Simple stratification based on hospitalization history and diuretic use can predict outcomes for heart failure patients
By Elana Gotkine HealthDay Reporter
THURSDAY, May 22, 2025 (HealthDay News) — About 40 percent of patients with heart failure diagnosis do not see a cardiologist annually, according to a study published online May 18 in the European Heart Journal.
Guillaume Baudry, M.D., Ph.D., from the Université de Lorraine in Nancy, France, and colleagues described prognosis and management across different strata using simple criteria in a nationwide cohort study. A total of 655,919 patients were classified into four groups: heart failure hospitalization (HFH) within the past year (HFH≤1y), HFH one to five years ago (HFH>1y), not hospitalized using loop diuretics (NoHFH/LD+), and not hospitalized without loop diuretics (NoHFH/LD−).
The researchers found that one-year all-cause mortality risk was 15.9 percent, varying from 8.0 to 25.0 percent for NoHFH/LD− and HFH≤1y, respectively. Compared with NoHFH/LD−, mortality risk was 1.61-, 1.83-, and 2.32-fold higher for NoHFH/LD+, HFH>1y, and HFH≤1y, respectively. Cardiology consultation rates were similar across groups during the first year of follow-up, with 40 percent of patients lacking an annual visit. Across all groups, a single cardiology visit in the previous year was associated with a 6 to 9 percent absolute reduction in one-year all-cause mortality. To prevent one modeled death, the number needed to consult was 11 to 16. Greater benefit was seen for additional visits with increasing heart failure severity. To minimize the number of deaths without increasing the total number of consultations, the optimal follow-up was one, two to three, and four annual visits for NoHFH/LD−, NoHFH/LD+ and HFH>1y, and HFH≤1y, respectively.
“Cardiology follow-up is essential for all patients with HF, while risk stratification based on loop diuretic use and HFH helps identify those who would benefit from more frequent consultations,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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