Articoli originali
13 maggio 2024
V. 12 (2024)
https://doi.org/10.4081/wpph.2024.9883

Dal Pronto Soccorso al Reparto di degenza: gestione dei pazienti con scompenso cardiaco a FE ridotta

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HFrEF, sacubitril-valsartan, ARNI, gliflozins, SGLT2-i
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Jacopo Mambella
jac.mmb@gmail.com
https://orcid.org/0009-0003-9776-0400
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italia.
Fabrizio Foieni
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italia.
Girolamo Sala
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italia.
Paolo Ghiringhelli
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italia.
Antonio Di Sabatino
Department of Internal Medicine, IRCCS San Matteo Policlinic Foundation, University of Pavia, Italia.

Obiettivi: endpoint primari - valutare la mortalità cardiovascolare e per tutte le cause nel primo anno in pazienti anziani arruolati con Angiotensin Receptor Inhibitor (ARNI) e/o Sodium Glucose Co-Transporter Type 2 Inhibitors (SGLT2-i) in un reparto internistico; valutare il ricovero ricorrente per Heart Failure with Reduced Ejection Fraction (HFrEF) acuto; analizzare la durata del ricovero confrontandola con i non arruolati. Endpoint secondari: identificare i parametri predittori della durata della ospedalizzazione; definire la sicurezza tramite l’incidenza di complicanze e di interruzione del trattamento. Materiali e Metodi: studio real-life prospettico osservazionale di coorte che analizza l’arruolamento durante il ricovero ed il followup 3-16-12 mesi dopo la dimissione. Sono stati registrati molteplici parametri per ogni paziente di diversa etnia, valutando la diagnosi di HFrEF acuto con NT-proBNP e RX-torace. Risultati: la durata del ricovero nel gruppo arruolato è stata inferiore rispetto ai non arruolati. La percentuale di re-ospedalizzazioni è stata inferiore rispetto a quella dei Randomized Clinical Trials (RCT) per ARNI. La mortalità cardiovascolare, l’ipotensione sintomatica e le Infezioni delle Vie Urinarie (IVU) sono state inferiori rispetto ai dati dei TCR. Età, eGFR, NT-proBNP, Cumulative Illness Rating Scale (CIRS), comorbidità severe, eccetto FE, sono stati predittori della durata del ricovero. Non sono state registrate ipoglicemie. Conclusioni: ARNI/SGLT2-i sono efficaci e sicuri nei pazienti anziani. Comorbidità ed indici bioumorali influenzano la qualità di vita e la storia naturale di HFrEF. L’obiettivo futuro è la conferma dei risultati ottenuti sin qui.

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Jacopo Mambella, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico I livello UO Medicina Interna II

Fabrizio Foieni, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico I livello UO Medicina Interna II

Girolamo Sala, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico I livello UO Medicina Interna II

Paolo Ghiringhelli, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico II livello UO Medicina Interna II

Antonio Di Sabatino, Department of Internal Medicine, IRCCS San Matteo Policlinic Foundation, University of Pavia

Dirigente Medico II livello UO Medicina Interna

Come citare



Dal Pronto Soccorso al Reparto di degenza: gestione dei pazienti con scompenso cardiaco a FE ridotta. (2024). Working Paper of Public Health, 12(1). https://doi.org/10.4081/wpph.2024.9883
Copyright (c) 2024 Jacopo Mambella, Fabrizio Foieni, Girolamo Sala, Paolo Ghiringhelli, Antonio Di Sabatino Creative Commons License

Questo volume è pubblicato con la licenza Creative Commons Attribuzione - Non commerciale 4.0 Internazionale.