Introduction: Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, emphasizing the critical role of optimal medical therapy (OMT) in improving patient outcomes. Despite extensive research, most scientific evidence regarding HF is gathered and studied in developed countries, leaving substantial knowledge gaps regarding HF in Latin America and the Caribbean. Objective: To characterize the sociodemographic and clinical profiles of HF patients and to assess their adherence to OMT in the Americas. Methods: The AMERICCAASS Registry is a prospective, observational, multicenter study, including patients aged 18 and older, both hospitalized and ambulatory, and diagnosed with HF. Sociodemographic and clinical data were collected from the first 2,500 patients to characterize the study population. Adherence to OMT was subsequently evaluated according to left ventricular ejection fraction (LVEF). Results: Among the 2,500 patients in the study, 36% were hospitalized and 64% were ambulatory. The median ages of the patients were 66.9 (hospitalized) and 66.3 years (ambulatory). Males made up 60.8% of hospitalized and 59.3% of ambulatory patients. The majority had HF with reduced LVEF (≤40%): 60.7% for hospitalized and 58.5% for ambulatory. The New York Heart Association (NYHA) functional class II predominated among ambulatory patients (67.9%), while NYHA functional class III predominated among hospitalized patients (46.6%). Only 21% of patients with reduced LVEF were receiving quadruple therapy, whereas 12.3% of patients with mildly reduced LVEF (41–49%) were on this treatment. Conclusion: The findings demonstrate that the sociodemographic and clinical profiles of HF patients in the Americas are broadly consistent with international reports. However, the low use of OMT observed in this population underscores gaps in adherence to current guidelines. These results highlight the need for targeted strategies to improve pharmacological treatment adherence to optimize health outcomes in this region.

Objective: To identify factors associated with mortality in indigenous populations diagnosed with tuberculosis in Peru, 2015–2019. Methods: We conducted a nested case-control study in a retrospective cohort using the registry of indigenous peoples of the National Health Strategy for TB Prevention and Control of the Ministry of Health of Peru. A descriptive analysis was performed, and then bivariate and multivariate logistic regression was used to evaluate associations between the variables and the outcome (alive–deceased). The results are shown as OR with their respective 95% confidence intervals. Results: The mortality rate of the total indigenous population of Peru was 1.75 deaths per 100,000 indigenous people diagnosed with TB. The community of Kukama Kukamiria-Yagua reported 505 (28.48%) individuals, followed by the Shipibo-Konibo community with 385. The final logistic model showed that indigenous males (OR = 1.93; 95% CI: 1.001–3.7) with a history of HIV prior to TB (OR = 16.7; 95% CI: 4.7–58.7), and indigenous people in old age (OR = 2.95; 95% CI: 1.5–5.7) were factors associated with a greater chance of dying from TB. Conclusions: It is important to reorient health services among indigenous populations, especially those related to improving a timely diagnosis and early treatment of TB/HIV co-infection, to ensure comprehensive care for this population considering that they are vulnerable groups.

