DATASET for Implementation of guideline-directed medical therapy among patients with acute heart failure admitted to cardiac rehabilitation: the PROMETEO registry

this is the dataset for manuscript Implementation of guideline-directed medical therapy among patients with acute heart failure admitted to cardiac rehabilitation: the PROMETEO registry Abstract Background and aimsTo provide an updated epidemiological description of patients referred to cardiac rehabilitation (CR) in Italy after hospitalization for acute heart failure (HF), focusing on the use and optimization of guideline-directed medical therapy (GDMT) across the spectrum of left-ventricular ejection fraction (LVEF).MethodsPROMETEO is a prospective, multicentre Italian registry enrolling consecutive adult patients admitted to CR after acute HF. Patients were stratified as HFrEF (LVEF <40%) or HFmrEF/HFpEF (LVEF ≥40%).ResultsAmong 263 patients with available LVEF, median age was 68.7 years, 21.7% were female, and 74.9% had HFrEF. Compared with HFmrEF/HFpEF, HFrEF were younger, less frequently female and with higher NT-proBNP levels. At CR admission, 72.1% of HFrEF patients received ACEi/ARB/ARNI, 91.9% beta-blockers, 79.2% MRAs, and 66.0% SGLT2 inhibitors, with a median GDMT score of 6 (IQR 4–8). At discharge, ARNI use increased significantly (58.9%) and the median GDMT score increased to 7 (IQR 4–8; p=0.013), alongside higher beta-blocker dosing and reduced loop diuretic use. Chronic kidney disease and higher baseline GDMT score were negatively associated with GDMT optimization, while higher BMI showed a positive association. In HFmrEF/HFpEF patients, SGLT2 inhibitor use increased from 28.8% to 47.0% (p=0.010), with a concomitant reduction in loop diuretic prescription and dose.ConclusionPatients referred to CR after acute HF are mainly male with HFrEF and show substantial comorbidity and treatment complexity. Residential CR represents a key opportunity for GDMT optimization across the HF spectrum. Note:Funding declaration: This work was funded by the European Union – Next Generation EU – NRRP M6C2 – Investment 2.1 Enhancement and strengthening of biomedical research in the NHS, project code: PNRR-MAD-2022-12376159. CUP: H43C22001120007.本数据集对应手稿：《急性心力衰竭（acute heart failure, HF）住院后接受心脏康复（cardiac rehabilitation, CR）的患者中指南导向药物治疗（guideline-directed medical therapy, GDMT）的实施情况——PROMETEO注册研究》 摘要 背景与目的 本研究旨在更新意大利急性心力衰竭（HF）住院后转诊至心脏康复（CR）患者的流行病学特征，重点分析不同左心室射血分数（left-ventricular ejection fraction, LVEF）分层人群中GDMT的使用与优化情况。 方法 PROMETEO是一项前瞻性、多中心意大利注册研究，纳入连续收治的急性HF住院后接受CR的成年患者。将患者按LVEF分层为射血分数降低型心力衰竭（HFrEF，LVEF <40%）与射血分数中间值/保留型心力衰竭（HFmrEF/HFpEF，LVEF ≥40%）。 结果 在263例具备完整LVEF数据的患者中，中位年龄为68.7岁，女性占比21.7%，74.9%为HFrEF患者。与HFmrEF/HFpEF患者相比，HFrEF患者更年轻，女性占比更低，且N末端B型利钠肽原（NT-proBNP）水平更高。 在CR入院时，72.1%的HFrEF患者接受了血管紧张素转换酶抑制剂（ACEi）/血管紧张素Ⅱ受体拮抗剂（ARB）/血管紧张素受体脑啡肽酶抑制剂（ARNI）、91.9%接受了β受体阻滞剂、79.2%接受了盐皮质激素受体拮抗剂（MRAs）、66.0%接受了钠-葡萄糖协同转运蛋白2抑制剂（SGLT2抑制剂），中位GDMT评分达6分（四分位距4~8）。 出院时，ARNI的使用率显著升至58.9%，中位GDMT评分升至7分（四分位距4~8；p=0.013），同时β受体阻滞剂剂量更高，袢利尿剂使用量减少。慢性肾脏病与更高的基线GDMT评分与GDMT优化呈负相关，而更高的体质量指数（body mass index, BMI）则呈正相关。 在HFmrEF/HFpEF患者中，SGLT2抑制剂的使用率从28.8%升至47.0%（p=0.010），同时袢利尿剂的处方与剂量均有所降低。 结论 急性HF住院后转诊至CR的患者以男性HFrEF患者为主，且合并症负担较重、治疗复杂度较高。住院式CR是实现全LVEF分层心衰人群GDMT优化的关键契机。 注：基金声明 本研究由欧盟——下一代欧盟——国家恢复与韧性计划（National Recovery and Resilience Plan, NRRP）M6C2——投资2.1：强化与加强国家卫生服务体系（National Health Service, NHS）生物医学研究项目资助，项目编号：PNRR-MAD-2022-12376159。CUP编号：H43C22001120007。