August 30, 2010Open Access
View Full PaperEUR Observational Research Programme: The Heart Failure Pilot Survey (ESC-HF Pilot)
Key Result
An observational survey of 5118 European heart failure patients revealed a 3.8% in-hospital mortality for acute cases, with only 25-33% of chronic patients reaching target doses of HF medications.
Study Design
Type
Observational (n=5,118)
Multicenter
Yes
Structured PICO
P
Population
5,118 outpatients with chronic heart failure (n=3,226) and inpatients admitted for acute heart failure (n=1,892) across 136 cardiology centres in 12 European countries.
O
Outcome
Clinical epidemiology, diagnostic/therapeutic processes, and in-hospital mortality
The ESC-HF Pilot Survey highlights that while prescription rates for guideline-directed medical therapies in chronic heart failure are high, achieving target doses remains a significant clinical challenge.
Abstract
AIMS: The primary objective of the new ESC-HF Pilot Survey was to describe the clinical epidemiology of outpatients and inpatients with heart failure (HF) and the diagnostic/therapeutic processes applied across 12 participating European countries. This pilot study was specifically aimed at validating the structure, performance, and quality of the data set, for continuing the survey into a permanent registry. METHODS AND RESULTS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 cardiology centres from 12 European countries selected to represent the different health systems and care attitudes across Europe. All outpatients with HF and patients admitted for acute HF were included during the enrolment period (1 day per week for 8 consecutive months). From October 2009 to May 2010, 5118 patients were included in this pilot survey, of which 1892 (37%) were admitted for acute HF and 3226 (63%) for chronic HF. Ischaemic aetiology was reported in about half of the patients. In patients admitted for acute HF, the most frequent clinical profile was decompensated HF (75% of cases), whereas pulmonary oedema and cardiogenic shock were reported, respectively, in 13.3 and 2.3% of the cases. The total in-hospital mortality rate was 3.8% and was cardiovascular in 90.1% of the cases. Lowest and highest mortality rates were observed in hypertensive HF and in cardiogenic shock, respectively. More than 80% of patients with chronic HF were treated with renin-angiotensin-aldosterone system blockers and β-adrenergic blockers. However, target doses of such drugs were reached in one-third to one-fourth of the patients only. CONCLUSION: The ESC-HF Pilot Survey is an example of the possibility of utilizing an observational methodology to get insights into the current clinical practice in Europe, whose picture will be completed by the 1-year follow-up. Moreover, this study offered the opportunity to refine the organizational structure of a long-term, extended European network.