The Impact of a Heart Failure Clinic on Clinical Outcomes: Our Experience

Background: Heart failure (HF) is an emerging pandemic associated with increased mortality, recurrent hospitaliza-tions, and reduced quality of life. Guideline-directed medical therapy has been shown to improve outcomes, particularly in patients with HF with reduced ejection fraction (HFrEF). The main goal of HF clinics is optimizing medical therapy. Objectives: To assess the impact of our HF clinic on medical therapy and clinical outcomes. Methods: We obtained demographic, echocardiographic, and clinical data of patients listed in our HF clinic during a 4-year period. Medical therapy was evaluated based on patient reports and documented data. Recurrent admissions for HF were documented. Results: A total of 317 patients (74.1% male, median age 66 years, IQR 55-74) were listed in the clinic with a total of 1140 visits. Of these patients, 62.5% had HFrEF, 20.5% presented with mildly reduced ejection fraction, and 17% showed preserved ejection fraction at the time of the first visit. The use of sodium glucose co-transporter 2 inhibitors and mineralo-corticoid receptor antagonists was optimized in 92% and 91 % of the patients, respectively. In the subgroup of patients with HFrEF, the use of angiotensin-receptor antagonist/nepri-lysin inhibitor increased from 22.6% to 87.9% (P< 0.001) and SGLT2 inhibitor use increased from 49.2% to 92% (P< 0.001). During the follow-up period (2.2 years, IQR 1.1-3.1), 203 patients (64%) were readmitted to the hospital for HF at least once. The rate of readmissions decreased over time. Conclusions: An HF clinic plays an important role in optimizing medical therapy and reducing readmissions.