Cor Vasa 2015, 57(1):e6-e11 | DOI: 10.1016/j.crvasa.2014.12.002

Comparison of hospitalized and ambulatory patients with heart failure in the Czech Republic and Europe. Data from the ESC Heart Failure Long-Term Registry

Jan Krupička^a,*, Anna Andrusková^b, Markéta Hegarová^c, Marie Lazarová^d, Filip Málek^e, Monika Mikolášková^f, Hana Poloczková^g, Dagmar Vondráková^e, Jaromír Hradec^a

^a III. interní klinika, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha, Česká republika

^b Interní oddělení, Nemocnice Znojmo, Znojmo, Česká republika

^c Klinika kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

^d I. interní klinika - kardiologická, Fakultní nemocnice Olomouc, Olomouc, Česká republika

^e Kardiologické oddělení, Nemocnice Na Homolce, Praha, Česká republika

^f Interní kardiologická klinika, Fakultní nemocnice Brno, Brno, Česká republika

^g I. interní kardioangiologická klinika, Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

Introduction: The ESC Heart Failure Long-Term Registry (ESC-HFLTR) is a prospective observational study which takes place in 211 cardiology centres of 21 European and Mediterranean countries, members of the European Society of Cardiology.

Aim: To compare basic demographic and clinical characteristics of both, the patients hospitalized for acute heart failure and the patients observed in outpatient clinics for chronic heart failure in the Czech Republic with published European-wide data.

Methods: Altogether 692 consecutive patients were included in the Czech part of ESC-HFLTR (5.6% of the whole registry) from May 2011 to April 2013. These patients were either admitted to hospital or examined in the outpatient clinic for HF during one predefined day of the week. The basic characteristics of 160 hospitalized (25.3%) and 532 ambulatory (74.7%) patients were analysed statistically, compared with each other and finally contrasted with available data from the whole ESC-HFLTR.

Results: Czech in-hospital patients were generally older than the ambulatory patients with HF (73 vs. 66 years; p < 0.001) and were less frequently men (62.5 vs. 75.7%). They had also significantly higher incidence of comorbidities. On the contrary, the outpatients underwent more often pacemaker implantation and coronary revascularization than hospitalized patients. The dominant HF aetiology was ischaemic in both groups. The HF with preserved ejection fraction was more frequently represented among the hospitalized HF patients. On the other hand, more ambulatory patients had dilated cardiomyopathy as the primary cause of HF. In comparison with the data from the whole ESC-HFLTR Czech HF patients in both groups had significantly higher body weight, systolic blood pressure and higher incidence of comorbidities. In addition, they had more frequently implanted a pacemaker.

Conclusion: Czech HF patients had worse cardiovascular risk profile as well as higher incidence of comorbidities compared to the patients from the whole ESC-HFLTR.

Keywords: Comorbidities; Demography; Heart failure; Outpatient clinics; Risk profile

Received: October 15, 2014; Revised: November 25, 2014; Accepted: December 1, 2014; Published: February 1, 2015  Show citation