Clinical profile, guideline-directed therapy uptake, and in-hospital mortality in acute heart failure at a public teaching hospital in southwestern Colombia: a single-centre retrospective registry (EVARISTO-AHF)

Background. Real-world data on acute heart failure (AHF) from Colombian public tertiary-care centres remain scarce. We aimed to characterize the clinical profile, treatment patterns, and in-hospital outcomes of patients admitted for AHF to a high-complexity public university hospital in southwestern Colombia. Methods. Institutional, observational, retrospective registry (June 2022–October 2024) including 251 consecutive patients ≥ 18 years with AHF and a hospital stay > 48 hours at Hospital Universitario del Valle Evaristo García ESE. Data across eight pre-specified domains were captured in REDCap. Continuous variables are reported as median (interquartile range, IQR) and categorical variables as n (%). Groups were compared by left ventricular ejection fraction (LVEF) category (< 40% vs ≥ 40%) using the chi-square or Fisher exact test and the Mann–Whitney U test. Discharge prescription was computed among hospital survivors (n = 234). Results. Median age was 70 years (IQR 60.5–79); 59.8% were men; 14.7% were Afro-descendant; and 77.3% were enrolled in the subsidized health-insurance regime. LVEF was reduced (< 40%) in 62.5% of patients, and the Stevenson wet–warm profile predominated (79.3%). In-hospital mortality was 6.8% (17/251). Guideline-directed medical therapy (GDMT) increased markedly from admission to discharge: SGLT-2 inhibitors 20.7%→76.1%, beta-blockers 46.2%→90.6%, mineralocorticoid receptor antagonists 30.3%→66.7%, and renin–angiotensin–aldosterone system inhibitors 61.4%→82.9%. At discharge, SGLT-2 inhibitor prescription was higher in HFrEF than in HFmrEF/HFpEF (84.5% vs 61.6%; odds ratio 3.38, 95% CI 1.82–6.30; p < 0.001). Conclusions. This institutional registry provides the first comprehensive characterization of AHF at a public teaching hospital in southwestern Colombia. Substantial progress in GDMT implementation was documented at discharge, with a residual LVEF-based gap in SGLT-2 inhibitor prescription that constitutes an actionable quality-improvement target. Clinical trial number: not applicable.