Enhanced Heart Failure Management: Impact of the therapeutic unit for heart failure (TUNI-HF) on mid-term prognosis.

BACKGROUND

Chronic heart failure (CHF) is a global and increasing problem responsible of uncontrolled rates of mortality and readmission. A therapeutic Unit of heart failure (TUNI-HF) was established to assume a treatment optimization, comorbidities management and education in order to improve heart failure (HF) prognosis.

AIM: This study aimed to describe the impact of the TUNI-HF on treatment optimization, mortality and readmission rates at 12 months in patients with heart failure with reduced ejection fraction (HFrEF).

METHODS

A retrospective study was conducted in the military hospital of Tunis, Tunisia. Two groups were compared: Group "C" included patients followed from March 2018 for 12 months with usual care. Group "U" included patients followed from Mars 2021 for 12 months in the TUNI-HF.

RESULTS

Groups "C" and "U" enrolled 108 and 110 patients respectively. At baseline, patients' characteristics were comparable. Prescription rates of guideline directed medical treatment (GDMT) at optimal doses were low in two groups. After 12 months, prescription rates of beta-blockers (BB) and mineralocorticoid receptor antagonist (MRA) were higher in group "U". In addition, optimal doses of BB, renin angiotensin aldosterone system inhibitors (RAASI) and MRA were more achieved in the same group "U". Loop diuretics were less prescribed in the group "U" and cardiac implantable devices rate was higher in the same group. Kaplan Meier analysis showed significantly lower rates of readmission and all-cause mortality rates in the group "U".

CONCLUSION

The management of HF in a specialized unit, compared with usual care, was associated with a better treatment optimization and a reduction in mortality and readmission rates.