AMERICCAASS Registry: A Contemporary View of Heart Failure in the Americas

BACKGROUND: Heart failure (HF) is a growing global health concern, particularly in low- and middle-income countries. Contemporary, region-specific data from the Americas remain scarce. The AMERICCAASS (Registro Americano de Insuficiencia Cardiaca Ambulatoria o Agudamente Descompensada [American Registry of Ambulatory or Acutely Decompensated Heart Failure]) registry was designed to provide broad, robust regional evidence on HF. METHODS: The AMERICCAASS registry is a prospective, multicenter, observational study including adults with HF enrolled as inpatients or outpatients at 119 institutions in 21 countries across the Americas. Sociodemographic and clinical variables were summarized descriptively. RESULTS: A total of 6732 patients were included; 30.1% were inpatients and 69.9% outpatients. The median age was 68.6 years, and 58.2% were men. Hypertension (69.6%), dyslipidemia (41.6%), and coronary artery disease (39.2%) were the most common comorbidities. Ischemic (39.9%) and hypertensive (17.9%) etiologies predominated, while Chagas disease was present in 3.4%. Unhealthy habits were common, with 39.8% reporting smoking, 24.4% alcohol use, and only 23.9% regular physical activity. New York Heart Association class III predominated in inpatients (45.2%), whereas New York Heart Association class II predominated in outpatients (52.6%). HF with reduced left ventricular ejection fraction was the most common phenotype in both settings: inpatients (56.8%) and outpatients (55.0%). β Blockers and mineralocorticoid receptor antagonists were the most frequently prescribed therapies, followed by sodium-glucose cotransporter-2 inhibitors. Among inpatients, intensive care unit admission occurred in 55.9%, and the in-hospital mortality rate was 7%. CONCLUSIONS: The AMERICCAASS registry offers a comprehensive overview of HF in the Americas. Although patient profiles were broadly consistent with global trends, important regional features were observed, including frequent unhealthy lifestyle habits and underuse of key therapies. The high prevalence of HF with reduced left ventricular ejection fraction, together with elevated intensive care unit admission rates and in-hospital death, suggests potential gaps in care and underscores the need to further evaluate HF care delivery across the region. REGISTRATION: URL: clinicaltrials.gov; Unique Identifier: NCT05295641.

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Journal
Journal of the American Heart Association
Published
2026-08-27
DOI
https://doi.org/10.1161/jaha.125.047844
Primary Topic
Heart Failure Treatment and Management
Type
article
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article

AMERICCAASS Registry: A Contemporary View of Heart Failure in the Americas

Mario Speranza, GUSTAVO ADOLFO MORENO SILGADO, Beder Gustavo Farez, Walter Alarco et al.
Journal of the American Heart Association
Heart Failure Treatment and Management
article

AMERICCAASS Registry: A Contemporary View of Heart Failure in the Americas

Mario Speranza, GUSTAVO ADOLFO MORENO SILGADO, Beder Gustavo Farez, Walter Alarco, Daniela García Brasca, Esteban Zavaleta‐Monestel, Maximiliano Pereda, Alberto Fernández, Juan Justiniano Encina, Esteban Zavaleta Monestel, Mailyn Vilaú Jiménez, Maite Goberna Rocha, Hoover León-Giraldo, Germán Camilo Giraldo, Pablo José González Velásquez, Andrés Felipe Buitrago Sandoval, Tessa Negrín Valdés, Juan Pablo Escalante, Daniel Quesada, Luís Lema, Juan Pablo Arango-Ibañez, Mario Speranza, Norberto Bornancini, Juan Esteban Gómez‐Mesa, Mark H. Drazner, Eduardo Perna, Clemente Barrón Magdaleno, Gerardo Chazzin, José Carlos López Martín, Sebastián Campbell‐Quintero, Ana Virginia Figueroa, Andrea Valencia, Guillermo Trout‐Guardiola, Julián Lugo-Peña, Víctor Rossel, Cristian Núñez‐Carrizo, Víctor Rossel, Luis E. Echeverría, José Rene Romano, Andrés Ulate Retana, Juan Alberto Ceron Benavides, Sebastián Seni-Molina, Luis Guillermo Muñoz, Álvaro Mauricio Quintero-Ossa, Orlando David Fernández-Flores, Annia María Carrero-Vásquez, Leandro Parrilla, Harold Segundo Cedeño Macias, Juan Pablo Allende, Yudmila Borges, Adrián Lescano, Elizabeth Sellén Sanchén, Carlos Hernán Calderón Franco, Domingo César Azcona, Alfa Kenia Fernandez, Sucel Lázara Figueredo Carrazana, Julián Lugo‐Peña, María Juliana Rodríguez‐González, Alex Rivera‐Toquica, Claudine Judith Coronel Mariño, Elién García Sánchez, Tahimí Chacón Quesada, Migdalia Cristina Cóbas Pérez, Raciel Victores Chacón, Aymé Alberna Cardoso, Valentina Villegas‐Céspedes, Eduardo R. Perna, Walter Alarco, Alexander Romero‐Guerra, Sandra Companioni Montero, Erwin Eladio Silva Cardona, Alexis José Bastardo López, Elda Lorena Brocal Ocampo, Gustavo Andrés Ortega Ramírez, Manuel Hipólito Chaple La Hoz, Juan Carlos Henríquez Bonilla, José Carlos Acosta Abad, Erika María Martínez Carreño, Yilian Herrera Domínguez, Fausto Bernardo Heredia Villacreses, Juan Esteban Gómez‐Mesa, Lauren Cooper, Miguel Eduardo Azañedo Velásquez, Elirub Rojas Gimon, Maikel Santos Medina
article en

