[PONTE-HF/ACS registry: optimization of medical therapy in outpatient clinics in Apulia for patients with heart failure].

BACKGROUND

Despite advances in therapy, heart failure (HF) remains a syndrome characterized by high morbidity and mortality. The PONTE-HF/ACS registry aims to assess the outcomes of a structured outpatient follow-up between hospital and community care for patients with HF or recently hospitalized for acute coronary syndrome. The purpose of this study is to evaluate one of the main process indicators of the registry for patients with HF, namely the prescribed pharmacological therapy, with particular reference to therapy with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) or angiotensin receptor-neprilysin inhibitors (ARNi), beta-blockers, mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter 2 inhibitors (SGLT2i).

METHODS

Between January 2024 and September 2025, 1203 patients were enrolled: 496 with HF and reduced ejection fraction (HFrEF), 189 with HF and mildly reduced ejection fraction (HFmrEF), 302 with HF and preserved ejection fraction (HFpEF), and 216 with HF and improved ejection fraction.

RESULTS

In HFrEF patients, after enrollment, therapy was prescribed as follows: ACEi/ARB/ARNi in 89% of cases (64% ARNi), beta-blockers in 97%, MRA in 85%, and SGLT2i in 85%. Quadruple therapy with and without ARNi was prescribed in 69% and 51% of cases, respectively. The percentage of patients receiving at least 50% of the recommended dose was 63% for ARNi, 41% for ACEi/ARB, 70% for beta-blockers, and 98% for MRA.

CONCLUSIONS

The PONTE-HF/ACS registry shows good optimization of therapy in enrolled patients with HFrEF. Achieving this important process indicator highlights the quality of care provided by the HF outpatient network in the Apulia region and confirms the relevance of the registry for the analysis and optimization of diagnostic-therapeutic pathways in patients with HF.