Temporal trends in characteristics, management and prognosis of patients with acute heart failure through two repeated snapshots
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Real-life data is very useful for gaining a better understanding of care in practice and identifying areas for improvement. This study aimed to assess changes in the clinical characteristics, care and outcomes of patients hospitalised with acute heart failure (HF). METHODS: Two multicentre snapshot surveys were conducted in 2009 and 2021 following the same methodology and enrolled 1658 and 1513 patients, respectively. Clinical characteristics, hospitalisation pathways, in-hospital management and short-term outcomes during a 6-month follow-up were collected. RESULTS: While the age of patients and the proportion in each left ventricular ejection fraction (LVEF) category remained largely unchanged (76 years and 53% with reduced LVEF in the two surveys), there was a rise in the prevalence of most comorbidities. Emergency department was the predominant and increasing route for hospitalisation (64-71%), and admission to critical care units remained frequent and stable (40%). In patients with reduced LVEF, the prescription rate of ACE inhibitors, angiotensin receptor blockers or angiotensin receptor-neprilysin inhibitors (ARNis) decreased from 77.8% to 70.6%, while the use of beta-blockers and mineralocorticoid receptor antagonists increased (67.7-74.2% and 26.6-35.5%, respectively) at discharge. Mortality at 1 and 6 months declined from 8.9% to 7.6% and from 24.7% to 21.3%, respectively. This difference was also significant after matching the two cohorts (HR 0.78 (0.66-0.94)). This improvement in mortality was observed in most patients except in the most elderly and those with preserved LVEF. CONCLUSIONS: A comparison of two cross-sectional surveys of acute HF, conducted 12 years apart, reveals an increasing burden of comorbidities, as well as a lack of dedicated admission pathways and a significant shortcoming in the prescription of evidence-based HF drugs on discharge. However, there has been a significant decrease in short-term mortality. TRIAL REGISTRATION NUMBER: NCT01080937 and NCT05232058.
Source: Heart
Authors: Damien Logeart, Benjamin Alos, Damien Legallois, Clerfond Guillaume, Jerome Costa, Etienne Puymirat, Guillaume Turlotte, Christophe Thuaire, François Picard, Guillaume Jondeau, Jean-Noel Trochu, Erwan Donal, Pascal De Groote, Diane Bodez, Clément Delmas, Muriel Salvat, Louise Legrand, Maxime Doublet, Claire Bouleti
Institutions: Université Paris Cité, Hôpital Fernand-Widal, Hôpital Lariboisière, Centre Hospitalier Universitaire de Poitiers, Centre Hospitalier Universitaire de Caen Normandie, Centre Hospitalier Universitaire de Clermont-Ferrand, Centre Hospitalier Universitaire de Reims, Hôpital Européen Georges-Pompidou, Centre Hospitalier Départemental Vendée, Les Hôpitaux de Chartres, Centre Hospitalier Universitaire de Bordeaux, Hôpital Bichat-Claude-Bernard, Centre Hospitalier Universitaire de Nantes, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Centre Hospitalier Universitaire de Lille, Lille’s Cardiology Hospital, Centre Cardiologique du Nord, Centre Hospitalier Universitaire de Toulouse, Centre Hospitalier Universitaire de Grenoble, Pitié-Salpêtrière Hospital, Université de Poitiers
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funder: Société Française de Cardiologie
OpenAlex ID: W7161022751