou-se tendência temporal decrescente para a taxa de internações por CCSAP (taxa de incremento anual [TIA] = -8,14 - IC95% -11,78;-4,35) e a taxa de insuficiência cardíaca (TIA = -12,07 - IC95% -14,75;-9,30); as tendências temporais das taxas de internações por hipertensão, angina e doenças cerebrovasculares foram estacionárias. Conclusão: as taxas de internação por CCSAP e insuficiência cardíaca diminuíram; entretanto as taxas por hipertensão, angina e doenças cerebrovasculares permaneceram constantes.

Objetivo: analizar la tendencia de las tasas de internación por condiciones cardiovasculares sensibles a la atención primaria de salud (CCSAP). Métodos: estudio ecológico de las series temporales de tasas de internación por CCSAP en el Sistema Único de Salud (SUS) en el municipio de Senador Canedo, GO, Brasil, en 2001-2016; se utilizaron datos del Sistema de Informaciones Hospitalarias y estimativas de población de la Red Interagencial de Informaciones para Salud (RIPSA) y de la Fundación IBGE; se utilizó el método de Prais-Winsten para el análisis de tendencia. Resultados: se utilizaron datos de 3.244 internaciones por CCSAP; hubo una tendencia temporal decreciente para la tasa de internaciones por CCSAP (tasa de incremento anual [TIA] = -8,14 - IC95% -11,78;-4,35) y de insuficiencia cardíaca (TIA = -12,07 - IC95% -14,75;-9,30); las tendencias temporales de las tasas de internaciones para hipertensión, angina y enfermedades cerebrovasculares (EC) fueron estacionarias. Conclusión: las tasas de internación por CCSAP e insuficiencia cardíaca disminuyeron; sin embargo, las tasas por hipertensión, angina y enfermedades cerebrovasculares permanecieron constantes.

Objective: to analyze trends of hospitalization for ambulatory care-sensitive cardiovascular conditions (ACSCC). Methods: this was an ecological study of time series of rates of hospitalization for ACSCC in the municipality of Senador Canedo, GO, Brazil, 2001-2016; we used data from the Hospital Information System and population estimates provided by the Inter-Agency Health Information Network (RIPSA) and the Brazilian Institute of Geography and Statistics (IBGE); the Prais-Winsten method was used to analyze trends. Results: we used data on 3,244 hospitalizations for ACSCC; there was decreasing trend in the rate of hospitalizations for ACSCC (annual increase rate [AIR] = -8.14 - 95%CI -11.78;-4.35) and in the heart failure rate (AIR = -12.07 - 95%CI -14.75;-9.30); hospitalization rate time trends for hypertension, angina and cerebrovascular diseases were stationary. Conclusion: rates of hospitalization for ACSCC and heart failure decreased, however rates for hypertension, angina and cerebrovascular diseases remained constant.

Humans , Male , Female , Adult , Middle Aged , Aged , Primary Health Care , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/therapy , Cardiovascular Diseases/epidemiology , Ambulatory Care/statistics & numerical data , Hospitalization/trends , Hospitalization/statistics & numerical data , Time Factors , Brazil/epidemiology , Cerebrovascular Disorders/epidemiology , Hospital Information Systems , Ecological Studies , Heart Failure/therapy , Heart Failure/epidemiology , Hypertension/therapy , Hypertension/epidemiology , Angina Pectoris/therapy , Angina Pectoris/epidemiology , National Health Programs/statistics & numerical data
Rev. Soc. Bras. Clín. Méd ; 16(4): 203-207, out.-dez. 2018. tab.
Article in Portuguese | LILACS | ID: biblio-1025791


OBJETIVO: Analisar o perfil e o seguimento clínico de pacientes com insuficiência cardíaca. MÉTODOS: Estudo prospectivo observacional de pacientes com insuficiência cardíaca, que comparou a população geriátrica (≥ 65 anos) com o restante da amostra (18 a 64 anos). Todos eram acompanhados ambulatorialmente em clínica especializada de um hospital-escola e foram incluídos consecutivamente entre abril e novembro de 2013, tendo sido acompanhados por 3 anos ou óbito. RESULTADOS: Da amostra total de 100 pacientes, 56% eram idosos. Na comparação entre idosos (média de 74±7 anos) e não idosos (média de 52±8 anos), houve diferença significativa quanto a peso corporal (72,6±16 kg vs. 80,8±19kg; p=0,02), índice de massa corporal (28,6±5,7kg/m2 vs. 32,6±5,9kg/m2; p=0,001), fibrilação atrial (35,7% vs. 11,3%; p=0,005) e doença renal crônica (28,5% vs. 13,6%; p=0,04). A prescrição de betabloqueadores e de inibidores da enzima conversora de angiotensina ou bloqueadores do receptor de angiotensina não diferiu entre os grupos, e nem os dados ecocardiográficos e a ocorrência de desfechos no seguimento clínico. CONCLUSÃO: Idosos foram a maioria dentre pacientes com insuficiência cardíaca e apresentaram maior prevalência de doença renal crônica e fibrilação atrial, além de menores peso e índice de massa corporal. Tais diferenças não resultaram em maior incidência de desfechos adversos na evolução de médio prazo. (AU)

