Pre-discharge and early post-discharge management of patients hospitalized for acute heart failure: A scientific statement by the Heart Failure Association of the ESC

Marco Metra, Marianna Adamo*, Daniela Tomasoni, Alexandre Mebazaa, Antoni Bayes-Genis, Magdy Abdelhamid, Stamatis Adamopoulos, Stefan D. Anker, Johann Bauersachs, Yuri Belenkov, Michael Böhm, Tuvia Ben Gal, Javed Butler, Alain Cohen-Solal, Gerasimos Filippatos, Finn Gustafsson, Loreena Hill, Tiny Jaarsma, Ewa A. Jankowska, Mitja LainscakYuri Lopatin, Lars H. Lund, Theresa McDonagh, Davor Milicic, Brenda Moura, Wilfried Mullens, Massimo Piepoli, Marija Polovina, Piotr Ponikowski, Amina Rakisheva, Arsen Ristic, Gianluigi Savarese, Petar Seferovic, Rajan Sharma, Thomas Thum, Carlo G. Tocchetti, Sophie Van Linthout, Cristiana Vitale, Stephan Von Haehling, Maurizio Volterrani, Andrew J.S. Coats, Ovidiu Chioncel, Giuseppe Rosano

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Acute heart failure is a major cause of urgent hospitalizations. These are followed by marked increases in death and rehospitalization rates, which then decline exponentially though they remain higher than in patients without a recent hospitalization. Therefore, optimal management of patients with acute heart failure before discharge and in the early post-discharge phase is critical. First, it may prevent rehospitalizations through the early detection and effective treatment of residual or recurrent congestion, the main manifestation of decompensation. Second, initiation at pre-discharge and titration to target doses in the early post-discharge period, of guideline-directed medical therapy may improve both short- and long-term outcomes. Third, in chronic heart failure, medical treatment is often left unchanged, so the acute heart failure hospitalization presents an opportunity for implementation of therapy. The aim of this scientific statement by the Heart Failure Association of the European Society of Cardiology is to summarize recent findings that have implications for clinical management both in the pre-discharge and the early post-discharge phase after a hospitalization for acute heart failure.

Original languageEnglish
Pages (from-to)1115-1131
Number of pages17
JournalEuropean Journal of Heart Failure
Volume25
Issue number7
DOIs
StatePublished - Jul 2023

Keywords

  • Acute heart failure
  • Early post-discharge
  • Management
  • Pre-discharge
  • Prognosis

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