ESC Heart Failure最新文献

{"title":"Analysis of the usefulness and benefits of ultrafiltration in cardiorenal syndrome: A systematic review.","authors":"Borja Guerrero Cervera, Raquel López-Vilella, Víctor Donoso Trenado, María Peris-Fernández, Paula Carmona, Amparo Soldevila, Sergi Tormo, Ramón Devesa, María Jesús Montero Hernández, Luis Martínez Dolz, Julio Hernández Jaras, Pilar Sánchez-Pérez, Luis Almenar-Bonet","doi":"10.1002/ehf2.15125","DOIUrl":"https://doi.org/10.1002/ehf2.15125","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac decompensation in cardiorenal syndrome (CRS) results in systemic congestion usually treated with diuretics. When despite high doses of diuretics, response is poor, ultrafiltration (UF) appears to be a useful and safe technique. The aim of the study was to analyse, by means of a systematic review, the efficacy and safety of UF versus conventional diuretic treatment.</p><p><strong>Methods and results: </strong>Search of the main databases (Pubmed, Embase and Cochrane Central Register of Controlled Trials) identifying comparative studies of UF versus diuretic therapy, from 2000 to the present. After screening the studies, 13 studies were analysed; 1100 patients (UF: 532, diuretic treatment: 568). Renal function: UF showed a trend to lower creatinine at discharge (SME = -0.68; 95% CI -1.50 to 0.13; I² = 97%) with no difference in glomerular filtration rate (SME = 0.05; 95% CI -0.17 to 0.27; I² = 0%). Diuretic response: With UF, there was a trend towards greater weight loss (SME = 1.82; 95% CI -0.79 to 4.42; I² = 99.7%) and greater volume removed (SME = 3.04; 95% CI -2.13 to 8.20; I² = 99.8%). Morbidity and mortality: No difference in days of hospital stay (LogOR = -0.14; 95% CI -0.52 to 0.23; I² = 66.9%) and mortality at 1 month (LogOR = -0.04; 95% CI -0.34 to 0.44; I² = 0%) but reduction in readmissions in patients with UF (LogOR = -0.60; 95% CI -0.94 to -0.26; I² = 40.5%).</p><p><strong>Conclusions: </strong>In decompensated HF and CRS with inadequate diuretic response, UF versus diuretic intensification is an effective and safe option; it reduces readmissions with a tendency to decrease weight, creatinine levels and increase volume depletion without affecting mortality. Prospective randomised studies with a sufficient number of patients are needed to corroborate these results.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trametinib alters contractility of paediatric Noonan syndrome-associated hypertrophic myocardial tissue slices.","authors":"Jules Hamers, Payel Sen, Sarala Raj Murthi, Laura Papanakli, Maria von Stumm, Francesca Baessato, Julie Cleuziou, Christian Meierhofer, Peter Ewert, Andreas Dendorfer, Daphne Merkus, Cordula M Wolf","doi":"10.1002/ehf2.15173","DOIUrl":"https://doi.org/10.1002/ehf2.15173","url":null,"abstract":"<p><strong>Aims: </strong>No curative treatment is available for RASopathy-associated childhood-onset hypertrophic cardiomyopathy (RAS-CM). Preclinical data and individual reports suggest a beneficial effect of small molecules targeting the RAS-mitogen-activated protein (MAP) kinase (MAPK) pathway in severely affected RAS-CM patients. The aim of this study was to evaluate the biophysical effects of trametinib, rapamycin and dasatinib on cultivated myocardial tissue slices of a paediatric RAS-CM patient using biomimetic cultivation chambers (BMCCs) and to correlate the findings with clinical data.</p><p><strong>Methods: </strong>Contracting right ventricular (RV) tissue slices were prepared from resected myocardium, cultivated in BMCCs and treated with distinct molecules directly and indirectly targeting the RAS-MAPK pathway (trametinib, rapamycin and dasatinib) or dimethyl sulfoxide (DMSO). Tissue biophysical properties were assessed using electrical stimulation protocols. Contractile function, force-frequency relationship and post-pause potentiation were compared before and after treatment. These parameters correlated to L-type Ca²⁺ channel function and sarcoplasmic Ca²⁺ loading.</p><p><strong>Results: </strong>In vivo, off-label treatment with MAPK kinase (MEK) inhibitor trametinib of a child with severe RAS-CM resulted in a modest reduction of RV outflow tract (RVOT) obstruction (RVOT 151 to 122 mmHg after 11 weeks) and improved diastolic function (E/A 0.68 to 1.09 after 11 weeks) and myocardial strain [RV global radial strain (RV-GRS) 25.94 to 42.76; RV global circumferential strain (RV-GCS) -15.26 to -18.61; and RV global longitudinal strain (RV-GLS) -10.31 to -16.78 at 11 weeks], as determined by echocardiography and cardiac magnetic resonance tomography. In cultivated RV myocardial tissue slices, contraction force decreased after addition of trametinib and rapamycin but not after addition of DMSO and dasatinib. Improvement of Ca²⁺ handling, as depicted by a more positive force-frequency relationship and enhanced post-pause potentiation (31.2%), was noted in the trametinib-treated slice. The increase in post-pause potentiation was less pronounced in rapamycin-treated (26%) and absent in dasatinib-treated (<1%) slices.