OBJECTIVE: To assess the clinical profile and follow-up of patients with heart failure. METHODS: This is a prospective, observational study that compared the geriatric population (≥ 65 years old) with the remaining portion of the sample (18 to 64 years old). All of them were assisted in a specialized outpatient clinic of a university hospital, and were included consecutively from April to November 2013, being followed for three years or until death. RESULTS: From the sample of 100 patients, 56% were older people. In the comparison between older people (average 74 ± 7 years old) and non-older people (average 52 ± 8 years old), a significant difference was found for body weight (72.6 ± 16Kg vs. 80.8 ± 19Kg, p=0.02), body mass index (28.6 ± 5.7Kg/m2 vs. 32.6 ± 5.9 Kg/m2, p=0.001), atrial fibrillation (35.7% vs. 11.3%, p=0.005), and chronic kidney disease (28.5% vs. 13.6%, p=0.04). The prescription of beta-blockers and angiotensin converting enzyme inhibitors, or angiotensin receptor blockers did not differ between the groups, neither did the echocardiographic values and the occurrence of outcomes at clinical follow-up. CONCLUSION: Older people were the majority among patients with heart failure, and presented a higher prevalence of chronic kidney disease and atrial fibrillation, and lower body weight and body mass index. Those differences did not result in greater incidence of adverse outcomes at mid-term follow-up. (AU)

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Aged/statistics & numerical data , Medical Records/statistics & numerical data , Heart Failure/epidemiology , Atrial Fibrillation/complications , Health Profile , Body Weights and Measures , Comorbidity , Continuity of Patient Care/statistics & numerical data , Stroke/etiology , Renal Insufficiency, Chronic/complications , Heart Failure/complications , Heart Failure/mortality , Hospitalization , Myocardial Infarction/etiology
Rev. cuba. med ; 57(2)abr.-jun. 2018. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-985552


Introducción: Existen escasas evidencias de que la glucemia se pueda utilizar para predecir las complicaciones de la insuficiencia cardiaca congestiva. Por esta razón se determinó medir los valores de glucemia de los pacientes con insuficiencia cardiaca congestiva en varios momentos de su ingreso. Objetivo: Identificar el valor pronóstico de los trastornos de la glucemia en la aparición de complicaciones de la insuficiencia cardiaca congestiva. Métodos: Se incluyeron los pacientes ingresados por insuficiencia cardiaca congestiva entre 2013 y 2015, que cumplieran con los criterios de Framingham y no tuvieran tratamientos hiperglucemiantes ni enfermedad terminal. Se les cuantificó glucemia al ingreso, al siguiente día en ayuno y posprandial, y de estar alteradas se realizó hemoglobina glucosilada para determinar si eran diabéticos previos. Se buscó asociación entre la glucemia y las complicaciones intrahospitalarias. Resultados: Se estudiaron 111 pacientes. Las complicaciones más frecuentes fueron los trastornos electrolíticos, la muerte, el shock y el edema pulmonar; los antecedentes patológicos no influyeron en la aparición de complicaciones. Hubo una asociación entre la hiperglucemia intrahospitalaria (p=0,032) y la hiperglucemia de estrés (p=0,035) con la presencia de complicaciones, la hiperglucemia posprandial fue la que mostró una influencia independiente en dicha evolución clínica (p=0,037). Conclusiones: Se encontró una alta frecuencia de hiperglucemia de ingreso, basal y posprandial y una asociación entre la hiperglucemia intrahospitalaria y la posibilidad de complicación durante los períodos de agudización de la insuficiencia cardiaca congestiva(AU)

Introduction: There are scanty evidences that glycemia can be used for predicting the complications of congestive heart failure (CHF). For this reason, it was decided to measure the glycemia values of patients with CHF in several moments of their admission. Objective: To identify the prognostic value of glycemia´s disorders in the appearance of complications of the congestive heart failure. Methods: There were included the patients admitted due to congestive heart failure between 2013 and 2015, who met with Framingham's criteria and had not been under hyperglycaemic treatments nor presenting a terminal illness. Their glycemia was quantified in the admission moment, also the following day in fasting and postprandial, and of being altered a glusocilada hemoglobin´s test was performed to determine if they were diabetics previously. Association between the glycemia and in-hospital complications was looked-up. Results: 111 patients were studied, finding as more frequent complications electrolytic disorders, death, shocks and pulmonary oedema; the pathological background did not have influence in the appearance of complications. There was an association between the in-hospital hyperglycaemia (p=0.032) and the hyperglycaemia due to stress (p=0.035) with the presence of complications, being the posprandial hyperglycaemia the one that showed an independent influence in the above mentioned clinical evolution (p=0.037). Conclusions: There was found a high frequency of hyperglycaemia in the admission moment, as well as basal and postprandial hyperglycaemia; and an association between the in-hospital hyperglycemia and the possibility of complications during the periods of worsening of the CHF(AU)

Humans , Male , Female , Prognosis , Heart Failure/diagnosis , Heart Failure/epidemiology , Hyperglycemia/complications