Introducción
En los países occidentales, se estima que entre una a dos personas por cada 100 adultos tienen diagnóstico de insuficiencia cardíaca. En América Latina, y particularmente en Ecuador, existen pocos estudios que hayan evaluado la sobrevida respecto a esta enfermedad. Por este motivo, este estudio se realizó con el fin de determinar los factores relacionados con la supervivencia y el pronóstico, en función de las características clínicas y sociodemográficas de los pacientes con insuficiencia cardiaca.

Métodos
Hicimos un estudio unicéntrico de supervivencia efectuado en 228 pacientes con insuficiencia cardíaca entre los años 2015-2019. El análisis de supervivencia se realizó mediante el método actuarial y por el método de regresión multivariada de Cox.

Resultados
La supervivencia global al año fue del 86% y a los cinco años fue del 46%. Variables como la etiología de la insuficiencia cardíaca (hazard ratio 1,162; intervalo de confianza 95%, 1,001 a 1,349; P = 0,049); la etnia (1,415; 10,1 a 199; P = 0,043), la edad (1,035, 1,011 a 1,06; P = 0,04) y los valores alterados de creatinina basal (1,21; 1,002 a 1,461; P = 0,048) se asociaron como factores de peor pronóstico.

Conclusiones
El tiempo de supervivencia global fue similar al reportado en estudios internacionales. Por otro lado, la etiología, la etnia, los valores de creatinina y la edad fueron factores asociados a un peor pronóstico vital.

Authors: Alvaro Francisco Gudiño-Gomezjurado[1], René Buitrón-Andrade[2]

Affiliation:
[1] Internal Medicine Service, Hospital General San Vicente de Paúl, Ibarra, Ecuador
[2] Epidemiology and biostatistic, Pontificia Universidad Católica del Ecuador, Quito, Ecuador

E-mail: alvaro.gudino@hsvp.gob.ec

Author address:
[1] Luís Vargas Torres 1156,
Ibarra, Ecuador
Postal code: 100105

Citation: Gudiño-Gomezjurado AF, Buitrón-Andrade R. Survival analysis of patients with heart failure in the Ecuadorian Andean population. Medwave 2021;21(07):e8440 doi: 10.5867/medwave.2021.07.8440

Submission date: 22/1/2021

Acceptance date: 5/7/2021

Publication date: 16/8/2021

Origin: Not commissioned.

Type of review: Externally peer-reviewed by three reviewers, double-blind.

Comments (0)

We are pleased to have your comment on one of our articles. Your comment will be published as soon as it is posted. However, Medwave reserves the right to remove it later if the editors consider your comment to be: offensive in some sense, irrelevant, trivial, contains grammatical mistakes, contains political harangues, appears to be advertising, contains data from a particular person or suggests the need for changes in practice in terms of diagnostic, preventive or therapeutic interventions, if that evidence has not previously been published in a peer-reviewed journal.

No comments on this article.

---

To comment please log in

Medwave provides HTML and PDF download counts as well as other harvested interaction metrics.

There may be a 48-hour delay for most recent metrics to be posted.

