Cannata, A. et al. (2024) A nationwide, population-based study on specialized care for acute heart failure throughout the COVID-19 pandemic. European Journal of Heart Failure, 26(7), pp. 1574-1584. (doi: 10.1002/ejhf.3306) (PMID:38837310)
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Abstract
Aims: The COVID-19 pandemic disrupted the delivery of care for patients with heart failure (HF), leading to fewer HF hospitalizations and increased mortality. However, nationwide data on quality of care and long-term outcomes across the pandemic are scarce. Methods and results: We used data from the National Heart Failure Audit (NHFA) linked to national records for hospitalization and deaths. We compared pre-COVID (2018–2019), COVID (2020), and late/post-COVID (2021–2022) periods. Data for 227 250 patients admitted to hospital with HF were analysed and grouped according to the admission year and the presence of HF with (HFrEF) or without reduced ejection fraction (non-HFrEF). The median age at admission was 81 years (interquartile range 72–88), 55% were men (n = 125 975), 87% were of white ethnicity (n = 102 805), and 51% had HFrEF (n = 116 990). In-hospital management and specialized cardiology care were maintained throughout the pandemic with an increasing percentage of patients discharged on disease-modifying medications over time (p < 0.001). Long-term outcomes improved over time (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.90–0.95, p < 0.001), mainly driven by a reduction in cardiovascular death. Receiving specialized cardiology care was associated with better long-term outcomes both for those who had HFrEF (HR 0.79, 95% CI 0.77–0.82, p < 0.001) and for those who had non-HFrEF (HR 0.87, 95% CI 0.85–0.90, p < 0.001). Conclusions: Despite the disruption of healthcare systems, the clinical characteristics of patients admitted with HF were similar and the overall standard of care was maintained throughout the pandemic. Long-term survival of patients hospitalized with HF continued to improve after COVID-19, especially for HFrEF.
Item Type: | Articles |
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Additional Information: | Funding: The British Heart Foundation (grant No SP/19/3/34678), awarded to Health Data Research UK (HDR UK) funded co-development (with NHS England) of the secure data environment (SDE), provision of linked datasets, data access, user software licences, computational usage, and data management, wrangling and curation support, with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser's National Core Studies programme to coordinate national COVID-19 priority research. Consortium partner organizations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. A.C. is supported by the British Heart Foundation (FS/CRTF/21/24175). D.B. is supported by a Medical Research Council (MR/X001881/1) and British Heart Foundation (RE/18/2/34213). |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Gardner, Professor Roy and Cleland, Professor John |
Authors: | Cannata, A., Mizani, M. A., Bromage, D. I., Piper, S. E., Hardman, S. M.C., Sudlow, C., de Belder, M., Deanfield, J., Gardner, R. S., Clark, A. L., Cleland, J. G.F., and McDonagh, T. A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
Journal Name: | European Journal of Heart Failure |
Publisher: | Wiley |
ISSN: | 1388-9842 |
ISSN (Online): | 1879-0844 |
Published Online: | 04 June 2024 |
Copyright Holders: | Copyright © 2024 The Author(s). |
First Published: | First published in European Journal of Heart Failure 26(7):1574-1584 |
Publisher Policy: | Reproduced under a Creative Commons license |
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