Clinical characteristics of newly diagnosed vs. chronic heart failure patients in Spain: SEC-Excelente registry results

Introduction Heart failure (HF) is a significant public health problem due to its high morbimortality and high consumption of healthcare resources. Several studies have pointed to some differences in the characteristics of patients with new diagnoses of HF compared to those with chronic HF, but the evidence is limited. Purpose To analyse the differences in clinical characteristics of patients with HF with reduced ejection fraction according to chronic or new diagnoses of HF. Methods A study was carried out, and patients were treated in HF units attached to the cardiology services of 68 hospitals in Spain with SEC-Excelente accreditation. The patients were included consecutively in two one-month cutoffs (March and October) between 2019 and 2023. The following data were collected: demographic, clinical, analytical, echocardiographic and treatment variables. For the differences between the two groups, the chi-square or Fisher's exact test was used, as appropriate, for qualitative variables and the Mann-Whitney U test for quantitative variables. Results 1,344 patients with HFrEF were included, 792 (58.9%) with chronic HF and the rest with new diagnoses. Most new-diagnosed patients were included during the hospitalisation (75.2 vs 59.1; p<0.001). Also, most of them were followed in specialised (62.9 vs 61.6 ) or community (19.6 vs 20.0) HF units, more frequently in newly diagnosed ones (p=0.010). Chronic patients are younger with more comorbidities. There are no differences in LVEF compared to newly diagnosed patients, but they have higher natriuretic peptides and worse renal function (table 1). The Implementation of medical treatment is quite similar, with more treatment with diuretics and sacubitril/valsartan in chronic patients and less treatment with SGLT2i. Finally, chronic patients were more frequently referred to structured follow-up in HF units and less frequently to cardiac rehabilitation programmes compared to new diagnoses (table 2). Conclusions In our cohort of HF patients, chronic patients had more comorbidities, both cardiovascular and non-cardiovascular ones, compared to newly diagnosed ones, and Implementation of drugs with prognostic benefit was quite similar, except on sacubitril-valsartan and SGLT2i. Chronic patients are more likely to be referred to specialised HF and less frequently to cardiac rehabilitation programmes.