Cor Vasa 2026, 68(4):396-403 | DOI: 10.33678/cor.2026.016

Survival benefits of specialized heart failure clinics: Czech real-world evidence.

Josef Daněk^a, Jiří Jarkovský^b, Klára Benešová^b, Miloš Táborský^c

^a Department of Internal Medicine, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, the Czech Republic

^b Institute of Health Information and Statistics of the Czech Republic, Prague 2, the Czech Republic

^c Kardiologie Prof. Táborský s.r.o., Prague, the Czech Republic

Background: Heart failure (HF) remains a leading cause of morbidity and mortality worldwide despite major advances in pharmacological and device therapy. Optimized guideline-directed medical therapy (GDMT) and access to specialized care are crucial for improving long-term outcomes. The impact of specialized heart failure clinics on survival in real-world clinical practice remains insufficiently documented in Central and Eastern Europe.

Methods: This retrospective observational study compared two complementary datasets of HF patients in the Czech Republic. Nationwide data were obtained from the National Reimbursement of Healthcare Services Database (NRHZS) covering the period 2015-2023. These data were compared with a cohort of 217 patients followed at a specialized outpatient heart failure clinic at the Military University Hospital in Prague between 2017 and 2024. Pharmacotherapy patterns, achievement of guideline-recommended target doses, use of device therapy (ICD, CRT), and all-cause mortality were analyzed using descriptive statistics and survival analysis.

Results: Patients managed in the specialized heart failure clinic received modern disease-modifying therapies more frequently than patients in nationwide care. Use of angiotensin receptor-neprilysin inhibitors and SGLT2 inhibitors was markedly higher, as was adherence to recommended combinations of GDMT. During long-term follow-up, all-cause mortality in the specialized-clinic cohort was 10.6%, with estimated survival rates of 90.1% at 2 years and 78.3% at 7 years. Treatment with SGLT2 inhibitors and a higher number of prognostic drug classes were associated with lower mortality.

Conclusions: Management in a specialized outpatient clinic was associated with high uptake of guidelinedirected medical therapy and numerically favorable survival compared with nationwide data. © 2026, ČKS.

Keywords: Guideline-directed medical, therapy, Heart failure, Pharmacotherapy, Specialized clinics

Received: January 2, 2026; Revised: February 14, 2026; Accepted: February 17, 2026; Prepublished online: August 24, 2026; Published: August 31, 2026  Show citation