Prevalence of cardiovascular risk factors and interventions in heart failure patients at the time of their first referral to a Canadian heart failure network clinic

Abstract:

The Canadian Heart Failure Network is a collaboration of specialized multidisciplinary heart failure clinics across Canada and provides a longitudinal electronic database to record patient demographics and disease variables to allow analysis of referral practice patterns and outcomes. Centers enter data that are helpful to them for patient management, clinical letters, and trend analyses. From January 1999 to December 2008, data on 16,078 patients have been entered into this national database. An analysis of the data from the first Network database entry visit was performed using standard statistical techniques. Data are described as population means or percentages. Within the total referred population, the referral physician was identified as either cardiologist (Card), internist (IM), family practitioner (FP), or Other.
At the time of referral, compared to the combined group of Card, IM, and Other, FP referrals were significantly more likely to be older (p<0.001), female (p<0.001), diabetes (p<0.05), dyslipidemia (p<0.05), cerebrovascular disease (p<0.01) and peripheral disease (P<0.02). They were also less likely to have received PCI (p=0.05), CABG (p<0.01) or ICD (p<0.001). Despite a heavier burden of traditional cardiovascular risk factors, patients referred by family practitioners to the CHFN heart failure clinics across Canada were less likely to have previously received cardiovascular interventions. While these patients were significantly older, the absolute age difference was relatively small. Opportunities still exist to improve the care of heart failure patients in the community through increased awareness, education and access to specialize care.