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

Metra M. Adamo M. Tomasoni D. Mebazaa A. Bayes-Genis A. Abdelhamid M. Adamopoulos S. Anker S.D. Bauersachs J. Belenkov Y. Böhm M. Gal T.B. Butler J. Cohen-Solal A. Filippatos G. Gustafsson F. Hill L. Jaarsma T. Jankowska E.A. Lainscak M. Lopatin Y. Lund L.H. McDonagh T. Milicic D. Moura B. Mullens W. Piepoli M. Polovina M. Ponikowski P. Rakisheva A. Ristic A. Savarese G. Seferovic P. Sharma R. Thum T. Tocchetti C.G. Van Linthout S. Vitale C. Von Haehling S. Volterrani M. Coats A.J.S. Chioncel O. Rosano G.
July 2023 John Wiley and Sons Ltd

European Journal of Heart Failure
2023 #25 Issue 7 1115 - 1131 pp.

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.

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

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Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
AP-HP Department of Anesthesia and Critical Care, Hôpital Lariboisière, Université Paris Cité, Inserm MASCOT, Paris, France
Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
Faculty of Medicine, Cairo University, Giza, Egypt
Second Department of Cardiovascular Medicine, Onassis Cardiac Surgery Center, Athens, Greece
Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
Lomonosv Moscow State University, Moscow, Russian Federation
Saarland University Hospital, Homburg, Saar, Germany
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Baylor Scott and White Research Institute, Dallas, TX, United States
Department of Medicine, University of Mississippi, Jackson, MS, United States
Inserm 942 MASCOT, Université de Paris, AP-HP, Hopital Lariboisière, Paris, France
Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Rigshospitalet-Copenhagen University Hospital, Heart Centre, Department of Cardiology, Copenhagen, Denmark
Queens University Belfast, Belfast, United Kingdom
Linkoping University, Linkoping, Sweden
Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Volgograd State Medical University, Volgograd, Russian Federation
Department of Medicine, Karolinska Institutet, and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
Department of Cardiovascular Science, Faculty of Life Science and Medicine, Kings College London, London, United Kingdom
Massachusetts General Hospital and Baim Institute for Clinical Research, Boston, MA, United States
Faculty of Medicine, University of Porto, Porto, Portugal
Cardiology Department, Porto Armed Forces Hospital, Porto, Portugal
Hospital Oost-Limburg, Genk, Belgium
Clinical Cardiology, IRCCS Policlinico San Donato, Milan, Italy
Department of Biomedical Science for Health, University of Milan, Milan, Italy
Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Scientific Research Institute of Cardiology and Internal Medicine, Almaty, Kazakhstan
School of Medicine, University of Belgrade, Belgrade, Serbia
Serbian Academy of Sciences and Arts, Belgrade, Serbia
St. Georges Hospitals NHS Trust University of London, London, United Kingdom
Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and Rebirth Center for Translational Regenerative Therapies, Hannover Medical School, Hannover, Germany
Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
Cardio-Oncology Unit, Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany
Berlin Institute of Health (BIH) at Charité-Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
Department of Cardiology and Pneumology, University Medical Center Goettingen, Georg-August University, Goettingen, Germany
German Center for Cardiovascular Research (DZHK), partner site Goettingen, Goettingen, Germany
University of Warwick Coventry, Coventry, United Kingdom
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’, University of Medicine Carol Davila, Bucharest, Romania

Cardiology and Cardiac Catheterization Laboratory
AP-HP Department of Anesthesia and Critical Care
Heart Failure Clinic and Cardiology Service
Department of Medicine
CIBERCV
Faculty of Medicine
Second Department of Cardiovascular Medicine
Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin
Department of Cardiology and Angiology
Lomonosv Moscow State University
Saarland University Hospital
Sackler Faculty of Medicine
Baylor Scott and White Research Institute
Department of Medicine
Inserm 942 MASCOT
Department of Cardiology
Rigshospitalet-Copenhagen University Hospital
Queens University Belfast
Linkoping University
Institute of Heart Diseases
Division of Cardiology
Faculty of Medicine
Volgograd State Medical University
Department of Medicine
Department of Cardiovascular Science
Massachusetts General Hospital and Baim Institute for Clinical Research
Faculty of Medicine
Cardiology Department
Hospital Oost-Limburg
Clinical Cardiology
Department of Biomedical Science for Health
Faculty of Medicine
Scientific Research Institute of Cardiology and Internal Medicine
School of Medicine
Serbian Academy of Sciences and Arts
St. Georges Hospitals NHS Trust University of London
Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and Rebirth Center for Translational Regenerative Therapies
Fraunhofer Institute of Toxicology and Experimental Medicine
Cardio-Oncology Unit
German Centre for Cardiovascular Research (DZHK)
Berlin Institute of Health (BIH) at Charité-Universitätmedizin Berlin
Department of Medical Sciences
Department of Cardiology and Pneumology
German Center for Cardiovascular Research (DZHK)
University of Warwick Coventry
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’

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