Early Care After Discharge of HF Patients

Usefulness of a Short-time But Very Early Specialized Follow-up After Hospitalization for Acute Heart Failure: a Randomized Controlled Trial.

After decompensated heart failure, a number of patients have high risk of early rehospitalization as well as death. Specialized medical management for a short period but very early after discharge could be critical for optimizing care and improving early outcome.

This study aims to compare such early intensive medical management with usual care in high-risk patients after discharge.

At discharge, high-risk HF patients are selected and randomized in two groups:

• Control group: usual disease management according to guidelines and including first medical consultation and biological test within the 4-week time following discharge.
• Active group: consultations with HF specialist including biological test at weeks 1, 2 and 4 are planned in addition to usual management.

Inclusion Criteria:

• 18 years or more

• consent signed

• Acute or decompensated heart failure with one or more of following criteria::

  • Discharge BNP > 350 pg/ml or NTproBNP > 2200 pg/ml
  • Discharge serum creatinine ≥ 180µM
  • Discharge systolic blood pressure ≤ 110mmHg
  • Previous hospitalisation for acute heart failure < 6 months

Exclusion Criteria:

• acute coronary syndrome,
• acute myocarditis,
• isolated right HF,
• transient HF,
• planned cardiac surgery,
• high risk of short-term non-cardiac death,
• planned management within rehabilitation center/HF clinic at discharge