Global differences in acute heart failure treatment: analysis of the STRONG‐HF site feasibility questionnaire

Aims Acute heart failure (AHF) has an impact on human health worldwide. Despite guidelines for treatment and management of AHF, mortality rates remain high. The main objective of this study was to compare standard in‐hospital treatment and management of AHF against current clinical guidelines and va...

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Bibliographic Details
Published in:	ESC Heart Failure Vol. 10; no. 4; pp. 2236 - 2247
Main Authors:	Novosadova, Maria, Gianchetti, Lauren, Takagi, Koji, Morishetty, Priyanka, Gaeta, Lauren, Edwards, Christopher, Davison, Beth A., Picod, Adrien, Mebazaa, Alexandre, Cotter, Gad
Format:	Journal Article
Language:	English
Published:	England John Wiley & Sons, Inc 01-08-2023 John Wiley and Sons Inc Wiley
Subjects:	Acute heart failure Adherence Aftercare Cardiology Clinics Emergency medical care Feasibility questionnaire Feasibility Studies Guidelines Heart failure Heart Failure - drug therapy Heart Failure - therapy Hospitalization Hospitals Humans Intensive care Internal medicine Medicine Mortality Original Patient Discharge Patients Physicians Questionnaires Regions Surveys and Questionnaires South America Eastern Europe Russia Middle East Austria Mozambique Poland Slovakia Nigeria Serbia France Bulgaria Tunisia Croatia Colombia Argentina Romania Hungary Africa Ukraine Western Europe Czech Republic Turkey South Africa Israel Adherence Regions Feasibility questionnaire Acute heart failure Guidelines
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Summary:	Aims Acute heart failure (AHF) has an impact on human health worldwide. Despite guidelines for treatment and management of AHF, mortality rates remain high. The main objective of this study was to compare standard in‐hospital treatment and management of AHF against current clinical guidelines and variations across regions. Methods Between February 2018 and May 2021, investigators were approached to participate in the STRONG‐HF study. The lead investigator at 158 sites in 20 countries completed a site feasibility questionnaire. Sites were grouped by country into five different regions: Africa and the Middle East, Eastern Europe, Russia, South America, and Western Europe. Results According to the questionnaires, there are large differences in how patients present due to AHF and where in the hospital they are treated. There were significant differences in reported percentage of AHF patients receiving angiotensin converting enzymes inhibitors across the regions (P < 0.001), mostly due to prescription of more angiotensin II receptor blockers and angiotensin receptor‐neprilysin inhibitors in South America and Western Europe. Reported beta‐blocker use was high across all of the regions. Device therapy and percutaneous interventions were more common in Europe. Sites reported a 5 to 8 day length of stay, while in Russia most have a 10 to 12 day length of stay. Regions reported that AHF patients follow up with a community cardiologist or general practitioner post‐discharge, although follow‐up was commonly more than 1 month post discharge, and not all sites had the capability to measure natriuretic peptides post discharge. Conclusions In this analysis of feasibility questionnaires, most sites reported general adherence to ESC guidelines for treatment and management of AHF patients although percutaneous and device therapy was less common outside Europe and follow‐up after discharge took place late and was not as extensive as recommended. There were wide variations seen within and across regions in some areas.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2055-5822 2055-5822
DOI:	10.1002/ehf2.14370