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Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(4): 195-200, jul.-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199466

RESUMO

INTRODUCCIÓN: La última guía de insuficiencia cardiaca (IC) de la Sociedad Europea de Cardiología define 3 tipos de IC según la fracción de eyección (FE): FE reducida (ICFEr) cuando FE<40%, FE intermedia (ICFEi), cuando FE 40-49%, y FE conservada (ICFEc) cuando FE≥50%. El objetivo es analizar las características y resultados de los ancianos ingresados con IC según la nueva categorización por la FE. MÉTODOS: Estudio prospectivo con 531 pacientes diagnosticados de IC, categorizados según la FE, mayores de 75 años e ingresados en 6 servicios de Geriatría en España. Se analizan las características demográficas, clínicas y las comorbilidades, así como la morbimortalidad al año de seguimiento. RESULTADO: Un 17,1% de los pacientes se encuadraron en ICFEr, 10% en ICFEi y 72,9% en ICFEc. Aquellos con ICFEi eran similares a los de ICFEr en cuanto a la menor edad, predominio de hombres e ingreso previo por IC, así como en el uso de fármacos para el bloqueo neurohormonal. En los pacientes con ICFEr, respecto a aquellos con ICFEi e ICFEc, se objetivó mayor porcentaje de muertes (35,2, 24,5 y 25,1%), reingresos por IC (17,6, 15,1 y 14,2%) y eventos (59,3, 45,3 y 50,6%), aunque no hubo diferencias significativas. Tampoco se observaron diferencias en el análisis de supervivencia entre los grupos de FE y las variables de resultados tiempo-dependientes. CONCLUSIONES: En ancianos hospitalizados con IC, los categorizados como ICFEi no muestran claras diferencias en las características clínicas respecto a aquellos con ICFEr o ICFEc. No hubo diferencias en cuanto a la morbimortalidad


INTRODUCTION: The latest European Society of Cardiology Heart Failure (HF) guidelines define three types of HF according to the ejection fraction (EF): HF with reduced EF (HFrEF) when EF<40%, HF with mid-range EF (HFmrEF), when EF 40-49%, and HF with preserved EF (HFpEF) when EF≥50%. The objective of this study was to analyse the characteristics and results of elderly patients hospitalised with HF according to the new classification using EF. METHODS: A prospective study was carried out with 531 HF patients aged ≥75 years classified according to EF, and admitted in the geriatric wards of 6 hospitals in Spain. An analysis was performed on the demographic and clinical characteristics, as well as well as the morbidity and mortality at one year of follow-up. RESULTS: As regards EF, 17.1% had HFrEF, 10% had HFmrEF, and 72.9% had HFpEF. Patients with HFmrEF were more similar to those with HFrEF in terms of a younger age, predominance of men, and previous admission due to HF. This was also the case with the use of drugs for neurohormonal blockade. Patients with HFrEF (compared to those with HFmrEF and HFpEF), had higher mortality (35.2%, 24.5%, and 25.6%, respectively), more readmissions for HF (17.6%, 15.1%, and 14.5%, respectively), and more events (61.5%, 45.3%, and 52.5%, respectively), although there were no significant differences. There were also no differences observed in the survival analysis between the EF groups and the time-dependent outcome variables. CONCLUSIONS: In elderly patients hospitalised with HF, those classified as HFmrEF did not show any clear differences with respect to those with HFrEF or HFpEF. There were no differences in terms of morbidity and mortality


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/fisiopatologia , Volume Sistólico/fisiologia , Disfunção Ventricular Esquerda/diagnóstico , Idoso de 80 Anos ou mais/fisiologia , Resultado do Tratamento , Função Ventricular Esquerda/fisiologia , Estudos Prospectivos , Pacientes Internados/estatística & dados numéricos , Insuficiência Cardíaca/classificação , Indicadores de Morbimortalidade
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