title: Burden of Heart Failure in Latin America: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  Heart failure is a major public health concern. The aim of this review was to estimate the burden of heart failure in Latin America.
  
  
  METHODS
  Systematic review and meta-analysis following a search in MEDLINE, EMBASE, LILACS, and CENTRAL for articles published between January 1994 and June 2014, with no language restrictions. We included experimental and observational studies with at least 50 participants aged ≥ 18 years.
  
  
  RESULTS
  In total, 143 of the 4792 references retrieved were included in the study. Most studies had been conducted in South America (92%), and mainly in Brazil (64%). The mean age of the patients was 60 ± 9 years, and mean ejection fraction was 36% ± 9%. The incidence of heart failure in the single population study providing this information was 199 cases per 100000 person-years. The prevalence of heart failure was 1% (95% confidence interval [95%CI], 0.1%-2.7%); hospital readmission rates were 33%, 28%, 31%, and 35% at 3, 6, 12, and 24 to 60 months of follow-up, respectively; and the median duration of hospitalization was 7.0 days. The 1-year mortality rate was 24.5% (95%CI, 19.4%-30.0%). In-hospital mortality was 11.7% (95%CI, 10.4%-13.0%), and the rate was higher in patients with a reduced ejection fraction, ischemic heart disease, or Chagas disease.
  
  
  CONCLUSIONS
  Few studies have evaluated the incidence and prevalence of heart failure in Latin America. High mortality and hospitalization rates were found, and the main limitation was heterogeneity between studies. The results presented provide useful epidemiologic information for decision-making related to this disease. Further studies with standardized methods and representative populations are needed in this line.
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina. Electronic address: aciapponi@iecs.org.ar.
authors.forename: Agustín
authors.initials: A
authors.lastname: Ciapponi
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
authors.forename: Andrea
authors.initials: A
authors.lastname: Alcaraz
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
authors.forename: María
authors.initials: M
authors.lastname: Calderón
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
authors.forename: María Gabriela
authors.initials: MG
authors.lastname: Matta
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
authors.forename: Martin
authors.initials: M
authors.lastname: Chaparro
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
authors.forename: Natalie
authors.initials: N
authors.lastname: Soto
authors.affiliation: Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
authors.forename: Ariel
authors.initials: A
authors.lastname: Bardach
mesh_terms: D000958:Antigua and Barbuda / Q000453:epidemiology; D001118:Argentina / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002598:Chagas Cardiomyopathy / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D003105:Colombia / Q000453:epidemiology; D003462:Cuba / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007563:Jamaica / Q000453:epidemiology; D007843:Latin America / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008800:Mexico / Q000453:epidemiology; D009026:Mortality; D010359:Patient Readmission / Q000706:statistics & numerical data; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013318:Stroke Volume; D014583:Uruguay / Q000453:epidemiology
keywords: América Latina; Epidemiology; Epidemiología; Heart failure; Incidence; Incidencia; Insuficiencia cardiaca; Latin America; Meta-analysis; Metanálisis; Mortalidad; Mortality