The Romanian Acute Heart Failure Syndromes (RO-AHFS) Registry

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• 作者：Ovidiu Chioncel MD^a ; ⁱ ; Dragos Vinereanu MD^b ; ⁱ ; Mihai Datcu MD^c ; ⁱ ; Dan Dominic Ionescu MD^d ; ⁱ ; Radu Capalneanu MD^e ; ⁱ ; Ioan Brukner MD^f ; ⁱ ; Maria Dorobantu MD^g ; ⁱ ; Andrew Ambrosy BS^h ; ⁱ ; Cezar Macarie MD^a ; ⁱ ; Mihai Gheorghiade MD^h ; ⁱ ; ^{ochioncel@yahoo.co.uk"" rel=""nofollow}
• 刊名：American Heart Journal
• 出版年：2011
• 出版时间：July 2011
• 年：2011
• 卷：162
• 期：1
• 页码：142-153.e1
• 全文大小：392 K

文摘

Aims

The objective of the RO-AHFS registry was to evaluate the epidemiology, clinical presentation, inpatient management, and hospital course in a population hospitalized for acute heart failure syndromes.

Methods

During a 12-month period, 13 Romanian medical centers enrolled all consecutive patients hospitalized with a primary diagnosis of AHFS. Patients were classified into the following 5 clinical profiles at admission: acute decompensated heart failure, cardiogenic shock, pulmonary edema, right heart failure, and hypertensive heart failure. Statistical significance was assessed using Fisher exact test or the χ² test for categorical variables and a 1-way analysis of variance for continuous variables. Independent predictors of in-hospital all-cause mortality (ACM) were identified using a multivariate logistic regression model.

Results

A total of 3,224 consecutive patients hospitalized with AHFS were enrolled. The cohort had a mean age of 69.2 ± 11.8 years and 56 % were men. The mean left ventricular ejection fraction was 37.7 % ± 12.5 % . The percentage of patients treated with evidence-based heart failure therapies increased from admission to discharge, but even at discharge, only 56 % , 66 % , and 54 % of patients were on a β-blocker, an angiotensin-converting enzyme inhibitors or an angiotensin receptor blocker, and a mineralocorticoid receptor antagonist, respectively. In-hospital ACM was 7.7 % with substantial variation between sites (4.1 % -11.0 % ). Increasing age, inotrope therapy, the presence of life-threatening ventricular arrhythmias, and elevated baseline blood urea nitrogen were all found to be independent risk factors for in-hospital ACM, whereas elevated systolic blood pressure and baseline treatment with a β-blocker had a protective effect.

Conclusions

The RO-AHFS study found substantial variation both among sites and between Romania and other European countries. National and regional registries have important clinical implications for patient care and the design and conduct of global clinical trials.