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Does a Heart Team Improve Clinical Outcomes?

Joel A Scott-Herridge1, William F McIntyre2, Brett M Hiebert3

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Following Heart Team (HT) recommendations for complex cardiac patients significantly reduces cardiac death, composite cardiac events, and hospital admissions. This study highlights the crucial role of multidisciplinary consultation in improving patient outcomes.

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Area of Science:

  • Cardiology
  • Clinical Outcomes
  • Health Services Research

Background:

  • Heart Team (HT) consultation is a Class I recommendation for complex cardiac disease management.
  • Evidence supporting HT's impact on long-term outcomes is limited (Level C).
  • This study addresses the gap by evaluating outcomes based on adherence to HT recommendations.

Purpose of the Study:

  • To prospectively analyze long-term outcomes of patients referred for Heart Team consultation.
  • To compare outcomes between patients whose HT recommendations were followed versus those not followed.
  • To assess the impact of HT recommendations on cardiac mortality and morbidity.

Main Methods:

  • Prospective analysis of 336 patients undergoing Heart Team consultation.
  • Collection of patient characteristics, referring physician's treatment preference, and HT recommendations.
  • Follow-up on key clinical outcomes, including cardiac death, composite cardiac events, and hospital admissions.

Main Results:

  • Heart Team recommendations were followed in 83.8% of cases.
  • Following HT recommendations was associated with a significant reduction in cardiac death (6.3% vs 15.3%, p=0.042).
  • Adherence to HT recommendations led to significant decreases in composite cardiac outcomes (23.4% vs 51.9%, p≤0.001) and hospital admissions (10.4% vs 36.5%, p≤0.001).

Conclusions:

  • Adherence to Heart Team recommendations significantly improves long-term outcomes for complex cardiac patients.
  • HT consultation plays a vital role in optimizing patient management and reducing adverse cardiac events.
  • The findings support the established recommendation for multidisciplinary Heart Team involvement in complex cardiac care.