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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Pro?le of hospitalized patients with heart failure admitted in an intensive care department of a tertiary care hospital
Session:
Painel 2 - Insuficiência Cardíaca 10
Speaker:
Ana Rita Moura
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
11. Acute Heart Failure
Subtheme:
11.2 Acute Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Ana Rita Moura; Marta Reina-Couto; Roncon de Albuquerque; José Artur Paiva
Abstract
<p><strong>Introduction</strong>: Heart failure (HF) is one of the major clinical challenges of public health, being the most common cardiovascular reason for hospital admission for people older than 60 years of age. In recent years there has been an evolution regarding the supportive measures that can be offered to these patients. Data about the epidemiology and prognosis of acute HF in the contemporary era is lacking in Portugal. <strong>Aim</strong>: to analyse the profile of the patients with acute HF admitted to an intermediate/intensive care unit (ICU) at a tertiary Portuguese hospital centre.</p> <p><strong>Methods</strong>: retrospective study of patients admitted at an ICU with the diagnosis of acute HF between January and December of 2018 of a tertiary care hospital. Patients were analysed regarding epidemiological data, aetiology, precipitant factors and in-hospital prognosis.</p> <p><strong>Results</strong>: 239 patients were included in the analysis, predominantly men (60.7%), with a mean age of 69.5±14.8 years old. The majority was admitted directly from the emergency department (67.4%). A high burden of cardiovascular risk factors was present with hypertension (71.1%), dyslipidemia (59.0%) and diabetes (40.2%) being the most prevalent ones. The majority did not have a previous known diagnosis of HF (59.9%). Ischaemic disease was the most prevalent underlying cause (27.6%), followed by primary valvular disease (11.3%). The most common precipitant factors were acute coronary syndrome (35.6%), infection (13.4%) and arrhythmia (12.6%). The mean maximum BNP was 1333.0±104 pg/mL, and the mean ejection fraction at admission was 37.5±16.9%. MCS was needed in 9.6% of the patients, with Veno-Arterial ExtraCorporeal Membrane Oxygenation (ECMO-VA) being the most used one (7.1%) with a mean duration of 12±6.7 days. ECMO-VA patients had a mean age of 45.2±15.4 years old, were predominantly men (64.7%), with previous unknow HF (82.4%) with myocarditis as the most common cause of admission (29.4%). Mean length of ICU stay for the overall group was 5.8±7.2 days and a high in-hospital mortality rate of 23.4% was found. Cardiogenic shock unresponsive to the therapeutic measures (56.1%) and septic shock (17.1%) were the main causes of death.</p> <p><strong>Conclusions</strong>: in this group of patients with high risk acute HF, ischemic heart disease prevailed as the most common aetiology and cause of decompensation. MCS was used in younger patients, with less comorbidities and myocarditis was the main diagnosis in a strategy of bridge to recovery. In-hospital mortality was significant with infection assuming a highly relevant role in the prognostic definition alongside with the severity of the underlying cardiac disease.</p>
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