Availability of prognostic markers for heart failure with preserved ejection fraction in Argentina: a cross-sectional study

POLITI, MARIA TERESA; SPAGNUOLO, DAMIAN NESTOR; CUETO, ABIGAIL; FARINA, JUAN; BORTMAN, GUILLERMO

Sevilla

Congreso; Heart Failure 2015 ? 2nd World Congress on Acute Heart Failure 2015. European Society of Cardiology; 2015

European Society of Cardiology

Purpose: Predictive risk models for heart failure with preserved ejection fraction (HF-PEF) are crucial for guiding clinical management and targeting populations for clinical trials. However, access to prognostic markers is sometimes restricted due to high costs. This survey has been designed to document the level of access to prognostic markers for HF-PEF in hospitals in Argentina. Methods: A survey instrument with 13 multiple-choice questions was developed and validated to assess the availability of prognostic markers for HF-PEF. In a cross-sectional observational study, this survey was applied through face-to-face questioning to Cardiology residents from 66 hospitals attending a national conference in Mar del Plata, Argentina in November 2014. The primary outcome was the prevalence of access restrictions to prognostic markers for HF-PEF. The associations between access restrictions and the hospital?s region and environment were also studied. Results: 57 hospitals completed the survey. 68.4% reported access restrictions to prognostic markers for HF-PEF. Among those with access restrictions, 51.3% reported that natriuretic peptide determinations were unavailable, and 46.2% had restrictions to troponin determinations due to costs. No hospitals reported restrictions concerning echocardiographic determinations. The association between access restrictions and region was statistically significant (χ2 = 7.617, p= 0.006), whereas the association with environment was not. Conclusions: A high proportion of the hospitals in Argentina in our study have access restrictions to prognostic markers for HF-PEF, mainly troponin and natriuretic peptide determinations. Thus, echocardiographic determinations may be a preferable approach towards establishing prognostic strategies in patients with HF-PEF in Argentina.