The AMERICCAASS registry offers a comprehensive overview of HF in the Americas, identifying important regional features including frequent unhealthy lifestyle habits and underuse of key therapies, with high prevalence of HF with reduced left ventricular ejection fraction, elevated ICU admission rates, and in-hospital mortality.
The AMERICCAASS registry enrolled 6,732 heart failure patients across 119 institutions in 21 countries throughout the Americas, with the majority being outpatients.
Hypertension, dyslipidemia, and coronary artery disease were the most common comorbidities among heart failure patients in the registry.
Ischemic and hypertensive etiologies were the predominant causes of heart failure in the registry population.
Unhealthy lifestyle habits were highly prevalent among heart failure patients in the Americas.
NYHA functional class distribution differed between inpatient and outpatient settings, with more severe symptoms in hospitalized patients.
Heart failure with reduced left ventricular ejection fraction (HFrEF) was the most common phenotype in both inpatient and outpatient settings.
Beta blockers and mineralocorticoid receptor antagonists were the most frequently prescribed therapies, followed by SGLT-2 inhibitors.
Inpatient heart failure in the Americas was associated with high rates of ICU admission and in-hospital mortality.
This research presents findings from the AMERICCAASS registry, the largest contemporary study of heart failure patients across the Americas, enrolling 6,732 people from 119 hospitals and clinics in 21 countries. The average patient was about 69 years old, and the majority were men. The most common underlying causes of heart failure were related to blocked coronary arteries (ischemic) and high blood pressure (hypertensive), while Chagas disease—a parasitic infection more common in Latin America—was also present in a notable minority of patients. Unhealthy lifestyle habits were widespread: nearly 40% reported smoking, about one in four reported drinking alcohol, and fewer than one in four engaged in regular physical activity. The study found that the most common type of heart failure was 'reduced ejection fraction,' meaning the heart was pumping weakly, in both hospitalized and outpatient populations. Among hospitalized patients, more than half required intensive care unit admission, and 7% died during their hospital stay—figures that suggest significant disease burden and possible gaps in how care is delivered across the region. The medicines used most often were beta blockers and mineralocorticoid receptor antagonists, with newer SGLT-2 inhibitor medications also being prescribed, though underuse of recommended therapies was noted as a concern. This research suggests that while heart failure patients in the Americas share many characteristics with patients globally, there are important regional differences, particularly around lifestyle risk factors and the high rate of reduced-ejection-fraction heart failure. These findings highlight the need for improved prevention strategies, better access to guideline-recommended treatments, and further study of how heart failure care can be strengthened across Latin America and the broader Americas region, especially in low- and middle-income countries.
Seni-Molina S, Arango-Ibanez J, Villegas-Céspedes V, Valencia-Orozco A, León-Giraldo H, Borges Y, et al.. (2026). AMERICCAASS Registry: A Contemporary View of Heart Failure in the Americas.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.047844