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Background Unexpected readmissions are frequent among heart failure patients, due to their natural history that implies multiple readmissions, with high costs and clinical relevance. Purpose We aimed to assess the impact of a Multidisciplinary Heart Failure Program (MHFP) on the readmission-free period after an episode of acute decompensated heart failure (ADHF). Methods We carried out an analytical and observational study including all patients admitted to our Universitary Hospital, which covers 220,000 individuals, with an episode of heart failure when there was not a Multidisciplinary Heart Failure Program (January 2013 to December 2013). Once the MHFP was established, we compared non-MHFP patients with every patient admitted during February 2019 and February 2020 in terms of clinical data, imaging technique findings and short-term readmissions. Results The rate of readmission during this period was a 24.8% in non-MHFP and 17.2% in MHFP (p=0.15). However, we could find differences in median time to readmission due to ADHF, that was 1.74 months (CI 95%, 0.12–3.35) in non-MHFP, compared to 5.125 months (CI 95%, 4.15–6.09) in MHFP (p=0.002) (see Graph 1). There were also no significant differences in terms of basic characteristics between the MHFP and the non-MHFP patients (age, gender, left ventricular ejection fraction, left bundle branch block, hypertension). It is remarkable that establishing a MHFP has lengthened the readmission-free period. The rate of decompensation in the first and sixth month was respectively in the non–MHFP 9% and 21%; and in the MHFP 2% and 10%. Conclusion According to our results, the implantation of this Multidisciplinary Heart Failure Program has shown a reduction in the time to ADHF readmission compared with a cohort of similar pts some years before, which is clinically relevant. Graph 1 Funding Acknowledgement Type of funding source: None

Background There are scarce data on clinical profile and prognosis of pts with Heart failure with mid-range ejection fraction (HFmrEF). The aim of this study was to analyse the patient's characteristics and their prognosis in terms of morbidity and mortality compared to those patients with acute heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction Methods We performed a retrospective analysis from a prospective observational study developed in a University Hospital, which covers 220.000 individuals. We analysed 600 discharges with the main diagnosis of Heart Failure with 52 months of median follow up. We obtain clinical and demographic data at the moment of admission and during de follow up. To analyse mortality and readmission we used a Kaplan-Meier model. Results A total of 551 patients (91%) had a transthoracic echocardiogram (TEE) during the admission. Eleven percent (11.8%) of the patients (pts) had HFmrEF (35.6% of them were women), 66.7% HFpEF (81.8% women) and 20.6% HFrEF (29.0% women). Median age of HFmrEF was 80.5±1.3 years, similar to HFpEF (81±0.5 years). However, pts with HFrEF were younger (75.2±1.1 years). A higher percent of pts with HFrEF were on beta-blocker (BB) treatment at admission compared to HFmrEF (51.79% vs 47.54%) and HFpEF (39.91%). At discharge, all of them were on high doses of BB (64.55% HFrEF, 54.10% HFmrEF and 33.62% HFpEF). After an adjusted analysis by age, pts with HFmrEF had higher mortality compared to HEpEF (HR: 0.55; 95% CI: 0.38–0.80; p=0.002) with no statically significant difference compared to HFrEF (HR: 0.88; 95% IC: 0.57–1.35; p=0.5). Pts with HFmrEF were on a higher risk of readmission compared to HFpEF (HR 0.59; 95% CI 0.41–0.84, p=0.004). There was also no statistical difference compared to HFrEF (HR 0.72, 95% CI 0.47–1.11; p=0.14). Conclusions According to our results, pts with HFmrEF and HFpEF are older compared to HFrEF. HFpEF were mostly women, compared to other groups. A lower percent of HFmrEF were also on BB treatment. HFmrEF and HFrEF had a similar prognosis in terms of readmission and mortality. HFmrEF pts were on higher risk of mortality and readmission compared to HFpEF. We need more studies to find more information and confirm these results. Graph 1 Funding Acknowledgement Type of funding source: None

Hypertension is a very important cardiovascular risk factor and directly leads to major atherosclerotic cardiovascular diseases, including coronary artery disease, stroke cardiac failure and peripheral artery disease. Hypertension tends to cluster with other atherogenic risk factors like dyslipidemia, insulin resistance, obesity and others. The association between hypertension and dyslipidemia is very frequent and the risk is more than additive and its possible pathogenesis may be of a common mechanism. Insulin resistance is the main cause of both risk factors. Endothelium dysfunction is present in arterial hypertension and dyslipidemia and the pathogenesis of atherosclerosis. The treatment of hypertensive patients must be individualized to accommodate both the concomitant dyslipidemia and other atherogenic factors.