Cardiovascular disease remains the leading cause of morbidity and mortality worldwide, with dyslipidemia playing a key role in its progression. Despite advances in lipid-lowering therapy (LLT), LDL-C (Low-Density Lipoprotein Cholesterol) goal achievement remains suboptimal. This study evaluated LDL-C goal attainment in Colombian patients with very high cardiovascular risk (CVR) due to coronary artery disease (CAD) following ESC/EAS guidelines updates. EDHIPO MARCA (Evaluación De adherencia a la terapia HIPOlipemiante en pacientes de Muy Alto Riesgo CArdiovascular) is a retrospective, multicenter study assessing LDL-C goal achievement in patients with CAD. Data were collected from previous coronary angiogram reports and medical records across 11 Colombian healthcare institutions with certified interventional cardiology services. Patients with CAD who had at least one follow-up LDL-C measurement and an LLT prescription within 12 months post-angiogram were included. LDL-C goal attainment was assessed across three periods—2011–2012, 2016–2017, and 2021–2022—corresponding to the updates of ESC/EAS guidelines (2011, 2016, and 2019, respectively). The LDL-C goals were <70 mg/dL for the first two periods and <55 mg/dL for the most recent one. LDL-C was measured or estimated using the Friedewald equation. Descriptive analyses were performed. A total of 1,788 patients were included, with a median age of 66 years (IQR: 59–74), and 70.7% were male. Hypertension (67.5%) and overweight (40.8%) were the most common comorbidities. At discharge, statins were prescribed in 84.1% (95% CI: 82.4–85.8%) of patients, increasing to 99.1% (95% CI: 98.6–99.5%) at the end of follow-up (median 6.8 months); PCSK9 inhibitors were prescribed in 1.5%, exclusively in 2019. At the end of follow-up, 36.6% (95% CI: 34.3%, 38.8%) achieved LDL-C goals. By guideline period, goal attainment was 12.1% (95% CI: 5.4%, 18.8%) in 2011, 42.3% (95% CI: 37.9%, 46.8%) in 2016, and 36.2% (95% CI: 33.5%, 38.9%) in 2019. By number of follow-ups, LDL-C goal achievement increased from 32.9% (1 follow-up) to 44.0% (4 follow-ups). Despite widespread LLT use, LDL-C target achievement remains suboptimal. Frequent follow-up and greater use of combination therapy beyond statins may be essential to improve lipid control in very high CVR patients.

To determine the profiles of highly frequent users of primary care services and the associations of these profiles with depressive anxiety disorders in Cali, Colombia. A case-control study, high-frequency cases were defined as those involving patients with a percentile >75 with regard to the frequency of spontaneous use of outpatient facilities in the last 12 months; controls were defined as those with a percentile <25. A multiple correspondence analysis was used to describe patient profiles, and the influences of depression and anxiety on frequent attendance was determined via logistic regression. Among the 780 participating patients, differences in the profiles among frequent users and controls were related to predisposing factors such as sex, age, and education, capacity factors such as the time required to visit the institution and the means of transport used, and need factors such as health perceptions, social support, family function, and the presence of anxiety or depressive disorders. A depression or anxiety disorder was found to associate positively with frequent attendance (adjusted odds ratio [aOR]: 1.99, 95% confidence interval [CI]: 1.19-3.31) and a referral system (aOR: 1.61, 95% CI: 1.01-2.76), but negatively with mild or no family dysfunction (aOR: 0.79; 95% CI: 0.48-0.88) after adjusting for age, sex, ethnicity, and health service-providing institutions. The profiles of high-frequency patients differ from control patients with respect to factors related to capacity, need, and willingness; in particular, the latter were independently associated with frequent attendance. Notably, the presence of an anxious or depressive disorder doubled the risk of highfrequency attendance at a primary care facility.

Objetivo: relacionar la percepción de estudiantes de pregrado y la evaluación realizada por pares académicos del Consejo Nacional de Acreditación en relación con el factor procesos académicos, como resultado de la autoevaluación con fines de acreditación en alta calidad. Metodología: el estudio fue observacional, descriptivo, transversal y correlacional. Se analizó la autoevaluación de 3408 estudiantes de 25 programas académicos entre 2014 y 2018, y se comparó con el informe de los pares académicos del Consejo Nacional de Acreditación con respecto al grado de cumplimiento de las características de los programas académicos. Se evaluaron las características que tuvieron mayor variabilidad: apoyo docente, interdisciplinariedad, evaluación y autorregulación, y recursos informáticos. La correlación se analizó utilizando el índice kappa y se consideró un valor de referencia menor de 0.05. Resultados: se encontró una concordancia débil entre las dos evaluaciones con respecto a la calidad de los procesos académicos (k = 0.242). Los pares académicos otorgaron una mejor calificación en las cinco categorías evaluadas. Conclusión: existe diferencia entre la percepción de los estudiantes de pregrado y la evaluación de los pares académicos con respecto a las características del factor procesos académicos, que fueron mejor evaluadas por los pares que por los estudiantes.