Epidemiology and treatment of heart failure in Spain: the HF-PATHWAYS study

Introduction and objectives: To describe the epidemiology and treatment of a large contemporary cohort of patients with heart failure (HF). Methods: Observational, retrospective, population-based study using the BIG-PAC database, which includes people aged > 18 years seeking care for HF between 2017 and 2019. The main variables were the prevalence/annual incidence rate, comorbidities, clinical variables, and medication administered. Results: We identified 19 762 patients with HF from a total of 1 189 003 persons seeking medical attention from 2017 to 2019 (2019: mean age, 78.3 years; 53.0% men). Distribution by type of left ventricular ejection fraction (LVEF) was as follows: 51.7% reduced, 40.2% preserved, and 8.1% mid-range. In 2019, the prevalence was 1.89% (95%CI, 1.70-2.08), with an incidence rate of 2.78 new cases per 1000 persons/y. No statistically significant differences were observed in prevalence and/or incidence from 2017 to 2019. Among patients with HF with reduced ejection fraction (HFrEF), 64% received betablockers, 80.5% angiotensin-converting enzyme inhibitor/angiotensin receptor blockers or sacubitrilvalsartan, and 29.8% an aldosterone antagonist. In addition, from the diagnosis (baseline) to 24 months of follow-up, there was discreet treatment optimization, which was notable in the first 3 to 6 months. Conclusions: Epidemiological data on HF remained stable during the study period, with a lower prevalence than that reported in non-population-based studies. There is wide room for improvement in the optimization of medical treatment of HFrEF. (C) 2020 Sociedad Espanola de Cardiologi acute accent a. Published by Elsevier Espana, S.L.U. All rights reserved.

Automated summary

This study describes the epidemiology and treatment of a large contemporary cohort of heart failure patients. The results show that the epidemiological data on heart failure remained stable during the study period, with a lower prevalence than reported in non-population-based studies. There is room for improvement in the optimization of medical treatment for heart failure patients.