Are there long-term benefits in following stable heart failure patients in a heart failure clinic?

Scand Cardiovasc J. 2009 Jun;43(3):158-62. doi: 10.1080/14017430802593443.

Abstract

Objectives and design: This study describes the long-term outcome of 163 patients with stable mild to moderate heart failure (NYHA II-III), who already were enrolled in a heart failure clinic and now were randomized to continued follow-up in the heart failure (HF) clinic or else to usual care (UC). The primary outcome was unplanned hospitalisations and death, the secondary endpoints were pharmacological therapy, NYHA class, six-minute-walking distances and NT-pro BNP level.

Results: At the end of follow-up we found no significant differences in total number of hospitalisation (p = 0.2) or mortality (16% vs. 16%) between the two groups. Patients in the HF clinic cohort achieved a significantly better NYHA score (p < 0.01), significantly longer walking-distances (p = 0.04) and received a significantly higher dose of angiotensin-converting enzyme inhibitors (p < 0.001) and beta-blockers (p < 0.001). No significant difference was found on the level of NT-pro BNP (p = 0.4).

Conclusions: Patients with mild to moderate HF may benefit from long-term follow-up in a HF clinic in terms of pharmacological therapy and functional status, but we found no significant impact on unplanned hospitalisations or death.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Denmark / epidemiology
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Heart Failure / drug therapy
  • Heart Failure / mortality
  • Heart Failure / rehabilitation*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Outpatient Clinics, Hospital / statistics & numerical data*
  • Peptide Fragments / blood
  • Prospective Studies
  • Survival Analysis

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain