Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular

Introducción: La falla cardíaca es considerada un problema de salud pública, afectando aproximadamente 1-3% de la población mundial. A pesar de los beneficios conocidos de la terapia médica óptima para esta condición, la evidencia refleja una brecha importante entre las recomendaciones de las guías...

Full description

Autores:
Tipo de recurso:
Fecha de publicación:
2024
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
spa
OAI Identifier:
oai:repository.urosario.edu.co:10336/43278
Acceso en línea:
https://doi.org/10.48713/10336_43278
https://repository.urosario.edu.co/handle/10336/43278
Palabra clave:
Falla cardíaca
Ciencias de la implementación
Adherencia a guías
Optimización de terapia médica
Inercia médica
Heart failure
Implementation science
Guideline adherence
Medical therapy optimization
Medical inertia
Rights
License
Attribution-ShareAlike 4.0 International
id EDOCUR2_c94d9793f5527a3f57f0b49c2153affe
oai_identifier_str oai:repository.urosario.edu.co:10336/43278
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.none.fl_str_mv Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
dc.title.TranslatedTitle.none.fl_str_mv Adjustments in Heart Failure Medical Therapy Following Hospitalization at a Cardiovascular Center
title Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
spellingShingle Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
Falla cardíaca
Ciencias de la implementación
Adherencia a guías
Optimización de terapia médica
Inercia médica
Heart failure
Implementation science
Guideline adherence
Medical therapy optimization
Medical inertia
title_short Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
title_full Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
title_fullStr Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
title_full_unstemmed Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
title_sort Cambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascular
dc.contributor.advisor.none.fl_str_mv Cruz Cuevas, Jose David
Moreno Medina, Karen
dc.subject.none.fl_str_mv Falla cardíaca
Ciencias de la implementación
Adherencia a guías
Optimización de terapia médica
Inercia médica
topic Falla cardíaca
Ciencias de la implementación
Adherencia a guías
Optimización de terapia médica
Inercia médica
Heart failure
Implementation science
Guideline adherence
Medical therapy optimization
Medical inertia
dc.subject.keyword.none.fl_str_mv Heart failure
Implementation science
Guideline adherence
Medical therapy optimization
Medical inertia
description Introducción: La falla cardíaca es considerada un problema de salud pública, afectando aproximadamente 1-3% de la población mundial. A pesar de los beneficios conocidos de la terapia médica óptima para esta condición, la evidencia refleja una brecha importante entre las recomendaciones de las guías de práctica clínica y la implementación del tratamiento. La hospitalización de pacientes con falla cardíaca representa una oportunidad para aumentar la terapia médica y un reto en la adherencia por la condición aguda de los pacientes. Objetivos: Establecer la frecuencia de los tratamientos médicos para falla cardíaca y evaluar el cambio en la terapia farmacológica antes y después de una hospitalización en un centro cardiovascular de alta complejidad. Métodos: Se realizó un estudio de cohorte histórica en pacientes con falla cardíaca, hospitalizados por más de 48 horas en la Fundación Cardioinfantil-Instituto de Cardiología, entre 2018 y 2023. Fueron excluidos aquellos pacientes que fallecieron durante la hospitalización o no tenían disponible información de las variables de estudio. Se realizó un muestreo aleatorio simple para la selección de los participantes y se registraron variables demográficas, clínicas, antecedentes y la terapia médica de falla cardíaca en términos de medicamentos y dosis al ingreso y el alta. Resultados: Incluimos 726 pacientes con falla cardíaca que consultaron por cualquier causa a la Fundación Cardioinfantil entre 2018 y 2023, encontrando que en el 44.5% se aumentó la terapia farmacológica, siendo estos más jóvenes (media de edad 69 vs. 73 años, p=0.08) y con una prevalencia ligeramente mayor de sexo masculino (65.6% vs. 60.3%, p=0.07). Se observó una menor prevalencia de hipertensión (68.1% vs. 76.4%, p=0.009) y enfermedad renal crónica (14.5% vs. 27.5%, p<0.001) en el grupo con aumento en la terapia. Sin embargo, este grupo presentó una mayor incidencia de fibrilación auricular (18.3% vs. 30.3%, p<0.001). La estancia hospitalaria no mostró diferencias significativas entre los grupos (mediana de 7 días para ambos, p=0.8). Conclusiones: Encontramos una baja tendencia de la modificación o el inicio de grupos farmacológicos en pacientes con falla cardíaca que se hospitalizaron por cualquier causa, a pesar de la alta incidencia y prevalencia de la falla cardíaca en nuestro medio y las recomendaciones de la optimización de la terapia médica dirigida por guías. La hospitalización es una potencial oportunidad para identificar a los pacientes que se beneficien del inicio o la titulación de la terapia farmacológica; se requieren nuevos estudios con evaluación de asociaciones entre este factor y desenlaces cardiovasculares mayores para optimizar la implementación del manejo farmacológico en falla cardíaca.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-08-14T21:00:10Z
dc.date.available.none.fl_str_mv 2024-08-14T21:00:10Z
dc.date.created.none.fl_str_mv 2024-08-13
dc.type.none.fl_str_mv bachelorThesis
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.document.none.fl_str_mv Trabajo de grado
dc.type.spa.none.fl_str_mv Trabajo de grado
dc.identifier.doi.none.fl_str_mv https://doi.org/10.48713/10336_43278
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/43278
url https://doi.org/10.48713/10336_43278
https://repository.urosario.edu.co/handle/10336/43278
dc.language.iso.none.fl_str_mv spa
language spa
dc.rights.*.fl_str_mv Attribution-ShareAlike 4.0 International
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.none.fl_str_mv Abierto (Texto Completo)
dc.rights.economicrights.none.fl_str_mv Fundación Cardioinfantil - LaCardio
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-sa/4.0/
rights_invalid_str_mv Attribution-ShareAlike 4.0 International
Abierto (Texto Completo)
Fundación Cardioinfantil - LaCardio
http://creativecommons.org/licenses/by-sa/4.0/
http://purl.org/coar/access_right/c_abf2
dc.format.extent.none.fl_str_mv 43 pp
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad del Rosario
dc.publisher.department.none.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv Especialización en Medicina Interna
publisher.none.fl_str_mv Universidad del Rosario
institution Universidad del Rosario
dc.source.bibliographicCitation.none.fl_str_mv Yan T, Zhu S, Yin X, Xie C, Xue J, Zhu M, et al. Burden, Trends, and Inequalities of Heart Failure Globally, 1990 to 2019: A Secondary Analysis Based on the Global Burden of Disease 2019 Study. J Am Heart Assoc. 2023 Mar 21;12(6).
Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023 Jan 18;118(17):3272–87.
Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, et al. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Health. 2017 Jul;5(7):e665–72.
Gómez E. Capítulo 2. Introducción, epidemiología de la falla cardiaca e historia de las clínicas de falla cardiaca en Colombia. Revista Colombiana de Cardiología. 2016 Mar;23:6–12.
