074 Is management of heart failure at hospital discharge differentiated according to the ejection fraction? Lessons from the DEVENIR study

RationaleHeart failure (HF) with preserved LVEF has been individualized in the recent years as a specific entity, with different mechanisms, special baseline characteristics, a poor prognosis and no clearly recognized treatment. Recent papers have focused on patients with LVEF between 40% and 50% who could not be clearly classified as patients with reduced or preserved LVEF.Objectivesto describe the management care of patients according to the LVEF with special emphasis on patients belonging to the “grey zone”.MethodsCross sectional observational survey with retrospective collection of data at hospital discharge. Patients must have been diagnosed with HF and have been hospitalised for HF within the previous 18 months. Patients are classified according to the LVEF at hospital discharge.Results412 French outhospital cardiologists included 1 452 patients meeting the inclusion criteria. Management care at hospital discharge according to LVEF (known in 1 408 patients) is detailed below.ConclusionThis is the first French survey in patients managed by cardiologists after hospital discharge for HF. Cardiologists mainly care for patients with low LVEF. Treatment at hospital discharge is optimal regarding medical classes, with poor differences according to EF. Rate of betablockers and ACEI is quite high in the group with EF > 50%, even if it is lower than in the groups with low EF. As a whole, in France, the 40-50% group is managed as the < 40% one.Table. Drug therapy according to LVEFLVEF<40% n=792LVEF 40-50% n=366LVEF>50% n=250pACEI/ARB91%90%†83%0,002Betablocker78%76%†64%<0,0001Loop diuretics90%83%*82%<0,001Spironolactone29%19%*21%0,0003Digoxin16%15%21%0,15Calcium antagonists9%18%†*27%<0,0001Anticoagulants43%41%43%0,64p by ANOVA with Bonferroni correction;†p<0.05 for comparisons between “grey zone” and LVEF>50%;*p<0.05 for comparisons between “grey zone” and LVEF