A systematic approach starting at admission and continuing through post-discharge is proposed to improve outcomes and optimize guideline-directed medical therapies in acute heart failure.
Hospitalization for acute heart failure should be utilized as a critical opportunity to optimize guideline-directed medical therapies and implement a systematic care approach to improve unacceptably high post-discharge event rates.
The global burden that acute heart failure (AHF) carries has remained unchanged over the past several decades (1). European registries (2–5) showed that 1-year outcome rates remain unacceptably high (Table 1) and confirm that hospitalization for AHF represents a change in the natural history of the disease process(6). As patients hospitalized for HF have a bad prognosis, it is crucial to utilize hospitalization as an opportunity to: 1) assess the individual components of the cardiac substrate; 2) identify and treat comorbidities; 3) identify early, safe endpoints of therapy to facilitate timely hospital discharge and outpatient follow-up; and 4) implement and begin optimization guideline-directed medical therapies (GDMTs). As outcomes are influenced by many factors, many of which are incompletely understood, a systematic approach is proposed that should start with admission and continues through post-discharge (7).
Chioncel et al. (Sun,) conducted a review in Acute heart failure. Systematic approach to hospitalization and post-discharge care was evaluated. A systematic approach starting at admission and continuing through post-discharge is proposed to improve outcomes and optimize guideline-directed medical therapies in acute heart failure.
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