Rivera-Toquica A, Saldarriaga-Giraldo CI, Echeverría LE, Buitrago A, Mariño A, Arias-Barrera CA, et al. Actualización 2022 del Consenso Colombiano de Insuficiencia Cardíaca con Fracción de Eyección Reducida: Capítulo de Falla Cardíaca, Trasplante Cardíaco e Hipertensión Pulmonar de la Asociación Sociedad Colombiana de Cardiología y Cirugía Cardiovascular. Revista Colombiana de Cardiologia. 2022;29(2):1–19.
Lee HY, Oh BH. Paradigm Shifts of Heart Failure Therapy: Do We Need Another Paradigm? International Journal of Heart Failure. 2020;2(3):145.
Ahn MS, Yoo BS, Son JW, Park YJ, Lee HY, Jeon ES, et al. Evaluation of Adherence to Guideline for Heart Failure with Reduced Ejection Fraction in Heart Failure with Preserved Ejection Fraction and with or without Atrial Fibrillation. J Korean Med Sci. 2021;36(40).
Vaduganathan M, Claggett BL, Jhund PS, Cunningham JW, Pedro Ferreira J, Zannad F, et al. Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials. The Lancet. 2020 Jul;396(10244):121–8.
Bauersachs J. Heart failure drug treatment: the fantastic four. Eur Heart J. 2021 Feb 11;42(6):681–3.
Pierce JB, Vaduganathan M, Fonarow GC, Ikeaba U, Chiswell K, Butler J, et al. Contemporary Use of Sodium-Glucose Cotransporter-2 Inhibitor Therapy Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction in the US. JAMA Cardiol. 2023 May 22;
Swedberg K. The clinical practice of treating patients with chronic heart failure needs to be improved. Eur J Heart Fail. 2021 Sep 26;23(9):1512–3.
Biegus J, Moayedi Y, Saldarriaga C, Ponikowski P. Getting ahead of the game: in-hospital initiation of HFrEF therapies. European Heart Journal Supplements. 2022 Dec 19;24(Supplement_L):L38–44.
Kim SE, Yoo BS. Treatment Strategies of Improving Quality of Care in Patients With Heart Failure. Korean Circ J. 2023;53(5):294.
Seferović PM, Polovina M, Adlbrecht C, Bělohlávek J, Chioncel O, Goncalvesová E, et al. Navigating between Scylla and Charybdis: challenges and strategies for implementing guideline‐directed medical therapy in heart failure with reduced ejection fraction. Eur J Heart Fail. 2021 Dec 13;23(12):1999–2007.
Van Spall HGC, Fonarow GC, Mamas MA. Underutilization of Guideline-Directed Medical Therapy in Heart Failure. J Am Coll Cardiol. 2022 Jun;79(22):2214–8.
Ahn MS, Yoo BS, Son JW, Park YJ, Lee HY, Jeon ES, et al. Evaluation of Adherence to Guideline for Heart Failure with Reduced Ejection Fraction in Heart Failure with Preserved Ejection Fraction and with or without Atrial Fibrillation. J Korean Med Sci. 2021;36(40).
Komajda M, Schöpe J, Wagenpfeil S, Tavazzi L, Böhm M, Ponikowski P, et al. Physicians’ guideline adherence is associated with long‐term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019 Jul;21(7):921–9.
Aggarwal M, Bozkurt B, Panjrath G, Aggarwal B, Ostfeld RJ, Barnard ND, et al. Lifestyle Modifications for Preventing and Treating Heart Failure. J Am Coll Cardiol. 2018 Nov;72(19):2391–405.
Hernández-Pinzón C, Flórez-Flórez ML. Adherencia al tratamiento en la insuficiencia cardiaca y las tecnologías de la información y la comunicación. Revista Colombiana de Cardiología. 2017 Mar;24(2):96–104.
Blumer V, Mentz RJ, Sun JL, Butler J, Metra M, Voors AA, et al. Prognostic Role of Prior Heart Failure Hospitalization Among Patients Hospitalized for Worsening Chronic Heart Failure. Circ Heart Fail. 2021 Apr;14(4).
Chimed S, Stassen J, Galloo X, Meucci MC, van der Bijl P, Knuuti J, et al. Impact of Worsening Heart Failure on Long-Term Prognosis in Patients With Heart Failure With Reduced Ejection Fraction. Am J Cardiol. 2022 Dec;184:63–71.
Metra M, Tomasoni D, Adamo M, Bayes‐Genis A, Filippatos G, Abdelhamid M, et al. Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2023 May 19;
Chimed S, Stassen J, Galloo X, Meucci MC, van der Bijl P, Knuuti J, et al. Impact of Worsening Heart Failure on Long-Term Prognosis in Patients With Heart Failure With Reduced Ejection Fraction. Am J Cardiol. 2022 Dec;184:63–71.
Tromp J, Bamadhaj S, Cleland JGF, Angermann CE, Dahlstrom U, Ouwerkerk W, et al. Post-discharge prognosis of patients admitted to hospital for heart failure by world region, and national level of income and income disparity (REPORT-HF): a cohort study. Lancet Glob Health. 2020 Mar;8(3):e411–22.
Adamo M, Pagnesi M, Mebazaa A, Davison B, Edwards C, Tomasoni D, et al. NT-proBNP and high intensity care for acute heart failure: the STRONG-HF trial. Eur Heart J. 2023 May 22;
Mallick A, Gandhi PU, Gaggin HK, Ibrahim N, Januzzi JL. The Importance of Worsening Heart Failure in Ambulatory Patients. JACC Heart Fail. 2016 Sep;4(9):749–55.
Srivastava PK, DeVore AD, Hellkamp AS, Thomas L, Albert NM, Butler J, et al. Heart Failure Hospitalization and Guideline-Directed Prescribing Patterns Among Heart Failure With Reduced Ejection Fraction Patients. JACC Heart Fail. 2021 Jan;9(1):28–38.
CONSENSUS Trial Study Group. Effects of Enalapril on Mortality in Severe Congestive Heart Failure. New England Journal of Medicine. 1987 Jun 4;316(23):1429–35.
Salim Yusuf, Bertram Pitt, Clarence E Davis, William B Hood JNC. Effect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure. New England Journal of Medicine. 1991 Aug;325(5):293–302.
Granger CB, McMurray JJ, Yusuf S, Held P, Michelson EL, Olofsson B, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. The Lancet. 2003 Sep;362(9386):772–6.
McMurray JJV, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, et al. Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. New England Journal of Medicine. 2014 Sep 11;371(11):993–1004.
Vaduganathan M, Docherty KF, Claggett BL, Jhund PS, de Boer RA, Hernandez AF, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. The Lancet. 2022 Sep;400(10354):757–67.
Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B, et al. Spironolactone for Heart Failure with Preserved Ejection Fraction. New England Journal of Medicine. 2014 Apr 10;370(15):1383–92.
Braunwald E. SGLT2 inhibitors: the statins of the 21st century. Eur Heart J. 2022 Mar 14;43(11):1029–30.
Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. New England Journal of Medicine. 2020;383(15):1413–24.
Anker SD, Butler J, Filippatos G, Ferreira JP, Bocchi E, Böhm M, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. New England Journal of Medicine. 2021 Oct 14;385(16):1451–61.
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599–726.
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18).
