Heart failure therapeutic units enhance adherence to ESC guidelines

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.