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Heart failure (HF) is a major public health problem. Patients admitted for acute heart failure (AHF) generally present with severe clinical characteristics and have a high in-hospital mortality rate as well as a prolonged length of stay, with, as a consequence, a strong socioeconomic impact.
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For this clinical condition, therapeutic developments have been scarce in the past decades. For this reason, current guidelines are not including recommendations based on solid evidences from randomized
Epidemiology of Heart Failure in Europe
Section snippets
Key points
Patients hospitalized for acute heart failure
AHF is a complex, heterogeneous, clinical syndrome, often life threatening and requiring urgent therapy.14, 15
Despite the relevant burden of this clinical condition, therapeutic developments have been scarce in the past couple of decades; as a consequence, current guidelines cannot include evidence-based recommendations based on solid evidences.16, 17
For this reason, patients with HF remain at substantial risk for recurrent acute exacerbations and death.2, 5, 18 Furthermore, local conditions
Italian Network on Heart Failure Outcome Registry Findings
The all-cause mortality rate at 1 year of patients with chronic stable HF was 5.9%, relevantly reduced with respect to the mortality rates observed in the previous decades.11 However, it was much higher, as expected, in patients in New York Heart Association (NYHA) class III–IV than in those in class I–II (14.5% vs 4.1%, P<.0001). The etiology did not seem to have a remarkable impact on outcome. The death rate was higher, but not statistically significant, in patients with ischemic etiology
Summary
While death rate of patients with chronic HF seems to slowly improve over time, outcome rates of patients admitted for AHF are still unacceptably high. AHF remains a major public health problem, and the data reported here confirms the strong socioeconomic impact of this clinical condition.
In the past 3 decades, there has been a small improvement in this field, and probably the most important issue to consider is that AHF is not a single entity with a unique cause but a spectrum of complex
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