</p><p><strong>Conclusions: </strong>Ex vivo analysis of cultivated and electrically stimulated RV myocardial tissue slices of a patient with RAS-CM showed decreased contractility and improved sarcoplasmic reticulum function after addition of trametinib and in part after addition of rapamycin, but not after addition of dasatinib.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two causes of COVID-19-related myocardial injury-associated cardiogenic shock: Myocarditis and microvascular thrombosis.","authors":"Takamasa Iwai, Hirohiko Aikawa, Yoshiaki Morita, Keiko Ohta-Ogo, Teruo Noguchi","doi":"10.1002/ehf2.15130","DOIUrl":"https://doi.org/10.1002/ehf2.15130","url":null,"abstract":"","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of sodium-glucose co-transporter inhibitors on individual clinical endpoints and quality of life.","authors":"Jia Liao, Yang Chen, Zhiyu Ling, Helmut Pürerfellner, Martin Martinek, Michael Derndorfer, Johannes Niel, Ramin Ebrahimi, Matthias Heukäufer, Sarah Janschel, Davide Di Vece, Klaus Empen, Astrid Hummel, Bishwas Chamling, Piotr Futyma, Fahim Ebrahimi, Márcio G Kiuchi, Shaowen Liu, Yuehui Yin, Alexandra Schratter, Willem-Jan Acou, Philipp Sommer, Boris Schmidt, Julian K R Chun, Christian Meyer, Marcus Dörr, Christian Templin, Shaojie Chen","doi":"10.1002/ehf2.15136","DOIUrl":"https://doi.org/10.1002/ehf2.15136","url":null,"abstract":"<p><strong>Aims: </strong>Sodium-glucose co-transporter inhibitors (SGLTis) have cardiovascular protective effects. We aimed to assess the effects of SGLTis on individual hard clinical endpoints and quality of life (QoL) in patients with cardiovascular risk factors.</p><p><strong>Methods and results: </strong>Data was searched in PubMed, Embase, Cochrane Library and clinicaltrials.gov databases up to February 2024. Randomized controlled trials (RCTs) comparing SGLTis with placebo were included. The primary outcomes were individual hard clinical endpoints (Subset A) and QoL (Subset B). For Subset A, 13 RCTs including 90 413 patients were enrolled (age 66 ± 10.1 years, 35.7% female, follow-up 2.4 ± 0.3 years); as compared with placebo, SGLTis were associated with significantly lower risk of all-cause mortality [risk ratio (RR): 0.90, 95% confidence interval (CI): 0.86-0.94, P < 0.01], cardiovascular mortality (RR: 0.87, 95% CI: 0.82-0.92, P < 0.01), hospitalization for heart failure (HF) (RR: 0.72, 95% CI: 0.68-0.76, P < 0.01), HF events (RR: 0.72, 95% CI: 0.68-0.75, P < 0.01), hospitalization for any cause (RR: 0.91, 95% CI: 0.88-0.93, P < 0.01) and myocardial infarction (MI) (RR: 0.92, 95% CI: 0.85-0.99, P = 0.03). Notably, the favourable effect of SGLTis on all-cause mortality was more pronounced in younger (<65 years) patients (RR: 0.86, 95% CI: 0.81-0.92) and in studies with less female (RR: 0.84, 95% CI: 0.79-0.90). The favourable effect of SGLTis on MI was only observed in patients who received sotagliflozin (RR: 0.47, 95% CI: 0.31-0.73). For Subset B, nine RCTs including 2552 HF patients were enrolled (age 67.8 ± 12.4 years, 36.4% female, follow-up 3.4 ± 1.9 months); SGLTis were associated with significant improvement in QoL as compared with placebo.</p><p><strong>Conclusions: </strong>In patients with a broad spectrum of cardiovascular risk factors, SGLTis substantially improve individual hard clinical outcomes and QoL.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based prediction of elevated N terminal pro brain natriuretic peptide among US general population.","authors":"Yuichiro Mori, Shingo Fukuma, Kyohei Yamaji, Atsushi Mizuno, Naoki Kondo, Kosuke Inoue","doi":"10.1002/ehf2.15056","DOIUrl":"10.1002/ehf2.15056","url":null,"abstract":"<p><strong>Aims: </strong>Natriuretic peptide-based pre-heart failure screening has been proposed in recent guidelines. However, an effective strategy to identify screening targets from the general population, more than half of which are at risk for heart failure or pre-heart failure, has not been well established. This study evaluated the performance of machine learning prediction models for predicting elevated N terminal pro brain natriuretic peptide (NT-proBNP) levels in the US general population.