Burden of Heart Failure In Latin America: A Systematic Review And Meta-Analysis

CIAPPONI A,; BARDACH A,; CALDERON M,; ALCARAZ A,; MATTA MG,; CHAPARRO M

VALUE IN HEALTH

WILEY-BLACKWELL PUBLISHING, INC

Lugar: Londres; Año: 2015

1098-3015

objeCtives: Heart failure (HF) is a common clinical syndrome representing the end-stage of several cardiac diseases. Our objective was to estimate the burden of heart failure in Latin America. Methods: A systematic review and meta-analysis was performed. We searched in MEDLINE, EMBASE, LILACS, and CENTRAL from January 1994 to June 2014. We included non-comparative data from experimental and observational studies. No language restriction was imposed. We included stud-ies with samples of at least 50 participants of 18 years of age or older with HF. The outcomes analyzed were incidence, prevalence, hospitalization rates and case fatal-ity ratios of HF at different time points, length of stay and mortality. Results: The search retrieved 4792 references of which 143 studies were finally included. Mostwere conducted in South America (92%), particularly in Brazil (64%). The mean age was 60 ± 9 years and the mean ejection fraction was 36 ± 9%. Most studies evalu-ated more than one etiology (79%) but the etiology more studies exclusively was Chagas disease (13%). The incidence of HF ranged from 199 to 557 cases per 100,000 person-years and the pooled prevalence was 1%, being higher in older populations. Hospitalization rates in patients with HF ranged from 28 to 31% at different time points, and the median length of stay was 7.0 days. In-hospital mortality was 11.7%, being higher in patients with worse ejection fraction, with ischemic and with Chagas disease. Mortality at one year was 24.52% (95%CI 19.42 to 30.02). ConClusions: This SR of HF in Latin America, could help decision-makers to design better preven-tive strategies, and guide effective patient-centered care.