Influence of chronic heart failure patient phenotypes on referring by general practitioners to office-based cardiologists (MIRROR-HF)

Abstract

The aim of the MIRROR-HF study, conducted among OB cardiologists, was, thus, to describe and compare respective phenotypes of patients referred for the first time or unfrequently versus that of the patients followed regularly by both a GP and cardiologist in a national, descriptive, prospective, multicenter study. Group 1: includes CHF patients referred for the first time or unfrequently (i.e. not referred to a cardiologist in the last 12 months). Group 2 include HF patients who were followed regularly (i.e. referred to a cardiologist at least once in the last 12 months) patients of group 2 had a more severe CHF, with more HFrEF (39.7% vs. 33.5%), more prior CHF hospitalization (31.4% vs. 15.9%), and more AF and ischemic HF in group 2 (50.5% vs. 40.2% and 50.1% versus 39.3%, respectively). As expected, patients of group 2 had a better medical monitoring and follow-up, having recent clinical (97.4% versus 25.5%), cardiac (95.1% vs. 22.5%), and biological examinations (72.9% vs. 45.9%) performed, and who were prescribed pharmacological (98.4% vs. 89.3%) and non-pharmacological (27.1% vs. 23.5%) HF treatments before the visit. The sociodemographic characteristics did not influence referring to cardiologists Interestingly HFrEF patients had a better medical monitoring/follow-up, with relatively more patients having recent clinical examinations (77.1% vs. 68.5% and 66.0% in the HFmrEF and HFpEF subgroups, respectively), other cardiac examinations (74.7% vs. 66.9% and 62.1%), other examinations and invasive procedures (20.9% vs. 12.1% and 10.5%) and biological examinations (69.0% vs. 57.0% and 63.3%) performed. The main reason for a GP or another HCP to refer a CHF patient was, overall, the management of their treatments (76.4%) or for HF diagnostic confirmation (62.9%). This study demonstrated that patients regularly seen by cardiologists had globally a more severe CHF and that, as expected, they had a better medical monitoring and follow-up than others patients.