Key result
Hospitalized heart failure patients in the ESC-HF-LT registry showed no significant difference in 1-year all-cause mortality compared to the earlier ESC-HF Pilot registry (16.9% vs 13.7%, p=0.11).
Why the study?
Heart failure management has changed significantly in recent decades, prompting an analysis of clinical profiles, 1-year outcomes, predictors of mortality, and readmissions across successive ESC registries.
Does management in the more recent ESC-HF-LT registry improve 1-year outcomes in hospitalized heart failure patients compared to the ESC-HF Pilot registry?
Observational (n=1,415)
Yes
Does management in the more recent ESC-HF-LT registry improve 1-year outcomes in hospitalized heart failure patients compared to the ESC-HF Pilot registry?
Absolute Event Rate: 16.9% vs 13.7%
p-value: p=0.11
Hospitalized heart failure patients in the more recent ESC-HF-LT registry had a lower risk of death or HF hospitalization at 1 year compared to the earlier ESC-HF Pilot registry, despite being older and having more comorbidities, suggesting improved guideline adherence.
No mortality difference observed between registries; leaves open whether contemporary management improves composite HF outcomes in observational cohorts.
INTRODUCTION The management of heart failure (HF) has changed significantly in recent decades. OBJECTIVES We analyzed the clinical profile, 1‑year outcomes, predictors of mortality, and hospital readmissions in hospitalized patients enrolled in the European Society of Cardiology Heart Failure Pilot Survey (ESC‑HF Pilot) and Heart Failure Long‑Term Registry (ESC‑HF‑LT). PATIENTS AND METHODS The analysis included hospitalized Polish patients from both registries. The primary endpoint was all‑cause death at 1 year, while the secondary endpoint was all‑cause death or hospitalization for worsening HF at 1 year. RESULTS The study included a total of 1415 hospitalized patients (650 from ESC‑HF Pilot; 765 from ESC‑HF‑LT). The primary endpoint occurred in 89 of the 650 patients (13.7%) and in 120 of the 711 patients (16.9%) from ESC‑HF Pilot and ESC‑HF‑LT, respectively (P = 0.11). The secondary endpoint was more frequent in ESC‑HF Pilot than in ESC‑HF‑LT (201 of 509 [39.5%] vs 222 of 663 [33.5%]; P = 0.04). Compared with ESC‑HF Pilot, patients from the ESC‑HF‑LT registry were older and more often had hypertension, atrial fibrillation, peripheral artery disease, and chronic kidney disease, while the incidence of chronic obstructive pulmonary disease was lower. The percentage of patients receiving drugs for HF (diuretics, angiotensin‑converting enzyme inhibitors, angiotensin receptor blockers, β‑blockers, mineralocorticoid receptor antagonists), anticoagulants, cardiac resynchronization therapy, and implantable cardioverter‑defibrillator were higher in the ESC‑HF‑LT group in comparison with the ESC‑HF Pilot group. CONCLUSIONS Patients from the ESC‑HF‑LT registry had a lower risk of death or hospitalization for worsening HF despite the fact that they were older and had more comorbidities. The results might suggest an improvement in physicians' adherence to the guidelines on the management of HF in the ESC‑HF‑LT registry.
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Balsam et al. (2019) conducted an observational in Heart failure (n=1,415). ESC-HF-LT registry enrollment vs. ESC-HF Pilot registry enrollment was evaluated on All-cause death at 1 year (p=0.11). Hospitalized heart failure patients in the ESC-HF-LT registry showed no significant difference in 1-year all-cause mortality compared to the earlier ESC-HF Pilot registry (16.9% vs 13.7%, p=0.11).
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