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
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
Affiliations
Balázs Muk
Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary
Fanni Bánfi-Bacsárdi
Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary
Máté Vámos
Cardiac Electrophysiology Division, Cardiology Center, Internal Medicine Clinic, University of Szeged, 6720 Szeged, Hungary
Dávid Pilecky
Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary
Zsuzsanna Majoros
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Gábor Márton Török
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Dénes Vágány
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Balázs Polgár
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Balázs Solymossi
Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary
Tünde Dóra Borsányi
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Péter Andréka
Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary
Gábor Zoltán Duray
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Róbert Gábor Kiss
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Miklós Dékány
Department of Cardiology, Central Hospital of Northern Pest—Military Hospital, 1134 Budapest, Hungary
Noémi Nyolczas
Department 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 (p p = 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.
