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Revista Uruguaya de Cardiología

Print version ISSN 0797-0048On-line version ISSN 1688-0420


MAGGIONI, Aldo P. et al. Real world evidence of heart failure: an Italian point of view. Rev.Urug.Cardiol. [online]. 2017, vol.32, n.3, pp.321-329. ISSN 0797-0048.


the population of patients with heart failure (HF) randomized in clinical trials is generally far from real practice because selected according to specific eligibility criteria. These patients do not fully represent the “real world” of this clinical condition. Analysis of an administrative database can be useful to better describe the characteristics of real world patients with HF.


data came from the Italian ARNO Observatory including a population of nearly 2,500,000 inhabitants of the Italian National Health Service (INHS).

Patients were selected when discharged for HF (January 1, 2008 - December 31, 2012). We described the clinical characteristics the pharmacological treatments, rate and type of re-hospitalizations and direct costs for the INHS occurring during 1 year follow-up (FU).


of the 2,456,739 subjects included in the database, 54,059 (2.2%) were hospitalized for HF: 41,413 were discharged alive and prescribed on HF treatments. Mean age was 78±11 years, females accounted for 51.4%. Just 26.6% were managed in a cardiology setting. The more frequent co-morbidities were diabetes (30.7%), COPD (30.5%) and depression (21%). ACE-inhibitors/Angiotensin Receptor Blockers, Betablockers and Aldosterone antagonists were prescribed in 65.8, 49.7 and 42.1% of patients.

At least one re-hospitalization occurred during the 1-year follow-up in 56.6% of patients, 49% of them were due to non-cardiovascular causes. INHS’s direct cost per patient per year was 11,867€ mainly driven by hospitalizations.


real world evidence provides a description of patients’ characteristics and treatment patterns that are very different from those reported by randomized clinical trials. Costs for the INHS are mainly driven by hospitalizations which are often due to non-cardiovascular reasons.

Keywords : Heart failure; drug therapy.

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