背景:心力衰竭(HF)是一种与死亡率增加相关的新兴流行病,反复住院,降低了生活质量。指南指导的药物治疗已被证明可以改善预后,特别是在HF射血分数降低(HFrEF)的患者中。HF诊所的主要目标是优化药物治疗。
目的:评估我们的HF诊所对药物治疗和临床结果的影响。
方法:我们获得了人口统计,超声心动图,以及在我们的HF诊所中列出的4年期间患者的临床数据。根据患者报告和记录数据评估药物治疗。记录了HF的经常性入院。
结果:总共317名患者(74.1%为男性,中位年龄66岁,IQR55-74)在诊所中列出,共1140次就诊。在这些病人中,62.5%有HFrEF,20.5%的人出现轻度降低的射血分数,17%的人在首次就诊时显示出保留的射血分数。92%和91%的患者优化了钠葡萄糖共转运蛋白2抑制剂和盐皮质激素受体拮抗剂的使用,分别。在HFrEF患者亚组中,血管紧张素受体拮抗剂/脑啡肽酶抑制剂的使用从22.6%增加到87.9%(P<0.001),SGLT2抑制剂的使用从49.2%增加到92%(P<0.001).在随访期间(2.2年,IQR1.1-3.1),203名患者(64%)因HF至少再次入院一次。再入院率随着时间的推移而下降。
结论:HF诊所在优化药物治疗和减少再入院方面发挥着重要作用。
BACKGROUND: Heart failure (HF) is an emerging pandemic associated with increased mortality, recurrent hospitalizations, and reduced quality of life. Guideline-directed medical therapy has been shown to improve outcomes, particularly in patients with HF with reduced ejection fraction (HFrEF). The main goal of HF clinics is optimizing medical therapy.
OBJECTIVE: To assess the impact of our HF clinic on medical therapy and clinical outcomes.
METHODS: We obtained demographic, echocardiographic, and clinical data of patients listed in our HF clinic during a 4-year period. Medical therapy was evaluated based on patient reports and documented data. Recurrent admissions for HF were documented.
RESULTS: A total of 317 patients (74.1% male, median age 66 years, IQR 55-74) were listed in the clinic with a total of 1140 visits. Of these patients, 62.5% had HFrEF, 20.5% presented with mildly reduced ejection fraction, and 17% showed preserved ejection fraction at the time of the first visit. The use of sodium glucose co-transporter 2 inhibitors and mineralocorticoid receptor antagonists was optimized in 92% and 91% of the patients, respectively. In the subgroup of patients with HFrEF, the use of angiotensin-receptor antagonist/neprilysin inhibitor increased from 22.6% to 87.9% (P < 0.001) and SGLT2 inhibitor use increased from 49.2% to 92% (P < 0.001). During the follow-up period (2.2 years, IQR 1.1-3.1), 203 patients (64%) were readmitted to the hospital for HF at least once. The rate of readmissions decreased over time.
CONCLUSIONS: An HF clinic plays an important role in optimizing medical therapy and reducing readmissions.