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Acute heart failure (AHF) is a leading etiology of hospitalization and mortality, and patients discharged after an AHF episode continue to face an amplified risk of death or recurrent HF admissions.
HF specialist care after AHF discharge significantly reduces long-term risks of rehospitalization and all-cause mortality across HFrEF, HFmrEF, and HFpEF—independent of age and comorbidities.
Acute heart failure (AHF) is a leading etiology of hospitalization and mortality, and patients discharged after an AHF episode continue to face an amplified risk of death or recurrent HF admissions. In the UK, the real-world benefits of post-discharge HF specialist care on long-term outcomes remain insufficiently explored.
Hence, this retrospective analysis explored the long-term predictive value of HF specialist care during and after hospitalization due to AHF.
This study analyzed 2104 subjects hospitalized with AHF. Researchers examined patient characteristics, left ventricular ejection fraction (LVEF) subtypes—HF with reduced ejection fraction (HfrEF; ≤40%), HF with mildly reduced ejection fraction (HfmrEF; 41–49%), and heart HF with preserved ejection fraction (HfpEF; ≥50%)—and survival free from all-cause death or AHF rehospitalization. Cox regression modelling was employed to determine how baseline clinical factors and specialist HF follow-up care influenced long-term outcomes.
The cohort had a median age of 83 years, with 36% HFrEF, 9% HFmrEF, and 55% HFpEF. In-hospital death during the index hospital stay was 13%. Among those discharged, the median follow-up was 618 days, during which 21% were rehospitalized for AHF and 63% died. Among the 1511 patients with echocardiographic data, receiving HF specialist care after discharge was independently linked with a prominent decrease in the composite risk of death or AHF rehospitalization across all the LVEF categories:
Post-discharge HF specialist follow-up provided a strong survival benefit for AHF patients, markedly minimizing the long-term risk of mortality and HF rehospitalization. This protective effect was consistent across HFrEF, HFmrEF, and HFpEF and remained independent of patient age and key comorbidities. These findings reinforce the critical role of structured HF specialist care enhancing long-term outcomes for those hospitalized with acute HF.
Open Heart
Outpatient heart failure specialist care following acute heart failure hospitalisation improves long-term outcomes
Jonathan Raby et al.
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