Heart failure & cardiomyopathies
Temporal trends in characteristics, management and prognosis of patients with acute heart failure through two repeated snapshots
Authors' conclusion
A comparison of two cross-sectional surveys of acute HF, conducted 12 years apart, reveals an increasing burden of comorbidities, as well as a lack of dedicated admission pathways and a significant shortcoming in the prescription of evidence-based HF drugs on discharge. However, there has been a significant decrease in short-term mortality.
Study context
- Population
- Patients hospitalised with acute heart failure (HF)enrolled 1658 and 1513 patients, respectively
- Participants
- 1,513 vs 1,658
- Comparison
- A comparison of two cross-sectional surveys of acute HF, conducted 12 years apart
- 2021n = 1,513
- 2009n = 1,658reference
- Outcome
- Age and LVEF category
Methodological detailsconducted in 2009 and 2021 following the same methodology, 6-month follow-up
- Conducted in 2009 and 2021 following the same methodology
- 6-month follow-up
Main finding
As reported in the abstract
Age remained largely unchanged
76 years
Reduced left ventricular ejection fraction (LVEF) in the two surveys
53%
Further findings
Discharge prescription in patients with reduced LVEF
ACE inhibitors, angiotensin receptor blockers or ARNis
Beta-blockers 2021 74.2% · 2009 67.7
Mineralocorticoid receptor antagonists 2021 35.5% · 2009 26.6
| Outcome | 2021 | 2009 | HR (CI) | |
|---|---|---|---|---|
| Mortality · 1 and 6 monthsAfter matching the two cohorts · matched | 0.78 (0.66–0.94) | |||
| 1 month | 7.6% | 8.9% | ||
| 6 months | 21.3% | 24.7% | ||
| 0.512Hazard ratio (log scale) |
Emergency department as route for hospitalisation
- Predominant and increasing route
- 64-71%
- Admission to critical care units, frequent and stable
- 40%
Mortality · 1 and 6 months
- Improvement in mortality observed in most patients except in the most elderly and those with preserved LVEF
Original publication
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