Abstract

BACKGROUND: Heart failure (HF) is a growing global health concern, particularly in low- and middle-income countries. Contemporary, region-specific data from the Americas remain scarce. The AMERICCAASS (Registro Americano de Insuficiencia Cardiaca Ambulatoria o Agudamente Descompensada [American Registry of Ambulatory or Acutely Decompensated Heart Failure]) registry was designed to provide broad, robust regional evidence on HF. METHODS: The AMERICCAASS registry is a prospective, multicenter, observational study including adults with HF enrolled as inpatients or outpatients at 119 institutions in 21 countries across the Americas. Sociodemographic and clinical variables were summarized descriptively. RESULTS: A total of 6732 patients were included; 30.1% were inpatients and 69.9% outpatients. The median age was 68.6 years, and 58.2% were men. Hypertension (69.6%), dyslipidemia (41.6%), and coronary artery disease (39.2%) were the most common comorbidities. Ischemic (39.9%) and hypertensive (17.9%) etiologies predominated, while Chagas disease was present in 3.4%. Unhealthy habits were common, with 39.8% reporting smoking, 24.4% alcohol use, and only 23.9% regular physical activity. New York Heart Association class III predominated in inpatients (45.2%), whereas New York Heart Association class II predominated in outpatients (52.6%). HF with reduced left ventricular ejection fraction was the most common phenotype in both settings: inpatients (56.8%) and outpatients (55.0%). β Blockers and mineralocorticoid receptor antagonists were the most frequently prescribed therapies, followed by sodium-glucose cotransporter-2 inhibitors. Among inpatients, intensive care unit admission occurred in 55.9%, and the in-hospital mortality rate was 7%. CONCLUSIONS: The AMERICCAASS registry offers a comprehensive overview of HF in the Americas. Although patient profiles were broadly consistent with global trends, important regional features were observed, including frequent unhealthy lifestyle habits and underuse of key therapies. The high prevalence of HF with reduced left ventricular ejection fraction, together with elevated intensive care unit admission rates and in-hospital death, suggests potential gaps in care and underscores the need to further evaluate HF care delivery across the region. REGISTRATION: URL: clinicaltrials.gov; Unique Identifier: NCT05295641.

Journal of the American Heart Association
Universidad del Norte (CO), North Shore University Hospital (US), El Hospital General de Agudos Carlos G. Durand (AR), Instituto Federal do Rio Grande do Norte (BR), Pontificia Universidad Católica del Ecuador (EC), Hospital Quirónsalud Sagrado Corazón (ES), Universidad Autónoma de Occidente (MX), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX), Fundación Valle del Lili (CO), Instituto Nacional del Tórax (CL), Hospital Doctor José Molina Orosa (ES), Instituto Nacional de Cardiologia (BR), Hospital São Vicente (BR), Administracion de los Servicios de Salud del Estado (UY), Saint Thomas Hospital (PA), Clínica MEDS (Chile) (CL), Centro Médico ABC (MX), Universidad Bíblica Latinoamericana (CR), Institute of Cardiology (CO), Clinica Santa Maria (CL), Institución Universitaria Colegios de Colombia (CO), Instituto de Cardiología y Cirugía Cardiovascular (CU), Fujian Provincial Hospital (CN), Hospital Metropolitano (EC), Hospital Privado (AR), Sociedad Española de Cardiología (ES), Southwestern Medical Center (US), University of Chile (CL), Icesi University (CO), The University of Texas Southwestern Medical Center (US)
Good health and well-being
Openalex Percentile: Top 10%
Heart Failure Treatment and Management
DOIOpen Access PDFOpenAlex
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