scholarly journals Nurse-coordinated collaborative disease management improves the quality of guideline-recommended heart failure therapy, patient-reported outcomes, and left ventricular remodelling

2015 ◽  
Vol 17 (4) ◽  
pp. 442-452 ◽  
Author(s):  
Gülmisal Güder ◽  
Stefan Störk ◽  
Goetz Gelbrich ◽  
Susanne Brenner ◽  
Nikolas Deubner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Disease Management ◽  
Patient Reported Outcomes ◽  
Left Ventricular ◽  
Heart Failure Therapy ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
Patient Reported

P1743Assessment of quality of care of patients with ST-segment elevation myocardial infarction in Poland

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Hudzik ◽  
A Budaj ◽  
M Gierlotka ◽  
A Witkowski ◽  
W Wojakowski ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Quality Of Care ◽  
Cardiac Rehabilitation ◽  
Quality Indicators ◽  
Medical Therapy ◽  
Patient Reported Outcomes ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Patient Reported

Abstract Introduction 2017 ESC Guidelines for the management of ST-elevation myocardial infarction (STEMI) patients have called for the assessment of the quality of care to establish measurable quality indicators in order to ensure that every patient with STEMI receives the best possible care. We investigated the quality indicators of health care services in Poland provided to STEMI patients. Methods The Polish Registry of Acute Coronary Syndromes (PL-ACS) is an ongoing, nationwide, multicenter, prospective, observational study of consecutively hospitalized patients with the whole spectrum of ACS in Poland. For the purpose of assessing quality indicators, we included 8,279 patients from the PL-ACS Registry hospitalized with STEMI between January 1 and December 31, 2018. Results All emergency medical services (EMS) are equipped with ECG/defibrillators. 408 of 8,279 patients (4.9%) arrived at PCI center by self-transport, 4,791 patients (57.9%) patients arrived at PCI center by direct EMS transport, and 2,900 patients (37.2%) were transferred from non-PCI facilities. Whilst 95.1% of STEMI patients arriving in the first 12 hours received reperfusion therapy, the rates of timely reperfusion were much lower (ranging from 39.4% to 55.0% for various STEMI pathways). 7,807 patients (94.3%) underwent PCI as a mode of primary reperfusion strategy. The median left ventricular ejection fraction (LVEF) was 46% and was assessed before discharge in 86.0% of patients. 489 of 8,279 patients (5.9%) died during hospital stay. Optimal medical therapy is prescribed in 50–85% of patients depending on various clinical settings. Only one in two STEMI patient is enrolled in a cardiac rehabilitation program at discharge. No patient-reported outcomes were recorded in the PL-ACS Registry. Figure 1 Conclusions The results of this study identified areas of healthcare systems that require solid improvement. These include prehospital ECG decision strategy, direct transport to PCI center, timely reperfusion, guidelines-based medical therapy (in particular in patients with heart failure), referral to cardiac rehabilitation/secondary prevention programs. More importantly, we recognized an urgent need for the initiation of recording quality indicators associated with patient-reported outcomes.

Patients with heart failure and a LVEF less than 40% present an overall lower health related quality of life than those with LVEF between 40% and 60%: a multinational real-world survey in EU

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Proudfoot ◽  
A.F Fonseca ◽  
R Lahoz ◽  
S Corda ◽  
S Cotton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract Background and purpose Heart Failure (HF) is associated with symptoms such as dyspnoea and fatigue which can impact patients' health related quality of life (HRQoL). This study aimed to characterize and assess the HRQoL of patients with HF and left-ventricular ejection fraction (LVEF) <40% versus those with ≥40%-60%. Methods A cross-sectional study of patients with HF was conducted in France, Germany, Italy, Spain and United Kingdom. Patient record forms (PRFs) were completed by 257 cardiologists and 158 general practitioners (GPs) for consecutively consulting patients. The same patients were invited to provide patient-reported outcomes including self-completion questionnaires, Minnesota Living with Heart Failure Questionnaire (MLHFQ) and EQ-5D-5L VAS. Results 204 HF patients with LVEF <40% (mean age 67.7 years) and 600 patients with LVEF ≥40–60% (mean age 68.9 years) were included. Proportion of males was significantly higher in the lower LVEF group (73.5% vs. 61.2%, p=0.0017). Overall, the patients with lower LVEF more frequently presented with comorbidities than those with LVEF ≥40–60% (p<0.05, Figure 1). NYHA stage III/IV (35.8%/7.4% vs. 15.3%/0.8%) as well as self-reported HF symptoms were more frequently reported in the lower LVEF group (p<0.05, Figure 1). Similarly, patients with LVEF <40% reported statistically significantly worse HRQoL compared to those with LVEF ≥40–60% (Table 1). Conclusions The HRQoL of all HF patients with LVEF ≤60% appears impacted, while those with LVEF <40% had significantly worse HRQoL than those with LVEF ≥40–60%. These differences in HRQoL may not only be related to the LVEF but also to the overall characteristics of these patients. Addressing the HRQoL burden for patients should be a key aspect of HF management strategies for all HF patients. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis Pharma AG

scholarly journals 155 Effects on sacubitril/valsartan on natriuretic peptides in patients with a reduced ejection fraction

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Norman Lamaida ◽  
Antonio Cerciello
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Positive Impact ◽  
Real Life ◽  
Left Ventricular ◽  
Favourable Effect ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
Positive Effects

Abstract Aims The PARADIGM-HF trial proved the superiority of sacubitril/valsartan (Sa/Va) vs. enalapril in reducing mortality and hospitalization for heart failure (HF). Sacubitril/valsartan, new drug used in treatment of heart failure with reduced systolic function (HFrEF) has recently been shown to improve tolerance to exercise and cardiovascular performance. Methods and results We prospectively enrolled 40 outpatient patients with HFrEF with indication for therapy with sacubitril/valsartan and subjected to serial controls with blood tests, echocardiogram before and during gradual optimization of therapy, with the aim of evaluating the effects of the drug on left ventricular remodelling. We studied 40 patients treated with sacubitril/valsartan for at least 3 months. After a mean follow-up of 120 ± 40 days, 95% of patients reached the maximum dose of the drug without major side effects. The ejection fraction increased while end-diastolic and end-systolic volumes of the left ventricle decreased. We also observed a significant reduction in NT-proBNP values without significant worsening of renal function or hyperkalaemia. There NYHA functional class has improved with a positive impact on the prognosis of heart failure at 2 years (P = 0.006). Conclusions In our population, medium-term treatment with sacubitril/valsartan demonstrated a favourable effect on left ventricular remodelling and functional status, confirming the data of previous clinical trials in real life. One more follow-up long and a larger population will help confirm these to confirm these positive effects of the drug on patients with HfrEF.

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