Update: Acute Heart Failure (I)Acute Heart Failure: Epidemiology, Risk Factors, and PreventionInsuficiencia cardiaca aguda: epidemiología, factores de riesgo y prevención
Introduction
Acute heart failure (AHF) is the rapid development or change of signs and symptoms of heart failure that requires medical attention and usually leads to patient hospitalization.1, 2, 3 Acute heart failure represents the first cause of hospital admission in elderly persons in the western world and, despite advances in medical and device therapy, it still has unacceptably high morbidity and mortality rates. As a result, AHF represents a major public health issue, an enormous financial burden, and a challenge for current cardiovascular research.3
Section snippets
Epidemiology
A number of large-scale registries, such as the ADHERE4, 5, 6 and OPTIMIZE-HF performed in the United States,4, 5, 6, 7 the EHFS I and II8, 9, 10 and the ESC-HF Pilot registry performed in Europe,8, 9, 10, 11 as well as the international ALARM-HF12 have provided us with some epidemiological evidence on AHF.
Patients admitted for AHF are aged > 70 years and about half of them are male. Most have a previous history a heart failure, while de novo AHF represents only one-fourth to one-third of
Risk factors
Several cardiovascular and noncardiovascular conditions may cause a rapid development or deterioration of signs and symptoms of heart failure leading to hospitalization. A detailed list of the causes and precipitating factors leading to AHF is provided in Table 3. Heart failure accounts for less than half of readmission causes. More specifically, according to the EVEREST trial, 46% of patients are admitted because of heart failure, while 39% are hospitalized because of noncardiovascular
Prevention
Primary prevention of AHF concerns the prevention and early diagnosis and treatment of the causes of heart failure (Table 3) and mainly of cardiovascular risk factors and heart disease. Coronary artery disease is the cause in two-thirds of heart failure patients, particularly those with reduced LVEF, while arterial hypertension is found in approximately 70% of patients, particularly those with preserved LVEF.3 Therefore, timely and effective treatment of risk factors for atherosclerosis,
CONFLICT OF INTERESTS
G. Filippatos is a member of steering committees of acute heart failure trials sponsored by Novartis, Cardiorentis, the European Union and Bayer. J. Parissis has received fees for conference presentations from Novartis International.
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