Heart failure in Europe: Guideline-directed medical therapy use and decision making in chronic and acute, pre-existing and de novo, heart failure with reduced, mildly reduced, and preserved ejection fraction - the ESC EORP Heart Failure III Registry

Lund, L. and Crespo-Leiro, M.G. and Laroche, C. and Zaliaduonyte, D. and Saad, A.M. and Fonseca, C. and Čelutkienė, J. and Zdravkovic, M. and Bielecka-Dabrowa, A.M. and Agostoni, P. and Xuereb, R.G. and Neronova, K.V. and Potabashniy, V. and Markova, O. and Kniazieva, O. (2024) Heart failure in Europe: Guideline-directed medical therapy use and decision making in chronic and acute, pre-existing and de novo, heart failure with reduced, mildly reduced, and preserved ejection fraction - the ESC EORP Heart Failure III Registry. European Journal of Heart Failure. ISSN 1879-0844(Online), 1388-9842(Print)

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Abstract

Aims: We analysed baseline characteristics and guideline-directed medical therapy (GDMT) use and decisions in the European Society of Cardiology (ESC) Heart Failure (HF) III Registry. Methods and results: Between 1 November 2018 and 31 December 2020, 10 162 patients with acute HF (AHF, 39%, age 70 [62-79], 36% women) or outpatient visit for HF (61%, age 66 [58-75], 33% women), with HF with reduced (HFrEF, 57%), mildly reduced (HFmrEF, 17%) or preserved (HFpEF, 26%) ejection fraction were enrolled from 220 centres in 41 European or ESC-affiliated countries. With AHF, 97% were hospitalized, 2.2% received intravenous treatment in the emergency department, and 0.9% received intravenous treatment in an outpatient clinic. AHF was seen by most by a general cardiologist (51%) and outpatient HF most by a HF specialist (48%). A majority had been hospitalized for HF before, but 26% of AHF and 6.1% of outpatient HF had de novo HF. Baseline use, initiation and discontinuation of GDMT varied according to AHF versus outpatient HF, de novo versus pre-existing HF, and by ejection fraction. After the AHF event or outpatient HF visit, use of any renin-angiotensin system inhibitor, angiotensin receptor-neprilysin inhibitor, beta-blocker, mineralocorticoid receptor antagonist and loop diuretics was 89%, 29%, 92%, 78%, and 85% in HFrEF; 89%, 9.7%, 90%, 64%, and 81% in HFmrEF; and 77%, 3.1%, 80%, 48%, and 80% in HFpEF. Conclusion: Use and initiation of GDMT was high in cardiology centres in Europe, compared to previous reports from cohorts and registries including more primary care and general medicine and regions more local or outside of Europe and ESC-affiliated countries.

Item Type:	Article
Additional Information:	https://doi.org/10.1002/ejhf.3445
Uncontrolled Keywords:	Ejection fraction, Guideline‐directed medical therapy, Heart failure, Implementation, Quality of care, Registry.
Subjects:	Cardiology
Divisions:	Faculty of Postgraduate Education > Department of Therapy, cardiology and family medicine FPE
Depositing User:	Анастасия Жигар
Date Deposited:	16 Dec 2024 10:14
Last Modified:	16 Dec 2024 10:14
URI:	http://repo.dma.dp.ua/id/eprint/9229

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