Impacto pronóstico de la especialidad en el paciente ambulatorio con insuficiencia cardiaca: un análisis emparejado de los registros REDINSCOR y RICA

Translated title of the contribution: Prognostic Impact of Physician Specialty on the Prognosis of Outpatients With Heart Failure: Propensity Matched Analysis of the REDINSCOR and RICA Registries

en representación de los grupos REDINSCOR y RICA

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Introduction and objectives The specialty treating patients with heart failure (HF) has a prognostic impact in the hospital setting but this issue remains under debate in the ambulatory environment. We aimed to compare the clinical profile and outcomes of outpatients with HF treated by cardiologists or internists. Methods We analyzed the clinical, electrocardiogram, laboratory, and echocardiographic data of 2 prospective multicenter Spanish cohorts of outpatients with HF treated by cardiologists (REDINSCOR, n = 2150) or by internists (RICA, n = 1396). Propensity score matching analysis was used to test the influence of physician specialty on outcome. Results Cardiologist-treated patients were often men, were younger, and had ischemic etiology and reduced left ventricular ejection fraction (LVEF). Patients followed up by internists were predominantly women, were older, and a higher percentage had preserved LVEF and associated comorbidities. The 9-month mortality was lower in the REDINSCOR cohort (11.6% vs 16.9%; P < .001), but the 9-month HF-readmission rates were similar (15.7% vs 16.9%; P = .349).The propensity matching analysis selected 558 pairs of comparable patients and continued to show significantly lower 9-month mortality in the cardiology cohort (12.0% vs 18.8%; RR, 0.64; 95% confidence interval [95%CI], 0.48-0.85; P = .002),with no relevant differences in the 9-month HF-readmission rate (18.1% vs 17.2%; RR, 0.95; 95%CI, 0.74-1.22; P = .695). Conclusions Age, sex, LVEF and comorbidities were major determinants of specialty-related referral in HF outpatients. An in-depth propensity matched analysis showed significantly lower 9-month mortality in the cardiologist cohort. Full English text available from: www.revespcardiol.org/en

Translated title of the contributionPrognostic Impact of Physician Specialty on the Prognosis of Outpatients With Heart Failure: Propensity Matched Analysis of the REDINSCOR and RICA Registries
Original languageSpanish
Pages (from-to)347-354
Number of pages8
JournalRevista Espanola de Cardiologia
Volume70
Issue number5
DOIs
StatePublished - May 2017
Externally publishedYes

Keywords

  • Heart failure
  • Prognosis
  • Propensity score
  • Registry

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