Original Article(s)
13 May 2024
Vol. 12 (2024)
https://doi.org/10.4081/wpph.2024.9883

From Emergency Department to clinic center: management of patients with heart failure with reduced ejection fraction

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HFrEF, sacubitril-valsartan, ARNI, gliflozins, SGLT2-i
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Authors

Jacopo Mambella
jac.mmb@gmail.com
https://orcid.org/0009-0003-9776-0400
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italy.
Fabrizio Foieni
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italy.
Girolamo Sala
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italy.
Paolo Ghiringhelli
Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital, Italy.
Antonio Di Sabatino
Department of Internal Medicine, IRCCS San Matteo Policlinic Foundation, University of Pavia, Italy.

Aims. Primary outcomes - cardiovascular and all-cause mortality evaluation within 1 year in elderly patients enrolled with Angiotensin Receptor Inhibitor (ARNI) and/or Sodium Glucose Co-Transporter Type 2 Inhibitors (SGLT2-i) in an Internal Medicine Department; recurrent hospitalization assessment for acute Heart Failure with Reduced Ejection Fraction (HFrEF); length of hospitalization analysis compared to not-enrolled patients. Secondary endpoints - to identify any parameters predicting the length of hospitalization; safety assessment through the incidence of complications and treatment interruption. Materials and Methods. Prospective observational real-life cohort study that analyzes the recruitment during hospitalization and follow-up 3-6-12 months after discharge. Several clinical parameters were recorded for each patient of any ethnicity, considering a diagnosis of acute HFrEF with NT-proBNP and chest x-ray. Results. The enrolled group (34 patients) showed a hospitalization period lower than the not-enrolled one. The rehospitalizations percentage was inferior to Randomized Clinical Trials (RCTs) for ARNI. Cardiovascular-cause mortality, symptomatic hypotension, and Urinary Tract Infections (UTI) were lower than RCTs data. Age, eGFR, NT-proBNP, Cumulative Illness Rating Scale (CIRS), and severe comorbidities, except for EF, predicted the lengthening of hospitalization. Hypoglycemia wasn’t recorded. Conclusions. ARNI/SGLT2-i are effective and safe in elderly patients. Comorbidities and bio-humoral features influence HFrEF and quality of life. The future aim is to confirm the results obtained so far.

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Jacopo Mambella, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico I livello UO Medicina Interna II

Fabrizio Foieni, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico I livello UO Medicina Interna II

Girolamo Sala, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico I livello UO Medicina Interna II

Paolo Ghiringhelli, Department of Internal Medicine, ASST Valle Olona, Busto Arsizio Hospital

Dirigente Medico II livello UO Medicina Interna II

Antonio Di Sabatino, Department of Internal Medicine, IRCCS San Matteo Policlinic Foundation, University of Pavia

Dirigente Medico II livello UO Medicina Interna

How to Cite



From Emergency Department to clinic center: management of patients with heart failure with reduced ejection fraction. (2024). Working Paper of Public Health, 12(1). https://doi.org/10.4081/wpph.2024.9883
Copyright (c) 2024 Jacopo Mambella, Fabrizio Foieni, Girolamo Sala, Paolo Ghiringhelli, Antonio Di Sabatino Creative Commons License

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