</p><p><strong>Methods and results: </strong>Individuals aged 20-79 years without cardiovascular disease from the nationally representative National Health and Nutrition Examination Survey 1999-2004 were included. Six prediction models (two conventional regression models and four machine learning models) were trained with the 1999-2002 cohort to predict elevated NT-proBNP levels (>125 pg/mL) using demographic, lifestyle, and commonly measured biochemical data. The model performance was tested using the 2003-2004 cohort. Of the 10 237 individuals, 1510 (14.8%) had NT-proBNP levels >125 pg/mL. The highest area under the receiver operating characteristic curve (AUC) was observed in SuperLearner (AUC [95% CI] = 0.862 [0.847-0.878], P < 0.001 compared with the logistic regression model). The logistic regression model with splines showed a comparable performance (AUC [95% CI] = 0.857 [0.841-0.874], P = 0.08). Age, albumin level, haemoglobin level, sex, estimated glomerular filtration rate, and systolic blood pressure were the most important predictors. We found a similar prediction performance even after excluding socio-economic information (marital status, family income, and education status) from the prediction models. When we used different thresholds for elevated NT-proBNP, the AUC (95% CI) in the SuperLearner models 0.846 (0.830-0.861) for NT-proBNP > 100 pg/mL and 0.866 (0.849-0.884) for NT-proBNP > 150 pg/mL.</p><p><strong>Conclusions: </strong>Using nationally representative data from the United States, both logistic regression and machine learning models well predicted elevated NT-proBNP. The predictive performance remained consistent even when the models incorporated only commonly available variables in daily clinical practice. Prediction models using regularly measured information would serve as a potentially useful tools for clinicians to effectively identify targets of natriuretic-peptide screening.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cilostazol in patients with heart failure and preserved ejection fraction-The CLIP-HFpEF trial.","authors":"Norman Aiad, Jeanne du Fay de Lavallaz, Michael J Zhang, Thanat Chaikijurajai, Bo Ye, Prabhjot S Nijjar, Julie A Lahiri, Cindy M Martin, Tamas Alexy, Markus Meyer","doi":"10.1002/ehf2.15162","DOIUrl":"https://doi.org/10.1002/ehf2.15162","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with heart failure with preserved ejection fraction (HFpEF) tend to have low resting and exercise heart rates. Phosphodiesterase-3 (PDE-3) inhibitors improve heart rates, haemodynamics and symptoms in patients with HFpEF. Cilostazol is an oral PDE-3 inhibitor used in peripheral artery disease. This study thought to evaluate the short-term effects of cilostazol on health status, N-terminal brain natriuretic peptide (NT-proBNP) levels and mechanisms of action.</p><p><strong>Methods: </strong>The effect of cilostazol was evaluated in 23 patients with HFpEF in a randomized placebo controlled multiple crossover trial (CLIP-HFpEF). Participants received placebo or cilostazol for 1 week followed by three crossovers to the alternate assignment at weeks 2, 3 and 4. The primary endpoint was the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) overall summary score obtained at the end of each treatment period. NT-proBNP was the secondary endpoint. In an exploratory mechanistic analysis, pulmonary artery (PA) pressures and heart rates were followed amongst the five participants with implanted pressure monitors.</p><p><strong>Results: </strong>Cilostazol improved the KCCQ score by 4.8 points (95% confidence interval, 2.0-7.7, P = 0.003). NT-proBNP levels were 448 (154-1056) pg/mL on placebo and 375 (68-974) pg/mL on cilostazol (P = 0.006). In patients with PA pressure monitors, diastolic pressure was 20.5 (18.7-23.0) mmHg on placebo and 18.0 (17.0-20.0) mmHg on cilostazol, an effect linked to higher heart rates (P < 0.001).</p><p><strong>Conclusions: </strong>Amongst patients with HFpEF, short-term treatment with cilostazol leads to improvements in health status and NT-proBNP when compared with placebo. These effects are likely conveyed by a heart rate-dependent reduction in cardiac filling pressures.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05126836.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting heart failure: Seasonal alignment of heart failure outcomes in New York.","authors":"Prerna Gupta, Ellen Brinza, Prateeti Khazanie, Pamela N Peterson, P Michael Ho, David P Kao","doi":"10.1002/ehf2.14964","DOIUrl":"10.1002/ehf2.14964","url":null,"abstract":"<p><strong>Background: </strong>Seasonal variations have been observed in heart failure (HF) hospitalization. Numerous explanatory mechanisms have been proposed, but no prior studies have examined potential contributors directly. Our objective was to identify specific factors that could contribute to seasonal variability using a large longitudinal dataset of HF hospitalizations.