Análise do perfil clínico em pacientes com insuficiência cardíaca atendidos no Centro de Especialidades Médicas do CESUPA no município de Belém-Pará

Abstract

INTRODUCTION: Heart failure is a disease of high prevalence in Brazil and a great burden for health systems. The Disease has a wide and disabling clinic and an obscure prognosis if not treated correctly. Local knowledge of the variables of patients with the disease is essential for improving the quality of care and improving the life expectancy of patients. OBJECTIVE: Analyze and document the clinical-epidemiological profile of patients with Heart Failure (CH) treated at the Centro de Especialidades Médicas do Centro Universitário do Estado do Pará (CEMEC). METHODS: The information was collected from 62 medical records of patients diagnosed with Chronic Heart Failure enrolled at CEMEC based at CESUPA Campus in Belém-PA, using a protocol made by the researchers for the collection of epidemiological data of these patients. Medical records of all patients registered at CEMEC with a diagnosis of HF who had described the results of at least one echocardiographic examination were included, excluding those with loss of follow-up greater than 3 years in the ambulatory and those ones with severe comorbidities that would hinder the objective analysis of the results. For quantitative statistical analysis, the Biostat 5.3 program was used. RESULTS: 54% of the patients are male (n = 34/62), with an average age of 68 years. Systemic arterial hypertension (SAH) was found in 93.5% (n = 58/62) of these patients, being the main comorbidity, followed by dyslipidemia (43.5%; n = 27/62). 58.1% had heart failure with preserved ejection fraction – HFPEF (n = 36/62), and 37.1% (n = 23/62) being in NYHA I functional class and 22.6% (n = 14 / 62) in NYHA III. It was found that 48.3% of these patients have a very high cardiovascular risk. Regarding therapy, 90.3% use ACE inhibitors or ARBs, with Losartan being the main representative (79%; n = 49/62). 85.5% use beta blockers, with carvedilol being the most used (69.4%; n = 43/62). Spironolactone is used by 43.5% of patients (n = 27/62). Statins are used by 72.6% of patients. CONCLUSION: The study confirmed that the clinical-epidemiological profile of patients seen at the cardiology ambulatory of CEMEC is compatible with the epidemiology described in other studies, being mostly composed of elderly men, with multiple comorbidities, with SAH being the main one. It was also found that the treatment proposed by the outpatient professionals is in accordance with that recommended by the Brazilian guideline for heart failure, as well as being supported by systematic reviews with meta-analyzes. The absence of documentation of echocardiographic examinations in some medical records was noted, as well as a lack of data such as the functional classification of the patient and the HF phenotype.