Temporal trends in characteristics, management and prognosis of patients with acute heart failure through two repeated snapshots
Abstract
BACKGROUND: Real-life data is very useful for gaining a better understanding of care in practice and identifying areas for improvement. This study aimed to assess changes in the clinical characteristics, care and outcomes of patients hospitalised with acute heart failure (HF). METHODS: Two multicentre snapshot surveys were conducted in 2009 and 2021 following the same methodology and enrolled 1658 and 1513 patients, respectively. Clinical characteristics, hospitalisation pathways, in-hospital management and short-term outcomes during a 6-month follow-up were collected. RESULTS: While the age of patients and the proportion in each left ventricular ejection fraction (LVEF) category remained largely unchanged (76 years and 53% with reduced LVEF in the two surveys), there was a rise in the prevalence of most comorbidities. Emergency department was the predominant and increasing route for hospitalisation (64-71%), and admission to critical care units remained frequent and stable (40%). In patients with reduced LVEF, the prescription rate of ACE inhibitors, angiotensin receptor blockers or angiotensin receptor-neprilysin inhibitors (ARNis) decreased from 77.8% to 70.6%, while the use of beta-blockers and mineralocorticoid receptor antagonists increased (67.7-74.2% and 26.6-35.5%, respectively) at discharge. Mortality at 1 and 6 months declined from 8.9% to 7.6% and from 24.7% to 21.3%, respectively. This difference was also significant after matching the two cohorts (HR 0.78 (0.66-0.94)). This improvement in mortality was observed in most patients except in the most elderly and those with preserved LVEF. CONCLUSIONS: A comparison of two cross-sectional surveys of acute HF, conducted 12 years apart, reveals an increasing burden of comorbidities, as well as a lack of dedicated admission pathways and a significant shortcoming in the prescription of evidence-based HF drugs on discharge. However, there has been a significant decrease in short-term mortality. TRIAL REGISTRATION NUMBER: NCT01080937 and NCT05232058.
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BibTeX
@article{logeart2026temporal,
title = {{Temporal trends in characteristics, management and prognosis of patients with acute heart failure through two repeated snapshots}},
author = {Damien Logeart and Benjamin Alos and Damien Legallois and Clerfond Guillaume and Jérôme Costa and Étienne Puymirat and Guillaume Turlotte and Christophe Thuaire and François Picard and Guillaume Jondeau and Jean-Noël Trochu and Erwan Donal and Pascal de Groote and Diane Bodez and Clément Delmas and Muriel Salvat and Louise Legrand and Maxime Doublet and Claire Bouleti},
journal = {Heart},
year = {2026},
month = oct,
doi = {10.1136/heartjnl-2025-327454},
url = {https://hal.science/hal-05830289v1},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Temporal trends in characteristics, management and prognosis of patients with acute heart failure through two repeated snapshots
AU - Damien Logeart
AU - Benjamin Alos
AU - Damien Legallois
AU - Clerfond Guillaume
AU - Jérôme Costa
AU - Étienne Puymirat
AU - Guillaume Turlotte
AU - Christophe Thuaire
AU - François Picard
AU - Guillaume Jondeau
AU - Jean-Noël Trochu
AU - Erwan Donal
AU - Pascal de Groote
AU - Diane Bodez
AU - Clément Delmas
AU - Muriel Salvat
AU - Louise Legrand
AU - Maxime Doublet
AU - Claire Bouleti
PY - 2026
DA - 2026/10/21
JO - Heart
DO - 10.1136/heartjnl-2025-327454
UR - https://hal.science/hal-05830289v1
AB - BACKGROUND: Real-life data is very useful for gaining a better understanding of care in practice and identifying areas for improvement. This study aimed to assess changes in the clinical characteristics, care and outcomes of patients hospitalised with acute heart failure (HF). METHODS: Two multicentre snapshot surveys were conducted in 2009 and 2021 following the same methodology and enrolled 1658 and 1513 patients, respectively. Clinical characteristics, hospitalisation pathways, in-hospital management and short-term outcomes during a 6-month follow-up were collected. RESULTS: While the age of patients and the proportion in each left ventricular ejection fraction (LVEF) category remained largely unchanged (76 years and 53% with reduced LVEF in the two surveys), there was a rise in the prevalence of most comorbidities. Emergency department was the predominant and increasing route for hospitalisation (64-71%), and admission to critical care units remained frequent and stable (40%). In patients with reduced LVEF, the prescription rate of ACE inhibitors, angiotensin receptor blockers or angiotensin receptor-neprilysin inhibitors (ARNis) decreased from 77.8% to 70.6%, while the use of beta-blockers and mineralocorticoid receptor antagonists increased (67.7-74.2% and 26.6-35.5%, respectively) at discharge. Mortality at 1 and 6 months declined from 8.9% to 7.6% and from 24.7% to 21.3%, respectively. This difference was also significant after matching the two cohorts (HR 0.78 (0.66-0.94)). This improvement in mortality was observed in most patients except in the most elderly and those with preserved LVEF. CONCLUSIONS: A comparison of two cross-sectional surveys of acute HF, conducted 12 years apart, reveals an increasing burden of comorbidities, as well as a lack of dedicated admission pathways and a significant shortcoming in the prescription of evidence-based HF drugs on discharge. However, there has been a significant decrease in short-term mortality. TRIAL REGISTRATION NUMBER: NCT01080937 and NCT05232058.
SN - 1355-6037
SN - 1468-201X
ER -