1. Taylor CJ, Ryan R, Nichols L, Gale N, Hobbs FR, Marshall T. Survival following a diagnosis of heart failure in primary care. Fam Pract. 2017 Apr 1;34(2):161-168. | CrossRef | PubMed |
2. Crespo-Leiro MG, Anker SD, Maggioni AP, Coats AJ, Filippatos G, Ruschitzka F, et al. European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions. Eur J Heart Fail. 2016 Jun;18(6):613-25. | CrossRef | PubMed |
3. Bocchi EA, Arias A, Verdejo H, Diez M, Gómez E, Castro P; Interamerican Society of Cardiology. The reality of heart failure in Latin America. J Am Coll Cardiol. 2013 Sep 10;62(11):949-58. | CrossRef | PubMed |
4. Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, et al. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Health. 2017 Jul;5(7):e665-e672. | CrossRef | PubMed |
5. Villacís B, Carrillo D. Estadística Demográfica en el Ecuador: Diagnóstico y Propuestas. Inec; 2011;86. [Internet] | Link |
6. Maggioni AP. Epidemiology of Heart Failure in Europe. Heart Fail Clin. 2015 Oct;11(4):625-35. | CrossRef | PubMed |
7. Cowie MR, Wood DA, Coats AJ, Thompson SG, Suresh V, Poole-Wilson PA, et al. Survival of patients with a new diagnosis of heart failure: a population based study. Heart. 2000 May;83(5):505-10. | CrossRef | PubMed |
8. Taylor CJ, Ordóñez-Mena JM, Roalfe AK, Lay-Flurrie S, Jones NR, Marshall T, et al. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019 Feb 13;364:l223. | CrossRef | PubMed |
9. Ciapponi A, Alcaraz A, Calderón M, Matta MG, Chaparro M, Soto N, et al. Burden of Heart Failure in Latin America: A Systematic Review and Meta-analysis. Rev Esp Cardiol (Engl Ed). 2016 Nov;69(11):1051-1060. | CrossRef | PubMed |
10. Sarría-Santamera A, Prado-Galbarro FJ, Martín-Martínez MA, Carmona R, Gamiño Arroyo AE, Sánchez-Piedra C, et al. Supervivencia de pacientes con insuficiencia cardiaca en atención primaria [Survival of patients with heart failure in primary care]. Aten Primaria. 2015 Aug-Sep;47(7):438-45. | CrossRef | PubMed |
11. Frigola-Capell E, Comin-Colet J, Davins-Miralles J, Gich-Saladich IJ, Wensing M, Verdú-Rotellar JM. Supervivencia de pacientes ambulatorios con insuficiencia cardiaca crónica del área mediterránea. Un estudio de base poblacional. Rev Esp Cardiol. 2013;66:539–44. | CrossRef |
12. Koudstaal S, Pujades-Rodriguez M, Denaxas S, Gho JMIH, Shah AD, Yu N, et al. Prognostic burden of heart failure recorded in primary care, acute hospital admissions, or both: a population-based linked electronic health record cohort study in 2.1 million people. Eur J Heart Fail. 2017 Sep;19(9):1119-1127. | CrossRef | PubMed |
13. Bocchi EA. Heart failure in South America. Curr Cardiol Rev. 2013 May;9(2):147-56. | CrossRef | PubMed |
14. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002 Oct 31;347(18):1397-402. | CrossRef | PubMed |
15. Gomez-Soto FM, Andrey JL, Garcia-Egido AA, Escobar MA, Romero SP, Garcia- Arjona R, et al. Incidence and mortality of heart failure: a community-based study. Int J Cardiol. 2011 Aug 18;151(1):40-5. | CrossRef | PubMed |
16. Gerber Y, Weston SA, Redfield MM, Chamberlain AM, Manemann SM, Jiang R, et al. A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA Intern Med. 2015 Jun;175(6):996-1004. | CrossRef | PubMed |
17. Taylor CJ, Ordóñez-Mena JM, Roalfe AK, Lay-Flurrie S, Jones NR, Marshall T, et al. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:1–10. | CrossRef | PubMed |
18. Loehr LR, Rosamond WD, Chang PP, Folsom AR, Chambless LE. Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). Am J Cardiol. 2008 Apr 1;101(7):1016-22. | CrossRef | PubMed |
19. Woods JA, Katzenellenbogen JM, Davidson PM, Thompson SC. Heart failure among Indigenous Australians: a systematic review. BMC Cardiovasc Disord. 2012 Nov 1;12:99. | CrossRef | PubMed |
20. Larsson SC, Orsini N, Wolk A. Alcohol consumption and risk of heart failure: a dose-response meta-analysis of prospective studies. Eur J Heart Fail. 2015 Apr;17(4):367-73. | CrossRef | PubMed |
21. Suskin N, Sheth T, Negassa A, Yusuf S. Relationship of current and past smoking to mortality and morbidity in patients with left ventricular dysfunction. J Am Coll Cardiol. 2001 May;37(6):1677-82. | CrossRef | PubMed |
22. Saltzman HE. Arrhythmias and heart failure. Cardiol Clin. 2014 Feb;32(1):125-33, ix. | CrossRef | PubMed |
23. Witt BJ, Brown RD Jr, Jacobsen SJ, Weston SA, Ballman KV, Meverden RA, et al. Ischemic stroke after heart failure: a community-based study. Am Heart J. 2006 Jul;152(1):102-9. | CrossRef | PubMed |
24. Park CS, Park JJ, Oh IY, Yoon CH, Choi DJ, Park HA, et al. Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction: an analysis from the Korean Heart Failure (KorHF) Registry. Korean Circ J. 2017 Sep;47(5):727-741. | CrossRef | PubMed |

Taylor CJ, Ryan R, Nichols L, Gale N, Hobbs FR, Marshall T. Survival following a diagnosis of heart failure in primary care. Fam Pract. 2017 Apr 1;34(2):161-168. | CrossRef | PubMed |

Crespo-Leiro MG, Anker SD, Maggioni AP, Coats AJ, Filippatos G, Ruschitzka F, et al. European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions. Eur J Heart Fail. 2016 Jun;18(6):613-25. | CrossRef | PubMed |

Bocchi EA, Arias A, Verdejo H, Diez M, Gómez E, Castro P; Interamerican Society of Cardiology. The reality of heart failure in Latin America. J Am Coll Cardiol. 2013 Sep 10;62(11):949-58. | CrossRef | PubMed |

Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, et al. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Health. 2017 Jul;5(7):e665-e672. | CrossRef | PubMed |

Villacís B, Carrillo D. Estadística Demográfica en el Ecuador: Diagnóstico y Propuestas. Inec; 2011;86. [Internet] | Link |

Maggioni AP. Epidemiology of Heart Failure in Europe. Heart Fail Clin. 2015 Oct;11(4):625-35. | CrossRef | PubMed |

Cowie MR, Wood DA, Coats AJ, Thompson SG, Suresh V, Poole-Wilson PA, et al. Survival of patients with a new diagnosis of heart failure: a population based study. Heart. 2000 May;83(5):505-10. | CrossRef | PubMed |

Taylor CJ, Ordóñez-Mena JM, Roalfe AK, Lay-Flurrie S, Jones NR, Marshall T, et al. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019 Feb 13;364:l223. | CrossRef | PubMed |

Ciapponi A, Alcaraz A, Calderón M, Matta MG, Chaparro M, Soto N, et al. Burden of Heart Failure in Latin America: A Systematic Review and Meta-analysis. Rev Esp Cardiol (Engl Ed). 2016 Nov;69(11):1051-1060. | CrossRef | PubMed |

Sarría-Santamera A, Prado-Galbarro FJ, Martín-Martínez MA, Carmona R, Gamiño Arroyo AE, Sánchez-Piedra C, et al. Supervivencia de pacientes con insuficiencia cardiaca en atención primaria [Survival of patients with heart failure in primary care]. Aten Primaria. 2015 Aug-Sep;47(7):438-45. | CrossRef | PubMed |

Frigola-Capell E, Comin-Colet J, Davins-Miralles J, Gich-Saladich IJ, Wensing M, Verdú-Rotellar JM. Supervivencia de pacientes ambulatorios con insuficiencia cardiaca crónica del área mediterránea. Un estudio de base poblacional. Rev Esp Cardiol. 2013;66:539–44. | CrossRef |

Koudstaal S, Pujades-Rodriguez M, Denaxas S, Gho JMIH, Shah AD, Yu N, et al. Prognostic burden of heart failure recorded in primary care, acute hospital admissions, or both: a population-based linked electronic health record cohort study in 2.1 million people. Eur J Heart Fail. 2017 Sep;19(9):1119-1127. | CrossRef | PubMed |

Bocchi EA. Heart failure in South America. Curr Cardiol Rev. 2013 May;9(2):147-56. | CrossRef | PubMed |

Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002 Oct 31;347(18):1397-402. | CrossRef | PubMed |

Gomez-Soto FM, Andrey JL, Garcia-Egido AA, Escobar MA, Romero SP, Garcia- Arjona R, et al. Incidence and mortality of heart failure: a community-based study. Int J Cardiol. 2011 Aug 18;151(1):40-5. | CrossRef | PubMed |

Gerber Y, Weston SA, Redfield MM, Chamberlain AM, Manemann SM, Jiang R, et al. A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA Intern Med. 2015 Jun;175(6):996-1004. | CrossRef | PubMed |

Taylor CJ, Ordóñez-Mena JM, Roalfe AK, Lay-Flurrie S, Jones NR, Marshall T, et al. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:1–10. | CrossRef | PubMed |

Loehr LR, Rosamond WD, Chang PP, Folsom AR, Chambless LE. Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). Am J Cardiol. 2008 Apr 1;101(7):1016-22. | CrossRef | PubMed |

Woods JA, Katzenellenbogen JM, Davidson PM, Thompson SC. Heart failure among Indigenous Australians: a systematic review. BMC Cardiovasc Disord. 2012 Nov 1;12:99. | CrossRef | PubMed |

Larsson SC, Orsini N, Wolk A. Alcohol consumption and risk of heart failure: a dose-response meta-analysis of prospective studies. Eur J Heart Fail. 2015 Apr;17(4):367-73. | CrossRef | PubMed |

Suskin N, Sheth T, Negassa A, Yusuf S. Relationship of current and past smoking to mortality and morbidity in patients with left ventricular dysfunction. J Am Coll Cardiol. 2001 May;37(6):1677-82. | CrossRef | PubMed |

Saltzman HE. Arrhythmias and heart failure. Cardiol Clin. 2014 Feb;32(1):125-33, ix. | CrossRef | PubMed |

Witt BJ, Brown RD Jr, Jacobsen SJ, Weston SA, Ballman KV, Meverden RA, et al. Ischemic stroke after heart failure: a community-based study. Am Heart J. 2006 Jul;152(1):102-9. | CrossRef | PubMed |

Park CS, Park JJ, Oh IY, Yoon CH, Choi DJ, Park HA, et al. Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction: an analysis from the Korean Heart Failure (KorHF) Registry. Korean Circ J. 2017 Sep;47(5):727-741. | CrossRef | PubMed |