Komajda M, Schöpe J, Wagenpfeil S, Tavazzi L, Böhm M, Ponikowski P, et al. Physicians’ guideline adherence is associated with long‐term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019 Jul;21(7):921–9.
Crespo-Leiro MG, Segovia-Cubero J, González-Costello J, Bayes-Genis A, López-Fernández S, Roig E, et al. Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry. Revista Española de Cardiología (English Edition). 2015 Sep;68(9):785–93.
Erhardt L, Komajda M, Hobbs FDR, Soler-Soler J. Cardiologists’ awareness and perceptions of guidelines for chronic heart failure. The ADDress your Heart survey. Eur J Heart Fail. 2008 Oct;10(10):1020–5.
Komajda M, Anker SD, Cowie MR, Filippatos GS, Mengelle B, Ponikowski P, et al. Physicians’ adherence to guideline-recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey. Eur J Heart Fail. 2016 May;18(5):514–22.
Seferović PM, Polovina M, Adlbrecht C, Bělohlávek J, Chioncel O, Goncalvesová E, et al. Navigating between Scylla and Charybdis: challenges and strategies for implementing guideline‐directed medical therapy in heart failure with reduced ejection fraction. Eur J Heart Fail. 2021 Dec 13;23(12):1999–2007.
Verhestraeten C, Heggermont WA, Maris M. Clinical inertia in the treatment of heart failure: a major issue to tackle. Heart Fail Rev. 2021 Nov 30;26(6):1359–70.
Muñoz Velandia OM, García ÁA, Bustamante ÁA, Pomares-Quimbaya A, González RA, Sierra A, et al. Evaluación automática de la adherencia a las recomendaciones de manejo en falla cardiaca a partir de las historias clínicas electrónicas: herramienta EXEMED. Revista Colombiana de Cardiología. 2018 Sep;25(5):321–6.
Chaves santiago W gabriel. CUMPLIMIENTO DE GUÍAS EN PACIENTES HOSPITALIZADOS CON FALLA CARDÍACA ¿COMO ESTAMOS. Acta Médica Colombiana. 2014 Mar 15;39(1):40–5.
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18):E895–1032.
Spoletini I, Lainscak M. Epidemiology and Prognosis of Heart Failure. International Cardiovascular Forum Journal. 2017 Jun 3;10.
Jones NR, Roalfe AK, Adoki I, Hobbs FDR, Taylor CJ. Survival of patients with chronic heart failure in the community: a systematic review and meta‐analysis. Eur J Heart Fail. 2019 Nov 16;21(11):1306–25.
Xanthakis V, Enserro DM, Larson MG, Wollert KC, Januzzi JL, Levy D, et al. Prevalence, Neurohormonal Correlates, and Prognosis of Heart Failure Stages in the Community. JACC Heart Fail. 2016 Oct;4(10):808–15.
Shrivastava A, Haase T, Zeller T, Schulte C. Biomarkers for Heart Failure Prognosis: Proteins, Genetic Scores and Non-coding RNAs. Front Cardiovasc Med. 2020 Nov 23;7.
Espinosa B, Llorens P, Gil V, Rossello X, Jacob J, Herrero P, et al. Pronóstico de la insuficiencia cardíaca aguda basado en datos clínicos de congestión. Rev Clin Esp. 2022 Jun;222(6):321–31.
Ansari M, Shlipak MG, Heidenreich PA, Van Ostaeyen D, Pohl EC, Browner WS, et al. Improving Guideline Adherence. Circulation. 2003 Jun 10;107(22):2799–804.
Brooksbank JA, Faulkenberg KD, Tang WHW, Martyn T. Novel Strategies to Improve Prescription of Guideline-Directed Medical Therapy in Heart Failure. Curr Treat Options Cardiovasc Med. 2023 May 5;25(5):93–110.
Shanbhag D, Graham ID, Harlos K, Haynes RB, Gabizon I, Connolly SJ, et al. Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: a systematic review. BMJ Open. 2018 Mar;8(3):e017765.
Komajda M, Schöpe J, Wagenpfeil S, Tavazzi L, Böhm M, Ponikowski P, et al. Physicians’ guideline adherence is associated with long‐term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019 Jul;21(7):921–9.
Parikh KS, Sheng S, Hammill BG, Yancy CW, Fonarow GC, Hernandez AF, et al. Characteristics of Acute Heart Failure Hospitalizations Based on Presenting Severity. Circ Heart Fail. 2019 Jan;12(1).
Arbeláez L, Calvo L, Valencia M, Juan M, Amaya N, Juan E, et al. Factores de riesgo asociados a estancia hospitalaria prolongada en pacientes con falla cardiaca aguda. Revista Colombiana de Cardiología. 2022 May 25;28(2).
Duflos C, Troude P, Strainchamps D, Ségouin C, Logeart D, Mercier G. Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission. Sci Rep. 2020 Jun 30;10(1):10644.
Arrigo M, Jessup M, Mullens W, Reza N, Shah AM, Sliwa K, et al. Acute heart failure. Nat Rev Dis Primers. 2020 Mar 5;6(1):16.
Fonarow GC. Risk Stratification for In-Hospital Mortality in Acutely Decompensated Heart Failure&lt;SUBTITLE&gt;Classification and Regression Tree Analysis&lt;/SUBTITLE&gt; JAMA. 2005 Feb 2;293(5):572
Metra M, Tomasoni D, Adamo M, Bayes‐Genis A, Filippatos G, Abdelhamid M, et al. Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2023 Jun 19;25(6):776–91.
Safiri S, Carson-Chahhoud K, Noori M, Nejadghaderi SA, Sullman MJM, Ahmadian Heris J, et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022 Jul 27;e069679.
Giezeman M, Sundh J, Athlin Å, Lisspers K, Ställberg B, Janson C, et al. Comorbid Heart Disease in Patients with COPD is Associated with Increased Hospitalization and Mortality – A 15-Year Follow-Up. Int J Chron Obstruct Pulmon Dis. 2023 Jan;Volume 18:11–21.
Yang X, Lupón J, Vidán MT, Ferguson C, Gastelurrutia P, Newton PJ, et al. Impact of Frailty on Mortality and Hospitalization in Chronic Heart Failure: A Systematic Review and Meta‐Analysis. J Am Heart Assoc. 2018 Dec 4;7(23).
Lee CS, Chien C V, Bidwell JT, Gelow JM, Denfeld QE, Creber RM, et al. Comorbidity profiles and inpatient outcomes during hospitalization for heart failure: an analysis of the U.S. Nationwide inpatient sample. BMC Cardiovasc Disord. 2014 Dec 5;14(1):73.
Terhoch CB, Moreira HF, Ayub-Ferreira SM, Conceição-Souza GE, Salemi VMC, Chizzola PR, et al. Clinical findings and prognosis of patients hospitalized for acute decompensated heart failure: Analysis of the influence of Chagas etiology and ventricular function. PLoS Negl Trop Dis. 2018 Feb 12;12(2):e0006207.
Fudim M, Yazdi D, Egolum U, Haghighat A, Kottam A, Sauer AJ, et al. Use of a Cardiac Scale to Predict Heart Failure Events: Design of SCALE-HF 1. Circ Heart Fail. 2023 May;16(5).
