Perfil epidemiológico, clínico y terapéutico de la insuficiencia cardíaca en hospital terciario

Abstract

Background: Heart failure is a complex syndrome with multiple risk factors involved in its genesis, making its prevention and management difficult to achieve. Objective: To identify the main etiologies and risk factors in heart failure; to compare clinical and demographic characteristics of patients according to the etiology; analyze whether the treatment is according to that recommended by the Brazilian guidelines. Methods: Retrospective, descriptive and observational study, carried out at Hospital das Clínicas of Universidade Federal de Goiás. The patients were divided in four groups, according to the etiology, for comparison: chagasic cardiomyopathy, hypertensive cardiomyopathy, dilated cardiomyopathy and others, ischemic cardiomyopathy. The Chi-square and Fisher's Exact tests, ANOVA and Kruskal-Wallis tests were used in the analysis of the groups and types of treatment. Results: A total of 144 patients' files were analyzed; the patients' mean age was 61 ± 15 years and 54.2% of them were males. Chagasic cardiomyopathy was the main etiology (41%). Arterial hypertension (48.6%), anemia (22.9%), coronary disease (19.4%), dyslipidemia (17.3%) and diabetes (16.6%) were the main risk factors. There was a higher prevalence of female individuals among the hypertensive patients (p=0.044) as well as a higher frequency of pulmonary rales (p<0.01). Heart rate was lower among chagasic patients (p<0.001). The most often prescribed medications were diuretics (81.2%), angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers (77.7%), beta-blockers (45.8%), spironolactone (35.4%), digitalis (30.5%) and vasodilators (8.3%). Conclusion: Chagasic cardiomyopathy was the main cause of heart failure. No significant clinical differences were observed among patients from the four etiologic groups.