</p><p><strong>Methods: </strong>Hospital discharge data were obtained for all hospitals in the state of New York from 1994 to 2007. Records with a primary diagnosis of HF by the International Classification of Diseases-9 Clinical Modification (ICD-9-CM) code (428.xx and 425.xx) were included. Year and month of admission were used as predictors to evaluate outcomes of in-hospital mortality, population-adjusted daily rate of hospital admissions and length of stay (LOS) using univariable regression including a sinusoidal model to assess the seasonality of HF outcomes. Observations were then adjusted for multiple medical covariables as well as the average local monthly temperature and humidity at each hospital using data from the Global Historical Climate Network to identify potential modifiers of seasonal variability.</p><p><strong>Results: </strong>Among 949 907 records, the median age was 76 [inter-quartile range (IQR) 65-84 years old], and the cohort was 54% female (510 945 records). The population-adjusted rate of HF admissions per day increased by 1.1 admissions/day/year between 1994 and 2007, whereas in-hospital mortality and LOS decreased by -0.3%/year and -0.3 days/year, respectively (P < 0.001 for all). Seasonal trends were identified for daily HF admissions (February peak, P < 0.0001), mortality (January peak, P < 0.001) and LOS (January peak, P < 0.01). Cosinor analysis revealed significant periodicity for HF admission rate (amplitude = ±0.9 admissions/day/100 000 people, P < 0.001), in-hospital mortality (amplitude = ±0.47%, P < 0.001) and LOS (amplitude = ±0.23 days, P < 0.01). No other patient characteristics were significant modifiers of seasonality. Odds of mortality were highest in July rather than January when adjusted for average local temperature but not humidity.</p><p><strong>Conclusions: </strong>Adverse outcomes in patients hospitalized with HF were significantly worse in the winter months even when adjusted for patient characteristics and concurrent acute diagnoses such as pneumonia. Local ambient temperature was the strongest modifier of the observed seasonality. Given the increasing frequency of extreme weather events, additional work to determine the mechanisms of this and other environmental risk factors is urgently needed.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unexpected ally in heart failure treatment: Unlocking the potential of sodium-glucose cotransporter 2 inhibitors across patient subpopulations.","authors":"Sander Trenson, Mateusz Sokolski","doi":"10.1002/ehf2.15167","DOIUrl":"https://doi.org/10.1002/ehf2.15167","url":null,"abstract":"","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Critical Role of Comorbidities in Managing Heart Failure with Preserved Ejection Fraction (HFpEF).","authors":"Piotr Gajewski, Robert Zymlinski, Jan Biegus","doi":"10.1002/ehf2.15169","DOIUrl":"https://doi.org/10.1002/ehf2.15169","url":null,"abstract":"","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident heart failure: comparing management and outcome in primary and hospital settings in Western Sweden 2008-2017.","authors":"Xiaojing Chen, Aldina Pivodic, Maria Schaufelberger, Annika Rosengren, Michael Fu","doi":"10.1002/ehf2.14999","DOIUrl":"https://doi.org/10.1002/ehf2.14999","url":null,"abstract":"<p><strong>Aim: </strong>Heart failure (HF) is a highly prevalent condition managed in both primary care (PC) and hospital care (HC)-based settings. HF patients managed in these two settings may differ in their demography, comorbidities and outcomes, so we aimed to compare the patient management in PC and HC in the Västra Götaland Region (VGR) in Sweden.</p><p><strong>Methods: </strong>The VEGA database is an administrative database that includes all patients living in VGR. Patients with a first principal or contributory diagnosis of HF (I50) ≥18 years old between 2008 and 2017 were included. One-year mortality was used as the outcome.</p><p><strong>Results: </strong>In total, 35 375 new-onset HF cases were included with 18 722 identified only in PC and 16 651 in HC. HF patients in PC were older (80.7 ± 10.9 vs. 76.1 ± 13.6), more women (57.1% vs. 44.9%), with more hypertension, musculoskeletal and mental disorders, but less myocardial infarction. Patients in HC had almost 4 times higher all-cause 1 year mortality [3.92 (3.77-4.08), P < 0.0001] compared with PC after adjustment for age and sex. Over a 10 year period, despite decreasing mortality in both settings, hazard ratios for HC versus PC were significantly increased for all patients (P for interaction 0.0004), which was more marked in female and for 70-80 years old patients.</p><p><strong>Conclusion: </strong>Over a 10 year period, we demonstrated the differences in demography, comorbidities and outcomes between heart failure patients managed in hospital care versus primary care.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}