Farmakis D, Parissis J, Lekakis J, Filippatos G. Acute Heart Failure: Epidemiology, Risk Factors, and Prevention. Revista Española de Cardiología (English Edition). 2015 Mar;68(3):245–8.
Gómez-Mesa JE, Saldarriaga-Giraldo CI, Echeverría LE, Luna P, RECOLFACA GI. Registro colombiano de falla cardiaca (RECOLFACA): metodología y datos preliminares. Revista Colombiana de Cardiología. 2022 May 25;28(3).
Kurmani S, Squire I. Acute Heart Failure: Definition, Classification and Epidemiology. Curr Heart Fail Rep. 2017 Oct 7;14(5):385–92.
Bozkurt B, Savarese G, Adamsson Eryd S, Bodegård J, Cleland JGF, Khordoc C, et al. Mortality, Outcomes, Costs, and Use of Medicines Following a First Heart Failure Hospitalization. JACC Heart Fail. 2023 Jun;
Targher G, Dauriz M, Laroche C, Temporelli PL, Hassanein M, Seferovic PM, et al. In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the <scp>ESC‐HFA</scp> Heart Failure Long‐Term Registry. Eur J Heart Fail. 2017 Jan 28;19(1):54–65.
Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, et al. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail. 2021 Apr;14(4).
Verdu‐Rotellar J, Abellana R, Vaillant‐Roussel H, Gril Jevsek L, Assenova R, Kasuba Lazic D, et al. Risk stratification in heart failure decompensation in the community: HEFESTOS score. ESC Heart Fail. 2022 Feb 22;9(1):606–13.
Bo X, Zhang Y, Liu Y, Kharbuja N, Chen L. Performance of the heart failure risk scores in predicting 1 year mortality and short‐term readmission of patients. ESC Heart Fail. 2023 Feb 3;10(1):502–17.
Arrigo M, Gayat E, Parenica J, Ishihara S, Zhang J, Choi D, et al. Precipitating factors and 90‐day outcome of acute heart failure: a report from the intercontinental GREAT registry. Eur J Heart Fail [Internet]. 2017 Feb 28;19(2):201–8.
Swat SA, Xu H, Allen LA, Greene SJ, DeVore AD, Matsouaka RA, et al. Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. 2023 Aug;11(8):918–29.
Brooksbank JA, Faulkenberg KD, Tang WHW, Martyn T. Novel Strategies to Improve Prescription of Guideline-Directed Medical Therapy in Heart Failure. Curr Treat Options Cardiovasc Med. 2023 May 5;25(5):93–110.
Bhatt AS, Varshney AS, Moscone A, Claggett BL, Miao ZM, Chatur S, et al. Virtual Care Team Guided Management of Patients With Heart Failure During Hospitalization. J Am Coll Cardiol [Internet]. 2023 May 2 [cited 2023 Sep 12];81(17):1680–93.
Savarese, G., Kishi, T., Vardeny, O., Adamsson Eryd, S., Bodegård, J., Lund, L. H., ... & Bozkurt, B. (2023). Heart failure drug treatment—inertia, titration, and discontinuation: a multinational observational study (EVOLUTION HF). Heart Failure, 11(1), 1-14.
Fortich, F., Morón, A. O., de La Cruz, B. B., Roa, J. R., Orego, D. H., Gándara, J., ... & Sánchez, J. M. S. (2020). Factores de riesgo para mortalidad en falla cardiaca aguda. Análisis de árbol de regresión y clasificación. Revista Colombiana de Cardiología, 27(1), 20-28.
dc.source.instname.none.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.none.fl_str_mv reponame:Repositorio Institucional EdocUR
bitstream.url.fl_str_mv https://repository.urosario.edu.co/bitstreams/381ebbfd-bf39-41c2-803c-9ff9decc593e/download
https://repository.urosario.edu.co/bitstreams/ea19a8af-20bd-46eb-b322-32cd25dfe906/download
https://repository.urosario.edu.co/bitstreams/6e956abc-4b4e-4478-a180-404f73a00175/download
https://repository.urosario.edu.co/bitstreams/03138475-5885-43bd-b195-56c98a67af2e/download
https://repository.urosario.edu.co/bitstreams/9e74fe6b-31dc-4ef3-a218-451e51b2a63b/download
bitstream.checksum.fl_str_mv b2825df9f458e9d5d96ee8b7cd74fde6
adb7af3ef071a784ffe1b544b9a344ab
cd83efb3e0c0fe7947f37af110b05a7b
acbd5eb0227d98452e4038f30d814d6b
f85375936348c31e29283393288815cb
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio institucional EdocUR
repository.mail.fl_str_mv edocur@urosario.edu.co
_version_ 1831928288698695680
spelling Cruz Cuevas, Jose David4f60a1d0-1b96-465f-b2bb-8dbcca51840f-1Moreno Medina, Karen7bad6093-e09b-4be3-9f69-f7050164d5a5-1Montejo Pino, Juan SebastiánCruz Cuevas, Jose DavidRuiz Ballesta, AdalbertoEspecialista en Medicina InternaMaestríaFull time7e17e555-db11-4b74-b5c8-d1dcf3c0a483-10de130af-ba26-4863-bb9c-69eb218f8be8-176de3072-fdf9-4cd2-afa4-985e82a4c620-12024-08-14T21:00:10Z2024-08-14T21:00:10Z2024-08-13Introducción: La falla cardíaca es considerada un problema de salud pública, afectando aproximadamente 1-3% de la población mundial. A pesar de los beneficios conocidos de la terapia médica óptima para esta condición, la evidencia refleja una brecha importante entre las recomendaciones de las guías de práctica clínica y la implementación del tratamiento. La hospitalización de pacientes con falla cardíaca representa una oportunidad para aumentar la terapia médica y un reto en la adherencia por la condición aguda de los pacientes. Objetivos: Establecer la frecuencia de los tratamientos médicos para falla cardíaca y evaluar el cambio en la terapia farmacológica antes y después de una hospitalización en un centro cardiovascular de alta complejidad. Métodos: Se realizó un estudio de cohorte histórica en pacientes con falla cardíaca, hospitalizados por más de 48 horas en la Fundación Cardioinfantil-Instituto de Cardiología, entre 2018 y 2023. Fueron excluidos aquellos pacientes que fallecieron durante la hospitalización o no tenían disponible información de las variables de estudio. Se realizó un muestreo aleatorio simple para la selección de los participantes y se registraron variables demográficas, clínicas, antecedentes y la terapia médica de falla cardíaca en términos de medicamentos y dosis al ingreso y el alta. Resultados: Incluimos 726 pacientes con falla cardíaca que consultaron por cualquier causa a la Fundación Cardioinfantil entre 2018 y 2023, encontrando que en el 44.5% se aumentó la terapia farmacológica, siendo estos más jóvenes (media de edad 69 vs. 73 años, p=0.08) y con una prevalencia ligeramente mayor de sexo masculino (65.6% vs. 60.3%, p=0.07). Se observó una menor prevalencia de hipertensión (68.1% vs. 76.4%, p=0.009) y enfermedad renal crónica (14.5% vs. 27.5%, p<0.001) en el grupo con aumento en la terapia. Sin embargo, este grupo presentó una mayor incidencia de fibrilación auricular (18.3% vs. 30.3%, p<0.001). La estancia hospitalaria no mostró diferencias significativas entre los grupos (mediana de 7 días para ambos, p=0.8). Conclusiones: Encontramos una baja tendencia de la modificación o el inicio de grupos farmacológicos en pacientes con falla cardíaca que se hospitalizaron por cualquier causa, a pesar de la alta incidencia y prevalencia de la falla cardíaca en nuestro medio y las recomendaciones de la optimización de la terapia médica dirigida por guías. La hospitalización es una potencial oportunidad para identificar a los pacientes que se beneficien del inicio o la titulación de la terapia farmacológica; se requieren nuevos estudios con evaluación de asociaciones entre este factor y desenlaces cardiovasculares mayores para optimizar la implementación del manejo farmacológico en falla cardíaca.Introduction: Heart failure is considered a public health issue, affecting approximately 1-3% of the global population. Despite the known benefits of optimal medical therapy for this condition, evidence highlights a significant gap between clinical practice guidelines and the actual implementation of treatment. Hospitalization of heart failure patients presents both an opportunity to intensify medical therapy and a challenge in adherence due to the acute nature of the patients' condition. Objectives: To determine the frequency of medical treatments for heart failure and to evaluate changes in pharmacological therapy before and after hospitalization at a high-complexity cardiovascular center. Methods: A retrospective cohort study was conducted on heart failure patients hospitalized for more than 48 hours at Fundación Cardioinfantil-Instituto de Cardiología between 2018 and 2023. Patients who died during hospitalization or lacked available information on study variables were excluded. Simple random sampling was used to select participants, and demographic, clinical, and historical variables were recorded, as well as heart failure medical therapy in terms of medications and dosages at admission and discharge. Results: We included 726 heart failure patients who were admitted to Fundación Cardioinfantil for any reason between 2018 and 2023. An increase in pharmacological therapy was observed in 44.5% of patients. This group tended to be younger (mean age 69 vs. 73 years, p=0.08) and had a slightly higher prevalence of males (65.6% vs. 60.3%, p=0.07). They also had a lower prevalence of hypertension (68.1% vs. 76.4%, p=0.009) and chronic kidney disease (14.5% vs. 27.5%, p<0.001), but a higher incidence of atrial fibrillation (18.3% vs. 30.3%, p<0.001). Hospital stay duration did not significantly differ between groups (median of 7 days for both, p=0.8). Conclusions: We found a low tendency to modify or initiate pharmacological groups in heart failure patients hospitalized for any reason, despite the high incidence and prevalence of heart failure in our setting and the recommendations for optimizing guideline-directed medical therapy. Hospitalization is a potential opportunity to identify patients who could benefit from initiating or titrating pharmacological therapy. Further studies are needed to evaluate the association between this factor and major cardiovascular outcomes to optimize the implementation of heart failure medical management.43 ppapplication/pdfhttps://doi.org/10.48713/10336_43278 https://repository.urosario.edu.co/handle/10336/43278spaUniversidad del RosarioEscuela de Medicina y Ciencias de la SaludEspecialización en Medicina InternaAttribution-ShareAlike 4.0 InternationalAbierto (Texto Completo)Fundación Cardioinfantil - LaCardioEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://creativecommons.org/licenses/by-sa/4.0/http://purl.org/coar/access_right/c_abf2Yan T, Zhu S, Yin X, Xie C, Xue J, Zhu M, et al. Burden, Trends, and Inequalities of Heart Failure Globally, 1990 to 2019: A Secondary Analysis Based on the Global Burden of Disease 2019 Study. J Am Heart Assoc. 2023 Mar 21;12(6).Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023 Jan 18;118(17):3272–87.Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, et al. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Health. 2017 Jul;5(7):e665–72.Gómez E. Capítulo 2. Introducción, epidemiología de la falla cardiaca e historia de las clínicas de falla cardiaca en Colombia. Revista Colombiana de Cardiología. 2016 Mar;23:6–12.Rivera-Toquica A, Saldarriaga-Giraldo CI, Echeverría LE, Buitrago A, Mariño A, Arias-Barrera CA, et al. Actualización 2022 del Consenso Colombiano de Insuficiencia Cardíaca con Fracción de Eyección Reducida: Capítulo de Falla Cardíaca, Trasplante Cardíaco e Hipertensión Pulmonar de la Asociación Sociedad Colombiana de Cardiología y Cirugía Cardiovascular. Revista Colombiana de Cardiologia. 2022;29(2):1–19.Lee HY, Oh BH. Paradigm Shifts of Heart Failure Therapy: Do We Need Another Paradigm? International Journal of Heart Failure. 2020;2(3):145.Ahn MS, Yoo BS, Son JW, Park YJ, Lee HY, Jeon ES, et al. Evaluation of Adherence to Guideline for Heart Failure with Reduced Ejection Fraction in Heart Failure with Preserved Ejection Fraction and with or without Atrial Fibrillation. J Korean Med Sci. 2021;36(40).Vaduganathan M, Claggett BL, Jhund PS, Cunningham JW, Pedro Ferreira J, Zannad F, et al. Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials. The Lancet. 2020 Jul;396(10244):121–8.Bauersachs J. Heart failure drug treatment: the fantastic four. Eur Heart J. 2021 Feb 11;42(6):681–3.Pierce JB, Vaduganathan M, Fonarow GC, Ikeaba U, Chiswell K, Butler J, et al. Contemporary Use of Sodium-Glucose Cotransporter-2 Inhibitor Therapy Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction in the US. JAMA Cardiol. 