In-Hospital Management and Long-term Clinical Outcomes and Adherence in Patients With Acute Decompensated Heart Failure: Primary Results of the First Brazilian Registry of Heart Failure (BREATHE)

J Card Fail. 2024 May;30(5):639-650. doi: 10.1016/j.cardfail.2023.08.014. Epub 2023 Aug 28.

Abstract

Background: Heart failure (HF), a common cause of hospitalization, is associated with poor short-term clinical outcomes. Little is known about the long-term prognoses of patients with HF in Latin America.

Methods: BREATHE was the first nationwide prospective observational study in Brazil that included patients hospitalized due to acute heart failure (HF). Patients were included during 2 time periods: February 2011-December 2012 and June 2016-July 2018 In-hospital management, 12-month clinical outcomes and adherence to evidence-based therapies were evaluated.

Results: A total of 3013 patients were enrolled at 71 centers in Brazil. At hospital admission, 83.8% had clear signs of pulmonary congestion. The main cause of decompensation was poor adherence to HF medications (27.8%). Among patients with reduced ejection fraction, concomitant use of beta-blockers, renin-angiotensin-aldosterone inhibitors and spironolactone decreased from 44.5% at hospital discharge to 35.2% at 3 months. The cumulative incidence of mortality at 12 months was 27.7%, with 24.3% readmission at 90 days and 44.4% at 12 months.

Conclusions: In this large national prospective registry of patients hospitalized with acute HF, rates of mortality and readmission were higher than those reported globally. Poor adherence to evidence-based therapies was common at hospital discharge and at 12 months of follow-up.

Keywords: heart failure; prescriptions; prognosis; registries.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • Disease Management
  • Female
  • Follow-Up Studies
  • Heart Failure* / drug therapy
  • Heart Failure* / therapy
  • Hospitalization* / statistics & numerical data
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Prospective Studies
  • Registries*
  • Time Factors
  • Treatment Outcome