Estudio PAPRICA-2: papel del factor precipitante del episodio de insuficiencia cardiaca aguda en el pronóstico a medio plazo

• Autores: Óscar Miró Andreu, Alfonso Aguirre Tejedo, Pablo Herrero Puente, Javier Jacob Rodríguez, Francisco Javier Martín Sánchez, Pere Llorens Soriano
• Localización: Medicina clínica, ISSN 0025-7753, Vol. 145, Nº. 9, 2015, págs. 385-389
• Idioma: español
• DOI: 10.1016/j.medcli.2015.01.014
• Títulos paralelos:
  • PAPRICA-2 study: Role of precipitating factor of an acute heart failure episode on intermediate term prognosis
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• Resumen

  • Objective To evaluate the precipitating factors (PF) associated with acute heart failure and their association with medium-term prognosis.

    Patients and methods Multipurpose prospective study from the EAHFE Registry. We included as PF: infection, rapid atrial fibrillation (RAF), anaemia, hypertensive crisis, non-adherence to diet or drug therapy and non-ST-segment-elevation acute coronary syndrome (NSTEACS). Patients without PF were control group. Hazard ratios (HR) crudes and adjusted for reconsultations and mortality at 90 days were calculated.

    Results 3535 patients were included: 28% without and 72% with PF. Patients with RAF (HR 0.67; 95%CI 0.50-0.89) and hypertensive crisis (HR 0.45; 95%CI 0.28-0.72) had less mortality and patients with NSTEACS (HR 1.79; 95%CI 1.19-2.70) had more mortality. Reconsultation was fewer in patients with infection (HR 0.74; 95%CI 0.64-0.85), RAF (HR 0.69; 95%CI 0.58-0.83) and hypertensive crisis (HR 0.71; 95%CI 0.55-0.91). These differences were maintained in all the adjusted models except for hypertensive crisis.

    Conclusions One PF is identified in 3 out of 4 patients and it may influence medium-term prognosis. At 90 days, NSTEACS and RAF were associated with more and less mortality respectively, and RAF and infection with less probability of reconsultation.