2023 May 22;Swedberg K. The clinical practice of treating patients with chronic heart failure needs to be improved. Eur J Heart Fail. 2021 Sep 26;23(9):1512–3.Biegus J, Moayedi Y, Saldarriaga C, Ponikowski P. Getting ahead of the game: in-hospital initiation of HFrEF therapies. European Heart Journal Supplements. 2022 Dec 19;24(Supplement_L):L38–44.Kim SE, Yoo BS. Treatment Strategies of Improving Quality of Care in Patients With Heart Failure. Korean Circ J. 2023;53(5):294.Seferović PM, Polovina M, Adlbrecht C, Bělohlávek J, Chioncel O, Goncalvesová E, et al. Navigating between Scylla and Charybdis: challenges and strategies for implementing guideline‐directed medical therapy in heart failure with reduced ejection fraction. Eur J Heart Fail. 2021 Dec 13;23(12):1999–2007.Van Spall HGC, Fonarow GC, Mamas MA. Underutilization of Guideline-Directed Medical Therapy in Heart Failure. J Am Coll Cardiol. 2022 Jun;79(22):2214–8.Ahn MS, Yoo BS, Son JW, Park YJ, Lee HY, Jeon ES, et al. Evaluation of Adherence to Guideline for Heart Failure with Reduced Ejection Fraction in Heart Failure with Preserved Ejection Fraction and with or without Atrial Fibrillation. J Korean Med Sci. 2021;36(40).Komajda M, Schöpe J, Wagenpfeil S, Tavazzi L, Böhm M, Ponikowski P, et al. Physicians’ guideline adherence is associated with long‐term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019 Jul;21(7):921–9.Aggarwal M, Bozkurt B, Panjrath G, Aggarwal B, Ostfeld RJ, Barnard ND, et al. Lifestyle Modifications for Preventing and Treating Heart Failure. J Am Coll Cardiol. 2018 Nov;72(19):2391–405.Hernández-Pinzón C, Flórez-Flórez ML. Adherencia al tratamiento en la insuficiencia cardiaca y las tecnologías de la información y la comunicación. Revista Colombiana de Cardiología. 2017 Mar;24(2):96–104.Blumer V, Mentz RJ, Sun JL, Butler J, Metra M, Voors AA, et al. Prognostic Role of Prior Heart Failure Hospitalization Among Patients Hospitalized for Worsening Chronic Heart Failure. Circ Heart Fail. 2021 Apr;14(4).Chimed S, Stassen J, Galloo X, Meucci MC, van der Bijl P, Knuuti J, et al. Impact of Worsening Heart Failure on Long-Term Prognosis in Patients With Heart Failure With Reduced Ejection Fraction. Am J Cardiol. 2022 Dec;184:63–71.Metra M, Tomasoni D, Adamo M, Bayes‐Genis A, Filippatos G, Abdelhamid M, et al. Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2023 May 19;Chimed S, Stassen J, Galloo X, Meucci MC, van der Bijl P, Knuuti J, et al. Impact of Worsening Heart Failure on Long-Term Prognosis in Patients With Heart Failure With Reduced Ejection Fraction. Am J Cardiol. 2022 Dec;184:63–71.Tromp J, Bamadhaj S, Cleland JGF, Angermann CE, Dahlstrom U, Ouwerkerk W, et al. Post-discharge prognosis of patients admitted to hospital for heart failure by world region, and national level of income and income disparity (REPORT-HF): a cohort study. Lancet Glob Health. 2020 Mar;8(3):e411–22.Adamo M, Pagnesi M, Mebazaa A, Davison B, Edwards C, Tomasoni D, et al. NT-proBNP and high intensity care for acute heart failure: the STRONG-HF trial. Eur Heart J. 2023 May 22;Mallick A, Gandhi PU, Gaggin HK, Ibrahim N, Januzzi JL. The Importance of Worsening Heart Failure in Ambulatory Patients. JACC Heart Fail. 2016 Sep;4(9):749–55.Srivastava PK, DeVore AD, Hellkamp AS, Thomas L, Albert NM, Butler J, et al. Heart Failure Hospitalization and Guideline-Directed Prescribing Patterns Among Heart Failure With Reduced Ejection Fraction Patients. JACC Heart Fail. 2021 Jan;9(1):28–38.CONSENSUS Trial Study Group. Effects of Enalapril on Mortality in Severe Congestive Heart Failure. New England Journal of Medicine. 1987 Jun 4;316(23):1429–35.Salim Yusuf, Bertram Pitt, Clarence E Davis, William B Hood JNC. Effect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure. New England Journal of Medicine. 1991 Aug;325(5):293–302.Granger CB, McMurray JJ, Yusuf S, Held P, Michelson EL, Olofsson B, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. The Lancet. 2003 Sep;362(9386):772–6.McMurray JJV, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, et al. Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. New England Journal of Medicine. 2014 Sep 11;371(11):993–1004.Vaduganathan M, Docherty KF, Claggett BL, Jhund PS, de Boer RA, Hernandez AF, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. The Lancet. 2022 Sep;400(10354):757–67.Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B, et al. Spironolactone for Heart Failure with Preserved Ejection Fraction. New England Journal of Medicine. 2014 Apr 10;370(15):1383–92.Braunwald E. SGLT2 inhibitors: the statins of the 21st century. Eur Heart J. 2022 Mar 14;43(11):1029–30.Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. New England Journal of Medicine. 2020;383(15):1413–24.Anker SD, Butler J, Filippatos G, Ferreira JP, Bocchi E, Böhm M, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. New England Journal of Medicine. 2021 Oct 14;385(16):1451–61.McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599–726.Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18).Komajda M, Schöpe J, Wagenpfeil S, Tavazzi L, Böhm M, Ponikowski P, et al. Physicians’ guideline adherence is associated with long‐term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019 Jul;21(7):921–9.Crespo-Leiro MG, Segovia-Cubero J, González-Costello J, Bayes-Genis A, López-Fernández S, Roig E, et al. Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry. Revista Española de Cardiología (English Edition). 