Heart failure burden and care among cardiology inpatients: insights from the Hellenic Cardiorenal Morbidity Snapshot (HECMOS) study

Abstract

Purpose: Heart failure (HF) burden and care varies significantly across different countries. We aimed to illustrate the clinical characteristics and HF-related care among cardiology inpatients in Greece.

Methods: We collected information about all cardiology inpatients on the 3rd of March 2022. The current analysis focuses on acute or chronic HF.

Results: Among a total of 923 participants, 280 (30%) concerned cases of acute HF whereas 351 patients (38%), (median age 79 ± 12 years, male gender 63.8%) had a history of chronic HF, with their majority presenting with multiple comorbidities and previous HF hospitalizations. 173 (49%) of chronic HF participants had reduced LVEF. Ischemic heart disease was the predominant HF etiology (182, 51.9%). Prior to the index admission, chronic HF cases were receiving diuretics, beta blockers, ACEi/ARBs, ARNI, MRAs, and SGLT2i at 79.8%, 74.4%, 43.3%, 10.8%, 40.7%, and 14%, respectively. Independent predictors of lower prescription rates of Guideline Directed Medical Therapy (GDMT) included advanced age (p < 0.001), chronic kidney disease (RASi OR 0.392, p = 0.008, MRA OR 0.523 p = 0.097), and lack of follow-up in dedicated HF clinics (p = 0.006). No regional differences with regards to GDMT were identified.

Conclusion: In this nation-wide real-world snapshot study, patients with chronic and acute HF accounted for a significant proportion of cardiology inpatients, while ischemic heart disease was the leading HF cause. GDMT and device therapy can be improved. Follow-up in dedicated HF units was related with increased prescription rates of GDMT, whereas this was not affected by geographical region.

Keywords: Acute heart failure; Chronic heart failure; Comorbidities; Guideline-directed medical treatment; Heart failure unit.