Impact of an intensive follow-up program on the outcome of acute heart failure patients hospitalized in internal medicine versus cardiology units: a single-center retrospective cohort study.

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. Patients hospitalized for AHF between October 2020 and November 2022 at a third-level center were retrospectively analyzed according to their hospitalization ward in CA vs IM. Patients deemed eligible for inclusion were ≥ 18 years-old and hospitalized for AHF. Only patients discharged alive were included in the post-AHF follow-up program. 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. 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% N = 18 vs CA 13.1% N = 16, 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. In this single-center retrospective cohort study, no significant differences in the risk of major adverse CV events were observed between patients hospitalized in CA and IM wards during mid-term follow-up after enrollment in a post-AHF follow-up program.