CONGRESS ABSTRACT

Background: Our aim was to assess the changes in patients diagnosed with HF in terms of quality of life, symptoms, hospital admissions and therapeutic adherence when taken in an extra-hospital therapeutic care path. Methods:  From January 23 to September 24, our cardiology clinic treated 192 patients diagnosed with heart failure. Among these patients, we considered the 89 who had completed at least 12 months of follow-up.They were inserted in a diagnostic/therapeutic and healthcare process, which includes an initial visit where patients or their caregivers are instructed on the importance of determining some parameters (e.g. body weight, blood pressure), to highlight the importance of therapeutic adherence. The patients were followed by nursing staff through telephone contacts at 15 days and 1-3-5-7-9-11 months. Cardiological evaluation and blood tests were scheduled at 1-3-6-12 months.For many patients, a multidisciplinary approach was necessary. Results: Among the 89 patients enrolled (M 60, F 29) ,59% had a history of CAD.The most frequently encountered pathologies are: 60% hypertension, 40% AF, 22% COPD, 20% diabetes, 19% CKD, 8% oncological diseases. At the first visit the NYHA class was: 27pts HYHA II, 50pts HYHA III, 12 pts NYHA III/IV At 12 months the NYHA class was: 46pts NYHA II, 34pts NYHAIII, 4 HYHA III/IV During the 12 months of follow-up, 5 patients died.  The NT-proBNP in all patients at 12 months reduced from an average value of 3610 to 3010, with maximum reduction in patients in NHYA class III (from 3232 to 2264) and III/IV (from 9045 to 7046). Important reduction also occurred in patients with fibrillation (from 4838 to 2867), while in patients with renal failure the reduction was less significant (from 5291 to 4423). For EF there was an average increase for the 84pts from 43% to 46% with a maximum increase for patients with HFrEF from 35 to 40%. Regarding optimization and therapeutic adherence, we obtained good results with: 65 pts with B-blockers,41 pts with ACE-i or ARBs- 30 pts with ARNI-43 pts with MRA-48 pts with SGLT2-70 pts with diuretics. Hospital admissions in the 12 months averaged 40% for the 89 patients with a maximum reduction for patients in NYHA class III and III/IV with a 50% reduction. Conclusion:Taking care of patients with heart failure in a diagnostic, therapeutic and healthcare process leads to improvements in symptoms and blood tests and also improves therapeutic adherence with the reduction of hospital admissions.