The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction
(1) Background: Besides the use of guideline-directed medical therapy (GDMT), multidisciplinary heart failure (HF) outpatient care (HFOC) is of strategic importance in HFrEF. (2) Methods: Data from 257 hospitalised HFrEF patients between 2019 and 2021 were retrospectively analysed. Application and t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/2/131 |
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| author | Balázs Muk Fanni Bánfi-Bacsárdi Máté Vámos Dávid Pilecky Zsuzsanna Majoros Gábor Márton Török Dénes Vágány Balázs Polgár Balázs Solymossi Tünde Dóra Borsányi Péter Andréka Gábor Zoltán Duray Róbert Gábor Kiss Miklós Dékány Noémi Nyolczas |
| author_facet | Balázs Muk Fanni Bánfi-Bacsárdi Máté Vámos Dávid Pilecky Zsuzsanna Majoros Gábor Márton Török Dénes Vágány Balázs Polgár Balázs Solymossi Tünde Dóra Borsányi Péter Andréka Gábor Zoltán Duray Róbert Gábor Kiss Miklós Dékány Noémi Nyolczas |
| author_sort | Balázs Muk |
| collection | DOAJ |
| description | (1) Background: Besides the use of guideline-directed medical therapy (GDMT), multidisciplinary heart failure (HF) outpatient care (HFOC) is of strategic importance in HFrEF. (2) Methods: Data from 257 hospitalised HFrEF patients between 2019 and 2021 were retrospectively analysed. Application and target doses of GDMT were compared between HFOC and non-HFOC patients at discharge and at 1 year. 1-year all-cause mortality (ACM) and rehospitalisation (ACH) rates were compared using the Cox proportional hazard model. The effect of HFOC on GDMT and on prognosis after propensity score matching (PSM) of 168 patients and the independent predictors of 1-year ACM and ACH were also evaluated. (3) Results: At 1 year, the application of RASi, MRA and triple therapy (TT: RASi + βB + MRA) was higher (<i>p</i> < 0.05) in the HFOC group, as was the proportion of target doses of ARNI, βB, MRA and TT. After PSM, the composite of 1-year ACM or ACH was more favourable with HFOC (propensity-adjusted HR = 0.625, 95% CI = 0.401–0.974, <i>p</i> = 0.038). Independent predictors of 1-year ACM were age, systolic blood pressure, application of TT and HFOC, while 1-year ACH was influenced by the application of TT. (4) Conclusions: HFOC may positively impact GDMT use and prognosis in HFrEF even within the first year of its initiation. |
| first_indexed | 2024-03-08T11:01:12Z |
| format | Article |
| id | doaj.art-71c90daae70b4c0faab0c86e43df4db4 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T11:01:12Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-71c90daae70b4c0faab0c86e43df4db42024-01-26T16:00:23ZengMDPI AGDiagnostics2075-44182024-01-0114213110.3390/diagnostics14020131The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection FractionBalázs Muk0Fanni Bánfi-Bacsárdi1Máté Vámos2Dávid Pilecky3Zsuzsanna Majoros4Gábor Márton Török5Dénes Vágány6Balázs Polgár7Balázs Solymossi8Tünde Dóra Borsányi9Péter Andréka10Gábor Zoltán Duray11Róbert Gábor Kiss12Miklós Dékány13Noémi Nyolczas14Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, HungaryDepartment of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, HungaryCardiac Electrophysiology Division, Cardiology Center, Internal Medicine Clinic, University of Szeged, 6720 Szeged, HungaryDepartment of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, HungaryDepartment of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary(1) Background: Besides the use of guideline-directed medical therapy (GDMT), multidisciplinary heart failure (HF) outpatient care (HFOC) is of strategic importance in HFrEF. (2) Methods: Data from 257 hospitalised HFrEF patients between 2019 and 2021 were retrospectively analysed. Application and target doses of GDMT were compared between HFOC and non-HFOC patients at discharge and at 1 year. 1-year all-cause mortality (ACM) and rehospitalisation (ACH) rates were compared using the Cox proportional hazard model. The effect of HFOC on GDMT and on prognosis after propensity score matching (PSM) of 168 patients and the independent predictors of 1-year ACM and ACH were also evaluated. (3) Results: At 1 year, the application of RASi, MRA and triple therapy (TT: RASi + βB + MRA) was higher (<i>p</i> < 0.05) in the HFOC group, as was the proportion of target doses of ARNI, βB, MRA and TT. After PSM, the composite of 1-year ACM or ACH was more favourable with HFOC (propensity-adjusted HR = 0.625, 95% CI = 0.401–0.974, <i>p</i> = 0.038). Independent predictors of 1-year ACM were age, systolic blood pressure, application of TT and HFOC, while 1-year ACH was influenced by the application of TT. (4) Conclusions: HFOC may positively impact GDMT use and prognosis in HFrEF even within the first year of its initiation.https://www.mdpi.com/2075-4418/14/2/131heart failure outpatient careheart failure with reduced ejection fractionprognosis |
| spellingShingle | Balázs Muk Fanni Bánfi-Bacsárdi Máté Vámos Dávid Pilecky Zsuzsanna Majoros Gábor Márton Török Dénes Vágány Balázs Polgár Balázs Solymossi Tünde Dóra Borsányi Péter Andréka Gábor Zoltán Duray Róbert Gábor Kiss Miklós Dékány Noémi Nyolczas The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction Diagnostics heart failure outpatient care heart failure with reduced ejection fraction prognosis |
| title | The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction |
| title_full | The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction |
| title_fullStr | The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction |
| title_full_unstemmed | The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction |
| title_short | The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction |
| title_sort | impact of specialised heart failure outpatient care on the long term application of guideline directed medical therapy and on prognosis in heart failure with reduced ejection fraction |
| topic | heart failure outpatient care heart failure with reduced ejection fraction prognosis |
| url | https://www.mdpi.com/2075-4418/14/2/131 |
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