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Journal Article Ahead of print 1 citation

PubMed: 40579187 DOI: 10.1093/ehjqcco/qcaf044

Current epidemiology and management of acute heart failure: the multicenter prospective OFICA2 cohort.

Eur Heart J Qual Care Clin Outcomes

Authors: Benjamin Alos, Claire Bouleti, Damien Legallois, Clement Riocreux, Jerome Costa, Etienne Puymirat, Jean-Noel Trochu, Guillaume Turlotte, Julie Perrin-Faurie, Teodora Dutoiu, François Picard, Gregory Ducrocq, Pascal de Groote, Thierry Laperche, Clement Delmas, Ariel Cohen, Maxime Doublet, Damien Logeart

Affiliations

  • University Hospital of Poitiers, Clinical Investigation Center (INSERM 1402), Cardiology Department, Poitiers, France.
  • University Hospital of Caen, Cardiology Department, Caen, France.
  • Cardiology Department, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France and Université Clermont Auvergne, Clermont-Ferrand, France.
  • University Hospital of Reims, Cardiology Department, Reims, France.
  • European Hospital Georges Pompidou, AP-HP, Cardiology Department, Paris, France.
  • University Hospital of Nantes, Cardiology Department, Nantes, France.
  • La Roche-sur-Yon Hospital, Cardiology Department, La Roche-Sur-Yon, France.
  • Hospital Metropole Savoie, Cardiology Department, Chambery, France.
  • Chartres Hospital, Cardiology Department, Le Coudray, France.
  • University Hospital of Bordeaux, Cardiology Department, Pessac, France.
  • Bichat University Hospital, AP-HP, Cardiology Department, Paris, France.
  • CHU Lille, Service de Cardiologie, F-59000 Lille, France - Inserm U1167, Institut Pasteur de Lille, F-59000 Lille, France.
  • Centre Cardiologique du Nord, Cardiology Department, Saint-Denis, France.
  • University Hospital of Toulouse, Cardiology Department, Toulouse, France.
  • Saint-Antoine University Hospital, AP-HP, Cardiology Department, Paris, France.
  • Clinityx Company, Paris, France.
  • Paris Cité University, AP-HP Hôpital Lariboisière, Inserm U942, 75010 Paris, France.

Abstract

AIM

Acute heart failure (AHF) represents a major cause of morbi-mortality. In the last decade, the management of HF has changed, but up-to-date real-life data are scarce. The aim of our study was to describe contemporary data about AHF patients' medical pathway, management and to identify predictors of in-hospital outcomes.

METHODS

OFICA2 is a French prospective multicenter cohort led from March to April 2021 in 80 participating centers. In-hospital outcomes were defined as a composite of all-cause death, cardiogenic shock or transfer to intensive care unit.

RESULTS

A total of 1513 consecutive patients (mean age 76 years, 61% male) hospitalized for AHF were included. One in five patients were not admitted in cardiology wards. A triggering factor was identified in 70% of cases, mostly supraventricular arrhythmia (21%). Median hospital stay was 11 days, and in-hospital mortality was 4.6%. Predictive factors of worse outcomes were a younger age, an initial acute coronary syndrome, a ventricular arrhythmia, a left ventricular ejection fraction (LVEF) ≤ 40%, a lower systolic blood pressure, a worse kidney function, and a higher C-reactive protein level on admission. At discharge, 61% of patients had an appointment scheduled with a cardiologist, 1 out of 4 patients with LVEF ≤ 40% had a combination of betablocker, renin-angiotensin system blocker and mineralocorticoid receptor antagonist, while 12% had no HF medication.

CONCLUSIONS

This comprehensive survey about patients hospitalized with AHF emphasizes HF care pathway, medical therapies and follow-up as weak spots. Filling these gaps might improve patients' management and prognosis.

MeSH

Mortality, Epidemiology, Heart Failure, Heart, Arrhythmias, Cardiac, Cardiovascular Diseases, Hospital Mortality, Clinical Medicine

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