No clinical trial data is available in the provided text, which consists only of a reviewers board list.
What is the prevalence and what are the clinical determinants of optimized pharmacological therapy in outpatients with HFrEF?
Despite high prescription rates of individual disease-modifying drugs, the use of fully optimized medical therapy in HFrEF remains very low (7.9%), often limited by factors like CKD, advanced age, and hypotension.
Anderson Oliveira Estevan , Ana Luísa Guedes de Franca e Silva , Salvador Rassi Filho , Aguinaldo Figueiredo de Freitas Júnior , Salvador Rassi DOI: 10.36660/abchf.20250018i In heart failure with reduced ejection fraction (HFrEF), optimized medical therapy (OMT) with beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs) (or sacubitril/valsartan), spironolactone, and sodium-glucose cotransporter-2 inhibitors (SGLT2i), at target or maximally tolerated doses, reduces morbidity and mortality. However, real-world data show its underuse. To estimate the prevalence and clinical associations that influence the use of OMT in clinical practice. Cross-sectional observational study including outpatients with HFrEF treated at a tertiary hospital. Clinical factors associated with therapy were assessed using binary logistic regression (95% confidence interval). A total of 266 patients were analyzed (mean age 61 years; 62.4% male), 113 (42.5%) with Chagas disease etiology. Mean ejection fraction was 34.2%. Vasodilators, beta-blockers, spironolactone, and SGLT2i were prescribed in 88%, 95.9%, 85.3%, and 27.4% of patients, respectively. The prevalence of OMT was 7.9% (21 patients). Diabetes was associated with a higher likelihood of OMT use (p = 0.034). Chagas disease was associated with lower probability of receiving vasodilators (p = 0.015) and greater use of furosemide, amiodarone, and digoxin (p 60 years, systolic blood pressure < 100 mmHg, and use of furosemide were associated with lower use of vasodilators (p = 0.003; 0.025; 0.010; and 0.046). CKD was associated with lower use of spironolactone (p = 0.002). Diabetes (p = 0.002) and use of furosemide (p = 0.005) were associated with SGLT2i use. Despite the high prevalence of prescription of disease-modifying drugs, the use of OMT was significantly lower than expected. CKD, advanced age, arterial hypotension, and concomitant use of furosemide were associated with a reduced likelihood of receiving these agents, whereas diabetes was associated with a higher probability of OMT use. Keywords: Drug Therapy ; Heart Failure ; Systolic Heart Failure 27
Estevan et al. (Wed,) conducted a other in Heart Failure with Reduced Ejection Fraction. No clinical trial data is available in the provided text, which consists only of a reviewers board list.