Heart failure therapeutic units enhance adherence to ESC guidelines

IF 2.2 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Archives of Cardiovascular Diseases Pub Date : 2025-01-01 Epub Date: 2025-01-15 DOI:10.1016/j.acvd.2024.10.028

O. Ferchichi , Z. Ibn El Hadj , L. Mariem , Z. Oumayma , H. Ben Arbia , A. Sghaier , M.A. Almi , S. Bousnina , R. Chaabouni , S. Allegui , S. Aouni , A. Ben Halima , E. Bennour , I. Kammoun

{"title":"Heart failure therapeutic units enhance adherence to ESC guidelines","authors":"O. Ferchichi , Z. Ibn El Hadj , L. Mariem , Z. Oumayma , H. Ben Arbia , A. Sghaier , M.A. Almi , S. Bousnina , R. Chaabouni , S. Allegui , S. Aouni , A. Ben Halima , E. Bennour , I. Kammoun","doi":"10.1016/j.acvd.2024.10.028","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure persists as a widespread health concern globally, affecting approximately 1–2% of the population in developed nations. Despite medical advancements, heart failure remains a significant cause of morbidity and mortality, primarily attributed to inadequate adherence to the latest ESC guidelines.</div></div><div><h3>Objective</h3><div>To underscore the importance of heart failure therapeutic units (HFTU) in aligning with ESC guidelines.</div></div><div><h3>Method</h3><div>This study was a prospective, descriptive, single-center investigation carried out in our cardiology department over a duration of 12 months. We included 159 patients diagnosed with chronic heart failure, who were divided into two groups to receive care either in the HFTU or usual care, regardless of their initial ejection fraction. Patients allocated to the HFTU had more frequent follow-up visits, prompt initiation of optimal treatment, and transition to second-line therapy if symptoms persisted compared to those receiving usual care. At the end of the follow-up period, we investigated the relationship between enrollment in the HFTU and adherence to ESC guidelines.</div></div><div><h3>Results</h3><div>The mean age of our cohort was 62.5±11.7 years, with a male predominance at 80.5%. Among the 159 patients, 108 patients allocated to the HFTU while 51 received usual care. Ischemic heart disease was the most prevalent underlying condition, accounting for 57.9% of cases. The average left ventricular ejection fraction was 31.6±8.31%. The prescription rates of beta-blockers, Angiotensin-Converting Enzyme inhibitors/Angiotensin II Receptor Blockers, Sodium-Glucose Co-Transporter 2 inhibitors, and mineralocorticoid receptor antagonists were 98.1%, 85.6%, 84.3%, and 79.6% respectively, in the HFTU group compared to 94.1%, 70.6%, 31.4%, and 88.2% respectively, in the usual care group.</div><div>Throughout the follow-up period, the HFTU group demonstrated significantly greater adoption of optimal medical treatment compared to those receiving usual care (54,6% vs. 7,8%; <em>P</em>  <!-->0,001).</div></div><div><h3>Conclusion</h3><div>HFTU enhance adherence to ESC guidelines, thus combating therapeutic inertia and potentially improving the prognosis of heart failure.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S37"},"PeriodicalIF":2.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1875213624003735","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Heart failure persists as a widespread health concern globally, affecting approximately 1–2% of the population in developed nations. Despite medical advancements, heart failure remains a significant cause of morbidity and mortality, primarily attributed to inadequate adherence to the latest ESC guidelines.

Objective

To underscore the importance of heart failure therapeutic units (HFTU) in aligning with ESC guidelines.

Method

This study was a prospective, descriptive, single-center investigation carried out in our cardiology department over a duration of 12 months. We included 159 patients diagnosed with chronic heart failure, who were divided into two groups to receive care either in the HFTU or usual care, regardless of their initial ejection fraction. Patients allocated to the HFTU had more frequent follow-up visits, prompt initiation of optimal treatment, and transition to second-line therapy if symptoms persisted compared to those receiving usual care. At the end of the follow-up period, we investigated the relationship between enrollment in the HFTU and adherence to ESC guidelines.

Results

The mean age of our cohort was 62.5 ± 11.7 years, with a male predominance at 80.5%. Among the 159 patients, 108 patients allocated to the HFTU while 51 received usual care. Ischemic heart disease was the most prevalent underlying condition, accounting for 57.9% of cases. The average left ventricular ejection fraction was 31.6 ± 8.31%. The prescription rates of beta-blockers, Angiotensin-Converting Enzyme inhibitors/Angiotensin II Receptor Blockers, Sodium-Glucose Co-Transporter 2 inhibitors, and mineralocorticoid receptor antagonists were 98.1%, 85.6%, 84.3%, and 79.6% respectively, in the HFTU group compared to 94.1%, 70.6%, 31.4%, and 88.2% respectively, in the usual care group.

Throughout the follow-up period, the HFTU group demonstrated significantly greater adoption of optimal medical treatment compared to those receiving usual care (54,6% vs. 7,8%; P < 0,001).

Conclusion

HFTU enhance adherence to ESC guidelines, thus combating therapeutic inertia and potentially improving the prognosis of heart failure.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

心力衰竭治疗单位提高了ESC指南的依从性

心力衰竭一直是全球普遍存在的健康问题，影响着发达国家约1-2%的人口。尽管医学进步，心力衰竭仍然是发病率和死亡率的重要原因，主要原因是没有充分遵守最新的ESC指南。目的强调心力衰竭治疗单位（HFTU）与ESC指南保持一致的重要性。方法本研究是一项前瞻性、描述性、单中心研究，在我院心内科进行，为期12个月。我们纳入了159例诊断为慢性心力衰竭的患者，无论其初始射血分数如何，他们被分为两组接受HFTU或常规护理。与接受常规治疗的患者相比，分配到HFTU的患者有更频繁的随访，及时开始最佳治疗，如果症状持续，则过渡到二线治疗。在随访期结束时，我们调查了HFTU入组与ESC指南依从性之间的关系。结果本组患者平均年龄为62.5±11.7岁，男性占80.5%。在159例患者中，108例患者被分配到HFTU， 51例患者接受常规护理。缺血性心脏病是最常见的基础疾病，占病例的57.9%。平均左室射血分数为31.6±8.31%。HFTU组β受体阻滞剂、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂、钠-葡萄糖共转运蛋白2抑制剂和矿皮质激素受体拮抗剂的处方率分别为98.1%、85.6%、84.3%和79.6%，而常规护理组分别为94.1%、70.6%、31.4%和88.2%。在整个随访期间，HFTU组与接受常规治疗的组相比，明显更多地采用了最佳药物治疗(54.6%对7.8%；P & lt;0001)。结论hftu提高了ESC指南的依从性，从而克服了治疗惰性，并可能改善心力衰竭的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.