Cardiologist follow-up and improved outcomes of heart failure: a French nationwide cohort

作者：Guillaume Baudry, Ouarda Pereira, François Roubille, Marc Villacèque, Thibaud Damy, Kévin Duarte, Philippe Tangre, Nicolas Girerd · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf218 · 被引用次数：26 · 研究领域：Heart Failure Treatment and Management、Acute Myocardial Infarction Research、Sepsis Diagnosis and Treatment

BACKGROUND AND AIMS: Outpatient cardiology follow-up is the cornerstone of heart failure (HF) management, requiring adaptation based on patient severity. However, risk stratification using administrative data is scarce, and the association between follow-up and prognosis according to patient risk has yet to be described at a population level. This study aimed to describe prognosis and management across different strata using simple criteria, including diuretic use and prior HF hospitalization (HFH). METHODS: This nationwide cohort included all French patients reported as having HF in the previous 5 years and alive on 1 January 2020. Patients were categorized into four groups: (i) HFH within the past year (HFH ≤ 1y), (ii) HFH 1-5 years ago (HFH > 1y), (iii) not hospitalized using loop diuretics (NoHFH/LD+), and (iv) not hospitalized without loop diuretics (NoHFH/LD-). Between-group associations, all-cause mortality (ACM), and cardiology follow-up were analysed using survival models. RESULTS: The study included 655 919 patients [80 years (70-87), 48% female]. One-year ACM risk was 15.9%, ranging from 8.0% (NoHFH/LD-) to 25.0% (HFH ≤ 1y). Mortality risk was 1.61-fold higher for NoHFH/LD+, 1.83-fold for HFH > 1y, and 2.32-fold for HFH ≤ 1y compared to NoHFH/LD- (P < .0001). During the first year of follow-up (2020), cardiology consultation rates were similar across groups, with 40% of patients lacking an annual visit. Compared to no consultation, a single cardiology visit in the ...