| Autor: |
Logeart, Damien, Berthelot, Emmannuelle, Bihry, Nicolas, Eschalier, Romain, Salvat, Muriel, Garcon, Philippe, Eicher, Jean-Christophe, Cohen, Ariel, Tartiere, Jean-Michel, Samadi, Alireza, Donal, Erwan, deGroote, Pascal, Mewton, Nathan, Mansencal, Nicolas, Raphael, Pierre, Ghanem, Nachwan, Seronde, Marie-France, Chavelas, Christophe, Rosamel, Yann, Beauvais, Florence |
| Předmět: |
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| Zdroj: |
European Journal of Heart Failure. Supplements; Jan2022, Vol. 24 Issue 1, p219-226, 8p |
| Abstrakt: |
Aims Hospitalization for acute heart failure (HF) is followed by a vulnerable time with increased risk of readmission or death, thus requiring particular attention after discharge. In this study, we examined the impact of intensive, early follow-up among patients at high readmission risk at discharge after treatment for acute HF. Methods and results Hospitalized acute HF patients were included with at least one of the following: previous acute HF<6months, systolic blood pressure=110 mmHg, creatininaemia=180 µmol/L, or B-type natriuretic peptide=350 pg/mL or N-terminal pro B-type natriuretic peptide=2200 pg/mL. Patients were randomized to either optimized care and education with serial consultations with HF specialist and dietician during the first 2-3weeks, or to standard post-discharge care according to guidelines. The primary endpoint was all-cause death or first unplanned hospitalization during 6-month follow-up. Among 482 randomized patients (median age 77 and median left ventricular ejection fraction 35%), 224 were hospitalized or died. In the intensive group, loop diuretics (46%), beta-blockers (49%), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (39%) and mineralocorticoid receptor antagonists (47%) were titrated. No difference was observed between groups for the primary endpoint (hazard ratio 0.97; 95% confidence interval 0.74-1.26), nor for mortality at 6 or 12months or unplanned HF rehospitalization. Additionally, no difference between groups according to age, previous HF and left ventricular ejection fraction was foun. Conclusions In high-risk HF, intensive follow-up early post-discharge did not improve outcomes. This vulnerable post-discharge time requires further studies to clarify useful transitional care services. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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