2015 Sep;68(9):785–93.Erhardt L, Komajda M, Hobbs FDR, Soler-Soler J. Cardiologists’ awareness and perceptions of guidelines for chronic heart failure. The ADDress your Heart survey. Eur J Heart Fail. 2008 Oct;10(10):1020–5.Komajda M, Anker SD, Cowie MR, Filippatos GS, Mengelle B, Ponikowski P, et al. Physicians’ adherence to guideline-recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey. Eur J Heart Fail. 2016 May;18(5):514–22.Seferović PM, Polovina M, Adlbrecht C, Bělohlávek J, Chioncel O, Goncalvesová E, et al. Navigating between Scylla and Charybdis: challenges and strategies for implementing guideline‐directed medical therapy in heart failure with reduced ejection fraction. Eur J Heart Fail. 2021 Dec 13;23(12):1999–2007.Verhestraeten C, Heggermont WA, Maris M. Clinical inertia in the treatment of heart failure: a major issue to tackle. Heart Fail Rev. 2021 Nov 30;26(6):1359–70.Muñoz Velandia OM, García ÁA, Bustamante ÁA, Pomares-Quimbaya A, González RA, Sierra A, et al. Evaluación automática de la adherencia a las recomendaciones de manejo en falla cardiaca a partir de las historias clínicas electrónicas: herramienta EXEMED. Revista Colombiana de Cardiología. 2018 Sep;25(5):321–6.Chaves santiago W gabriel. CUMPLIMIENTO DE GUÍAS EN PACIENTES HOSPITALIZADOS CON FALLA CARDÍACA ¿COMO ESTAMOS. Acta Médica Colombiana. 2014 Mar 15;39(1):40–5.Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18):E895–1032.Spoletini I, Lainscak M. Epidemiology and Prognosis of Heart Failure. International Cardiovascular Forum Journal. 2017 Jun 3;10.Jones NR, Roalfe AK, Adoki I, Hobbs FDR, Taylor CJ. Survival of patients with chronic heart failure in the community: a systematic review and meta‐analysis. Eur J Heart Fail. 2019 Nov 16;21(11):1306–25.Xanthakis V, Enserro DM, Larson MG, Wollert KC, Januzzi JL, Levy D, et al. Prevalence, Neurohormonal Correlates, and Prognosis of Heart Failure Stages in the Community. JACC Heart Fail. 2016 Oct;4(10):808–15.Shrivastava A, Haase T, Zeller T, Schulte C. Biomarkers for Heart Failure Prognosis: Proteins, Genetic Scores and Non-coding RNAs. Front Cardiovasc Med. 2020 Nov 23;7.Espinosa B, Llorens P, Gil V, Rossello X, Jacob J, Herrero P, et al. Pronóstico de la insuficiencia cardíaca aguda basado en datos clínicos de congestión. Rev Clin Esp. 2022 Jun;222(6):321–31.Ansari M, Shlipak MG, Heidenreich PA, Van Ostaeyen D, Pohl EC, Browner WS, et al. Improving Guideline Adherence. Circulation. 2003 Jun 10;107(22):2799–804.Brooksbank JA, Faulkenberg KD, Tang WHW, Martyn T. Novel Strategies to Improve Prescription of Guideline-Directed Medical Therapy in Heart Failure. Curr Treat Options Cardiovasc Med. 2023 May 5;25(5):93–110.Shanbhag D, Graham ID, Harlos K, Haynes RB, Gabizon I, Connolly SJ, et al. Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: a systematic review. BMJ Open. 2018 Mar;8(3):e017765.Komajda M, Schöpe J, Wagenpfeil S, Tavazzi L, Böhm M, Ponikowski P, et al. Physicians’ guideline adherence is associated with long‐term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019 Jul;21(7):921–9.Parikh KS, Sheng S, Hammill BG, Yancy CW, Fonarow GC, Hernandez AF, et al. Characteristics of Acute Heart Failure Hospitalizations Based on Presenting Severity. Circ Heart Fail. 2019 Jan;12(1).Arbeláez L, Calvo L, Valencia M, Juan M, Amaya N, Juan E, et al. Factores de riesgo asociados a estancia hospitalaria prolongada en pacientes con falla cardiaca aguda. Revista Colombiana de Cardiología. 2022 May 25;28(2).Duflos C, Troude P, Strainchamps D, Ségouin C, Logeart D, Mercier G. Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission. Sci Rep. 2020 Jun 30;10(1):10644.Arrigo M, Jessup M, Mullens W, Reza N, Shah AM, Sliwa K, et al. Acute heart failure. Nat Rev Dis Primers. 2020 Mar 5;6(1):16.Fonarow GC. Risk Stratification for In-Hospital Mortality in Acutely Decompensated Heart Failure&lt;SUBTITLE&gt;Classification and Regression Tree Analysis&lt;/SUBTITLE&gt; JAMA. 2005 Feb 2;293(5):572Metra M, Tomasoni D, Adamo M, Bayes‐Genis A, Filippatos G, Abdelhamid M, et al. Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2023 Jun 19;25(6):776–91.Safiri S, Carson-Chahhoud K, Noori M, Nejadghaderi SA, Sullman MJM, Ahmadian Heris J, et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022 Jul 27;e069679.Giezeman M, Sundh J, Athlin Å, Lisspers K, Ställberg B, Janson C, et al. Comorbid Heart Disease in Patients with COPD is Associated with Increased Hospitalization and Mortality – A 15-Year Follow-Up. Int J Chron Obstruct Pulmon Dis. 2023 Jan;Volume 18:11–21.Yang X, Lupón J, Vidán MT, Ferguson C, Gastelurrutia P, Newton PJ, et al. Impact of Frailty on Mortality and Hospitalization in Chronic Heart Failure: A Systematic Review and Meta‐Analysis. J Am Heart Assoc. 2018 Dec 4;7(23).Lee CS, Chien C V, Bidwell JT, Gelow JM, Denfeld QE, Creber RM, et al. Comorbidity profiles and inpatient outcomes during hospitalization for heart failure: an analysis of the U.S. Nationwide inpatient sample. BMC Cardiovasc Disord. 2014 Dec 5;14(1):73.Terhoch CB, Moreira HF, Ayub-Ferreira SM, Conceição-Souza GE, Salemi VMC, Chizzola PR, et al. Clinical findings and prognosis of patients hospitalized for acute decompensated heart failure: Analysis of the influence of Chagas etiology and ventricular function. PLoS Negl Trop Dis. 2018 Feb 12;12(2):e0006207.Fudim M, Yazdi D, Egolum U, Haghighat A, Kottam A, Sauer AJ, et al. Use of a Cardiac Scale to Predict Heart Failure Events: Design of SCALE-HF 1. Circ Heart Fail. 2023 May;16(5).Farmakis D, Parissis J, Lekakis J, Filippatos G. Acute Heart Failure: Epidemiology, Risk Factors, and Prevention. Revista Española de Cardiología (English Edition). 2015 Mar;68(3):245–8.Gómez-Mesa JE, Saldarriaga-Giraldo CI, Echeverría LE, Luna P, RECOLFACA GI. Registro colombiano de falla cardiaca (RECOLFACA): metodología y datos preliminares. Revista Colombiana de Cardiología. 2022 May 25;28(3).Kurmani S, Squire I. Acute Heart Failure: Definition, Classification and Epidemiology. Curr Heart Fail Rep. 2017 Oct 7;14(5):385–92.Bozkurt B, Savarese G, Adamsson Eryd S, Bodegård J, Cleland JGF, Khordoc C, et al. Mortality, Outcomes, Costs, and Use of Medicines Following a First Heart Failure Hospitalization. JACC Heart Fail. 2023 Jun;Targher G, Dauriz M, Laroche C, Temporelli PL, Hassanein M, Seferovic PM, et al. In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the <scp>ESC‐HFA</scp> Heart Failure Long‐Term Registry. Eur J Heart Fail. 2017 Jan 28;19(1):54–65.Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, et al. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail. 2021 Apr;14(4).Verdu‐Rotellar J, Abellana R, Vaillant‐Roussel H, Gril Jevsek L, Assenova R, Kasuba Lazic D, et al. Risk stratification in heart failure decompensation in the community: HEFESTOS score. ESC Heart Fail. 2022 Feb 22;9(1):606–13.Bo X, Zhang Y, Liu Y, Kharbuja N, Chen L. Performance of the heart failure risk scores in predicting 1 year mortality and short‐term readmission of patients. ESC Heart Fail. 2023 Feb 3;10(1):502–17.Arrigo M, Gayat E, Parenica J, Ishihara S, Zhang J, Choi D, et al. Precipitating factors and 90‐day outcome of acute heart failure: a report from the intercontinental GREAT registry. Eur J Heart Fail [Internet]. 2017 Feb 28;19(2):201–8.Swat SA, Xu H, Allen LA, Greene SJ, DeVore AD, Matsouaka RA, et al. Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. 2023 Aug;11(8):918–29.Brooksbank JA, Faulkenberg KD, Tang WHW, Martyn T. Novel Strategies to Improve Prescription of Guideline-Directed Medical Therapy in Heart Failure. Curr Treat Options Cardiovasc Med. 2023 May 5;25(5):93–110.Bhatt AS, Varshney AS, Moscone A, Claggett BL, Miao ZM, Chatur S, et al. Virtual Care Team Guided Management of Patients With Heart Failure During Hospitalization. J Am Coll Cardiol [Internet]. 2023 May 2 [cited 2023 Sep 12];81(17):1680–93.Savarese, G., Kishi, T., Vardeny, O., Adamsson Eryd, S., Bodegård, J., Lund, L. H., ... & Bozkurt, B. (2023). Heart failure drug treatment—inertia, titration, and discontinuation: a multinational observational study (EVOLUTION HF). Heart Failure, 11(1), 1-14.Fortich, F., Morón, A. O., de La Cruz, B. B., Roa, J. R., Orego, D. H., Gándara, J., ... & Sánchez, J. M. S. (2020). Factores de riesgo para mortalidad en falla cardiaca aguda. Análisis de árbol de regresión y clasificación. Revista Colombiana de Cardiología, 27(1), 20-28.instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURFalla cardíacaCiencias de la implementaciónAdherencia a guíasOptimización de terapia médicaInercia médicaHeart failureImplementation scienceGuideline adherenceMedical therapy optimizationMedical inertiaCambio en la terapia médica de falla cardiaca posterior a una hospitalización en un centro cardiovascularAdjustments in Heart Failure Medical Therapy Following Hospitalization at a Cardiovascular CenterbachelorThesisTrabajo de gradoTrabajo de gradohttp://purl.org/coar/resource_type/c_7a1fEscuela de Medicina y Ciencias de la SaludBogotáLICENSElicense.txtlicense.txttext/plain1483https://repository.urosario.edu.co/bitstreams/381ebbfd-bf39-41c2-803c-9ff9decc593e/downloadb2825df9f458e9d5d96ee8b7cd74fde6MD52CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81154https://repository.urosario.edu.co/bitstreams/ea19a8af-20bd-46eb-b322-32cd25dfe906/downloadadb7af3ef071a784ffe1b544b9a344abMD53ORIGINALCambio_en_la_terapia_medica.pdfCambio_en_la_terapia_medica.pdfapplication/pdf612877https://repository.urosario.edu.co/bitstreams/6e956abc-4b4e-4478-a180-404f73a00175/downloadcd83efb3e0c0fe7947f37af110b05a7bMD54TEXTCambio_en_la_terapia_medica.pdf.txtCambio_en_la_terapia_medica.pdf.txtExtracted texttext/plain93538https://repository.urosario.edu.co/bitstreams/03138475-5885-43bd-b195-56c98a67af2e/downloadacbd5eb0227d98452e4038f30d814d6bMD55THUMBNAILCambio_en_la_terapia_medica.pdf.jpgCambio_en_la_terapia_medica.pdf.jpgGenerated Thumbnailimage/jpeg2257https://repository.urosario.edu.co/bitstreams/9e74fe6b-31dc-4ef3-a218-451e51b2a63b/downloadf85375936348c31e29283393288815cbMD5610336/43278oai:repository.urosario.edu.co:10336/432782024-08-15 03:03:53.855http://creativecommons.org/licenses/by-sa/4.0/Attribution-ShareAlike 4.0 Internationalhttps://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.coRUwoTE9TKSBBVVRPUihFUyksIG1hbmlmaWVzdGEobWFuaWZlc3RhbW9zKSBxdWUgbGEgb2JyYSBvYmpldG8gZGUgbGEgcHJlc2VudGUgYXV0b3JpemFjacOzbiBlcyBvcmlnaW5hbCB5IGxhIHJlYWxpesOzIHNpbiB2aW9sYXIgbyB1c3VycGFyIGRlcmVjaG9zIGRlIGF1dG9yIGRlIHRlcmNlcm9zLCBwb3IgbG8gdGFudG8gbGEgb2JyYSBlcyBkZSBleGNsdXNpdmEgYXV0b3LDrWEgeSB0aWVuZSBsYSB0aXR1bGFyaWRhZCBzb2JyZSBsYSBtaXNtYS4KPGJyLz4KUEFSQUdSQUZPOiBFbiBjYXNvIGRlIHByZXNlbnRhcnNlIGN1YWxxdWllciByZWNsYW1hY2nDs24gbyBhY2Npw7NuIHBvciBwYXJ0ZSBkZSB1biB0ZXJjZXJvIGVuIGN1YW50byBhIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBzb2JyZSBsYSBvYnJhIGVuIGN1ZXN0acOzbiwgRUwgQVVUT1IsIGFzdW1pcsOhIHRvZGEgbGEgcmVzcG9uc2FiaWxpZGFkLCB5IHNhbGRyw6EgZW4gZGVmZW5zYSBkZSBsb3MgZGVyZWNob3MgYXF1w60gYXV0b3JpemFkb3M7IHBhcmEgdG9kb3MgbG9zIGVmZWN0b3MgbGEgdW5pdmVyc2lkYWQgYWN0w7phIGNvbW8gdW4gdGVyY2VybyBkZSBidWVuYSBmZS4KPGhyLz4KRUwgQVVUT1IsIGF1dG9yaXphIGEgTEEgVU5JVkVSU0lEQUQgREVMIFJPU0FSSU8sICBwYXJhIHF1ZSBlbiBsb3MgdMOpcm1pbm9zIGVzdGFibGVjaWRvcyBlbiBsYSBMZXkgMjMgZGUgMTk4MiwgTGV5IDQ0IGRlIDE5OTMsIERlY2lzacOzbiBhbmRpbmEgMzUxIGRlIDE5OTMsIERlY3JldG8gNDYwIGRlIDE5OTUgeSBkZW3DoXMgbm9ybWFzIGdlbmVyYWxlcyBzb2JyZSBsYSBtYXRlcmlhLCAgdXRpbGljZSB5IHVzZSBsYSBvYnJhIG9iamV0byBkZSBsYSBwcmVzZW50ZSBhdXRvcml6YWNpw7NuLgoKLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0KClBPTElUSUNBIERFIFRSQVRBTUlFTlRPIERFIERBVE9TIFBFUlNPTkFMRVMuIERlY2xhcm8gcXVlIGF1dG9yaXpvIHByZXZpYSB5IGRlIGZvcm1hIGluZm9ybWFkYSBlbCB0cmF0YW1pZW50byBkZSBtaXMgZGF0b3MgcGVyc29uYWxlcyBwb3IgcGFydGUgZGUgTEEgVU5JVkVSU0lEQUQgREVMIFJPU0FSSU8gIHBhcmEgZmluZXMgYWNhZMOpbWljb3MgeSBlbiBhcGxpY2FjacOzbiBkZSBjb252ZW5pb3MgY29uIHRlcmNlcm9zIG8gc2VydmljaW9zIGNvbmV4b3MgY29uIGFjdGl2aWRhZGVzIHByb3BpYXMgZGUgbGEgYWNhZGVtaWEsIGNvbiBlc3RyaWN0byBjdW1wbGltaWVudG8gZGUgbG9zIHByaW5jaXBpb3MgZGUgbGV5LiBQYXJhIGVsIGNvcnJlY3RvIGVqZXJjaWNpbyBkZSBtaSBkZXJlY2hvIGRlIGhhYmVhcyBkYXRhICBjdWVudG8gY29uIGxhIGN1ZW50YSBkZSBjb3JyZW8gaGFiZWFzZGF0YUB1cm9zYXJpby5lZHUuY28sIGRvbmRlIHByZXZpYSBpZGVudGlmaWNhY2nDs24gIHBvZHLDqSBzb2xpY2l0YXIgbGEgY29uc3VsdGEsIGNvcnJlY2Npw7NuIHkgc3VwcmVzacOzbiBkZSBtaXMgZGF0b3MuCg==

Publicaciones similares