A DARK AND
DANGEROUS
30 DAYS
FOR heart failure patients
post discharge1,2
Though clinical focus can stress the importance of the vulnerable period 90 days post discharge for heart failure (HF), the first 30 days is a critical time1,3,4
During this period, patients with HF face a journey fraught with risks.1,2 From high mortality and rehospitalization rates, to gaps in timely guideline-directed medical therapy (GDMT) initiation, and subpar transition of care, it is a time filled with dangerous uncertainty and darkness.1,2,5-9
Test your knowledge of the 30 days of risk
Unpack the first 30 days of risk1,2
And the risks continue to 90 days, and beyond3,15
Your patients
are at risk for
rehospitalization
Some more than others16
Factors that impact 30-day readmissions16
People with the greatest risk for readmissions for HF, including those readmitted within the first critical 30 days post discharge, often are16,17:
Diagnosed with multiple
comorbidities
(diabetes mellitus, chronic kidney disease [CKD], peripheral vascular disease, stroke)
African American
From lower income
households
Comorbidities can leave patients at an even higher risk16
Patients with HF and comorbidities, such as type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), are at significantly higher risk of being rehospitalized during the critical 30 days post discharge when compared to patients with HF alone.16‑18
Type 2 diabetes mellitus
Compared to patients without T2DM, patients with both HF and T2DM had a significantly higher risk of being rehospitalized for HF or myocardial infarction at 30 days and 90 days post discharge.19
Chronic kidney disease
By the onset of stage 3, CKD is a significant contributor to poor prognosis in patients with HF, leading to significantly higher rates of hospitalization, 30-day readmissions, and mortality.20
See latest Guidelines to help keep your patients out of the hospital6,21
The underuse of GDMT
Did you know GDMT is often not initiated early enough for many patients?6,9
The AHA/ACC/HFSA Joint Guidelines recommend initiating GDMT during hospitalization for patients with HF once hemodynamically stable.6
Additionally, the ESC recommends administering optimal medical therapy pre discharge for patients
with HF.4
Although initiation of therapy before discharge is critical to reduce risk of rehospitalization, more than 40% of patients do not receive GDMT even within 30 days after discharge.6,9
Help Keep your patients
out of the hospital longer6,21
HF TREATMENT
GUIDELINES
TO LIGHT THEIR PATH21
The AHA/ACC/HFSA Joint Guidelines and the ESC Guidelines were updated to include SGLT inhibitors along with beta-blockers, MRAs, and ARNIs in the treatment of HF.4,6
Early initiation of appropriate therapy was recommended across both guidelines.4,6
The AHA/ACC/HFSA Joint Guidelines advise in-hospital initiation of GDMT for HFrEF patients.6
The ESC Guidelines recommend administering optimal medical therapy prior to discharge.4
IMPORTANT THINGS TO
REMEMBER ABOUT GDMT
- Updated to recommend the use of SGLT inhibitors, regardless of ejection fraction, along with beta-blockers, MRAs, and ARNIs for patients with HF6
- Recommended for initiation during hospitalization after clinical stability is achieved in patients with HFrEF6
- Can be initiated simultaneously, or sequentially over several months, at initial recommended doses for patients with HFrEF6,27
- Should reflect a clear plan for optimization—a key component of transitional care before discharge6
- Can be beneficial in decreasing HF hospitalizations and CV death for patients with HF6
ARNI=angiotensin receptor-neprilysin inhibitor; CV=cardiovascular; GDMT=guideline-directed medical therapy; HF=heart failure; MRA=aldosterone receptor antagonist; SGLT=sodium-glucose cotransporter.
Test your knowledge of the 30-day Danger Zone post discharge
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