Does a Heart Team Improve Clinical Outcomes?

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.