Exploring comorbidities, triggers, and etiologies in heart failure. Insights from the SEPE registry subanalysis
Introduction and objectives Heart failure (HF) is a complex clinical syndrome characterized by a high burden of comorbidities and multiple underlying etiologies. This sub-analysis of the SEPE-Registry aimed to characterize the clinical profiles of hospitalized patients with HF and to analyze the incidence and association between etiologies, precipitating factors of decompensation and comorbidities. Methods A multicenter, cross-sectional study was conducted in Santa Cruz de la Sierra, Bolivia, including 418 patients hospitalized with a diagnosis of HF between January 2023 and April 2024. Results Hypertension was significantly associated with a higher prevalence of ischemic HF etiology (PR, 2.0; P = .001). Coronary artery disease was strongly associated with an ischemic etiology of HF (PR, 4.6; P < .001). Rheumatic HF etiology demonstrated a statistically significant inverse association with comorbidity. Chagas disease was the most prevalent HF etiology in the SEPE registry and was associated with a trend toward increased cardiovascular mortality, reaching borderline statistical significance (PR, 1.3; P = .052). Moreover, Chagasic HF showed a significant inverse association with hypertension (PR, 0.6; P = .001) but a higher prevalence of pacemakers (PR, 1.7; P = .001). The coexistence of Chagas disease and coronary artery disease within the same HF patient was statistically significant (χ 2: 15.0; P = .001) The overall cardiovascular mortality in HF patients on SEPE-HF Registry was founded as 5.5%. Conclusions HF exhibits significant clinical heterogeneity driven by the interplay between etiologies, comorbidities, and decompensating factors. The identification of distinct clinical profiles may support more personalized and effective treatment strategies.
