Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar;13(3):402-413.
doi: 10.1016/j.jchf.2024.06.013. Epub 2024 Aug 7.

Heart Failure Specialist Care and Long-Term Outcomes for Patients Admitted With Acute Heart Failure

Antonio Cannata  1 , Mehrdad A Mizani  2 , Daniel I Bromage  1 , Susan E Piper  1 , Suzanna M C Hardman  3 , Cathie Sudlow  2 , Mark de Belder  4 , Paul A Scott  1 , John Deanfield  4 , Roy S Gardner  5 , Andrew L Clark  6 , John G F Cleland  7 , Theresa A McDonagh  8 ; CVD-COVID-UK/COVID-IMPACT Consortium
Affiliations
Free article

Heart Failure Specialist Care and Long-Term Outcomes for Patients Admitted With Acute Heart Failure

Antonio Cannata et al. JACC Heart Fail. 2025 Mar.
Free article

Abstract

Background: For patients with acute heart failure (HF), specialist HF care during admission improves diagnosis and treatments.

Objectives: The authors aimed to investigate the association of HF specialist care with in-hospital and longer term prognosis.

Methods: The authors used data from the National Heart Failure Audit from January 1, 2018, to December 31, 2022, linked to electronic records for hospitalization and deaths. All-cause mortality was the primary outcome measure and in-hospital mortality the secondary outcome measure.

Results: Data for 227,170 patients admitted to hospital with HF (median age: 81 years; IQR: 72-88 years), were analyzed. Approximately 80% of acute HF admissions received support from HF specialists. Thirty-nine percent of patients (n = 70,720) were seen by a multidisciplinary team (HF physicians and heart failure specialist nurses [HFSNs]), 22% (n = 40,330) were seen by HFSNs alone, and the remaining 39% (n = 71,700) were seen exclusively by specialist HF physicians. At discharge, more patients who received HF specialist care were prescribed medical therapy for HF and had specialized follow-up. Conversely, diuretic agents were prescribed to fewer patients. HF specialist care was independently associated with a higher rate of prescribing HF therapies at discharge and a lower likelihood of receiving diuretic therapy (OR: 0.90 [95% CI: 0.86-0.95]; P < 0.001). HF specialist care was associated with better long-term survival (HR: 0.89 [95% CI: 0.87-0.90]; P < 0.001) and lower in-hospital mortality (OR: 0.92 [95% CI: 0.0.88-0.97]; P < 0.001).

Conclusions: Receiving HF specialist care during admission for HF is associated with a higher rate of implementation of medical therapy, fewer discharges on diuretic therapy, and lower in-hospital and long-term mortality across the left ventricular ejection fraction spectrum, especially for patients with heart failure with reduced ejection fraction.

Keywords: COVID-19; National Heart Failure Audit; heart failure; specialist care.

PubMed Disclaimer

Conflict of interest statement

Funding Support and Author Disclosures The British Heart Foundation Data Science Centre (grant number SP/19/3/34678), awarded to Health Data Research United Kingdom (HDR UK) funded co-development (with NHS England) of the secure data environment, provision of linked data sets, data access, user software licenses, computational usage, and data management, wrangling, and curation support, with additional contributions from the HDR UK Data and Connectivity component of the United Kingdom Government Chief Scientific Adviser’s National Core Studies program to coordinate national COVID-19 priority research. Consortium partner organizations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. Dr Bromage is supported by a Medical Research Council (MRC) Clinician Scientist Fellowship (MR/X001881/1). Dr Cannata is supported by the British Heart Foundation (FS/CRTF/21/24175). The funder played no role in the study design, collection, analysis, interpretation of data, writing of the report, or in the decision to submit the paper for publication. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.