OBLIC: a nationwide French prospective cohort of heart failure ambulatory patients managed in private practice

  • Mouquet F
  • Guedj-Meynier D
  • Godin G
  • et al.
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Abstract

Background Although private cardiologists manage the majority of patients with heart failure (HF) in France, no contemporary epidemiological data are available regarding the characteristics of these patients and the quality of care in private practice. Purpose Gathering epidemiological data and assessing the quality of care of HF patients managed in private practice. Methods A prospective cohort of HF patients was collected between January and March 2016. Private cardiologists gathered all ambulatory patients with a HF history during 2 consecutive weeks. Results A total of 1018 patients were included: 76% were managed for chronic HF with reduced ejection fraction (HFrEF) whereas 24% had history of HF with preserved ejection fraction (HFpEF). 77% had planned visits, 8% came for urgent unscheduled visits and 14% were seen after their hospitalization for decompensated HF. Mean age was 74 years (15-96). 63% among the patients were male. 61% had hypertension, 28% diabetes, 17% COPD, 14% sleep apnea, 12% chronic renal failure and 8% anoemia. Each co-morbidity was more frequent among patients with HFpEF as compared to patients with HFrEF. Among patients with HFrEF, etiology was ischemic cardiomyopathy for 49%. 13%, 60%, 24% and 2% of patients were in NYHA I, II, II and IV respectively, and 71% had at least one hospitalization for decompensated heart failure. Among patients with an ejection fraction below 35% (n=253, 33%), 85% received a betablocker, 84% an ACEI or ARB, 28% received mineralo corticoid receptor antagonist. 6% received ivabradine. 18% were implanted with CRT and 30% with an ICD. At the end of the consultation, 11% were hospitalized for decompensated HF. Conclusions The OBLIC cohort provides epidemiological data from HF patients managed by private cardiologists in France. The patients' characteristics seem to be similar to those managed in hospital, and treatment is in adequation with the last European Society of Cardiology guidelines.

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Mouquet, F., Guedj-Meynier, D., Godin, G., Beard, T., Raphael, M., Attias, D., … Cohen Solal, A. (2017). OBLIC: a nationwide French prospective cohort of heart failure ambulatory patients managed in private practice. Archives of Cardiovascular Diseases Supplements, 9(1), 36. https://doi.org/10.1016/s1878-6480(17)30134-9

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