Impact of an intensive follow up program on the outcome of acute heart failure patients hospitalized in internal medicine versus cardiology units

Background This study evaluates the efficacy of a post-discharge follow-up program in patients recovering from acute heart failure (AHF) hospitalized in internal medicine (IM) and in cardiology (CA) wards. Methods Patients hospitalized for AHF between June 2020 and November 2022 at a third-level center were retrospectively analyzed according to their hospitalization ward in CA vs IM. The primary endpoint was a composite of time to first HF hospitalization or cardiovascular (CV) death at 6 months, while secondary endpoints were its individual components, all-cause death and a composite of time to first HF hospitalization or all-cause mortality at 6 months. Results Out of 230 patients, 122 were hospitalized in CA and 108 in IM wards. Patients hospitalized in CA were younger and less frequently affected by extra-cardiac comorbidities compared to patients managed in IM. At 6 months, no difference in the primary endpoint was registered in the two groups (IM 16.6% vs CA 13.1%, log-rank p = 0.425; IR 37.5 per 100 p/y CI 23.7-59.6 vs 28.4 per 100 p/y CI 17.4-46.5; p = 0.523). Moreover, the cohorts did not differ for any of the secondary endpoints. A secondary analysis according both to ward of hospitalization and ejection fraction (> 40% vs ≤ 40%) did not show any significant difference in the primary composite outcome between the subgroups. Conclusion No difference in the risk of major adverse CV events were found among patients hospitalized in CA and IM wards during mid-term follow-up after the inclusion in a post-AHF follow up program.