Are there long-term benefits in following stable heart failure patients in a heart failure clinic?
OBJECTIVE
This study describes the long-term outcome of 163 patients with stable mild to moderate heart failure (NYHA II-III), who already were enrolled in a heart failure clinic and now were randomized to continued follow-up in the heart failure (HF) clinic or else to usual care (UC). The primary outcome was unplanned hospitalisations and death, the secondary endpoints were pharmacological therapy, NYHA class, six-minute-walking distances and NT-pro BNP level.


RESULTS
At the end of follow-up we found no significant differences in total number of hospitalisation (p = 0.2) or mortality (16% vs. 16%) between the two groups. Patients in the HF clinic cohort achieved a significantly better NYHA score (p < 0.01), significantly longer walking-distances (p = 0.04) and received a significantly higher dose of angiotensin-converting enzyme inhibitors (p < 0.001) and beta-blockers (p < 0.001). No significant difference was found on the level of NT-pro BNP (p = 0.4).


CONCLUSIONS
Patients with mild to moderate HF may benefit from long-term follow-up in a HF clinic in terms of pharmacological therapy and functional status, but we found no significant impact on unplanned hospitalisations or death.
Leetmaa
Tina H
TH
Department of Cardiology, Odense University Hospital, Denmark. tina.leetmaa.@gmail.com
Villadsen
Henrik
H
Mikkelsen
Kirsten V
KV
Davidsen
Flemming
F
Haghfelt
Torben
T
Videbaek
Lars
L
D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality / Q000534:rehabilitation*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D016019:Survival Analysis
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain