BACKGROUND: No clinical practice guidelines are available for the treatment of heart failure (HF) in patients with preserved left ventricular ejection fraction (LVEF). AIMS: To determine how cardiologists manage medical treatment in HF patients after hospital discharge, according to LVEF. METHODS: The FUTURE study was a cross-sectional survey conducted in HF outpatients by French private cardiologists between September 2007 and August 2008. Patients had to have been hospitalized within the previous 18 months with a diagnosis of HF. Clinical data and HF treatments (angiotensin-converting enzyme inhibitors [ACEIs], angiotensin receptor blockers [ARBs], beta-blockers, diuretics and aldosterone antagonists) were recorded retrospectively, with precise information on drug doses, at two successive time points (at hospital discharge and at the index consultation). HF treatment was compared in patients with reduced (less than or equal to 40%) versus preserved (more than 40%) LVEF. RESULTS: Completed data were available for 1137 HF patients enrolled by 424 cardiologists. Mean patient age was 72±11 years; LVEF was reduced in 56% and preserved in 44%. The therapeutic approach was similar in the two groups, both at hospital discharge and at the index consultation. At the index consultation, HF treatment was: beta-blocker (74%); ACEI/ARB (83%); loop diuretic (86%); aldosterone antagonist (31%). The majority of patients (62%) received a beta-blocker plus an ACEI or an ARB; 56% reached more than or equal to 50% of the target dose for each treatment. There were no major differences in treatments and dosages between the groups with low and preserved LVEF. In 15% of cases where the drug dose was not increased, fear of adverse events was reported as the reason. CONCLUSION: The FUTURE survey showed a similar approach to HF treatment irrespective of LVEF. Compared with previous studies, we saw an improvement in the use of recommended HF drugs, especially beta-blockers. However, achievement of target doses could be improved.
BACKGROUND: No clinical practice guidelines are available for the treatment of heart failure (HF) in patients with preserved left ventricular ejection fraction (LVEF). AIMS: To determine how cardiologists manage medical treatment in HF patients after hospital discharge, according to LVEF. METHODS: The FUTURE study was a cross-sectional survey conducted in HF outpatients by French private cardiologists between September 2007 and August 2008. Patients had to have been hospitalized within the previous 18 months with a diagnosis of HF. Clinical data and HF treatments (angiotensin-converting enzyme inhibitors [ACEIs], angiotensin receptor blockers [ARBs], beta-blockers, diuretics and aldosterone antagonists) were recorded retrospectively, with precise information on drug doses, at two successive time points (at hospital discharge and at the index consultation). HF treatment was compared in patients with reduced (less than or equal to 40%) versus preserved (more than 40%) LVEF. RESULTS: Completed data were available for 1137 HF patients enrolled by 424 cardiologists. Mean patient age was 72±11 years; LVEF was reduced in 56% and preserved in 44%. The therapeutic approach was similar in the two groups, both at hospital discharge and at the index consultation. At the index consultation, HF treatment was: beta-blocker (74%); ACEI/ARB (83%); loop diuretic (86%); aldosterone antagonist (31%). The majority of patients (62%) received a beta-blocker plus an ACEI or an ARB; 56% reached more than or equal to 50% of the target dose for each treatment. There were no major differences in treatments and dosages between the groups with low and preserved LVEF. In 15% of cases where the drug dose was not increased, fear of adverse events was reported as the reason. CONCLUSION: The FUTURE survey showed a similar approach to HF treatment irrespective of LVEF. Compared with previous studies, we saw an improvement in the use of recommended HF drugs, especially beta-blockers. However, achievement of target doses could be improved.
Authors: Ken Lee Chin; Marina Skiba; Andrew Tonkin; Christopher M Reid; Danny Liew; Henry Krum; Ingrid Hopper Journal: Heart Fail Rev Date: 2016-11 Impact factor: 4.214
Authors: Òscar Miró; Christian Müller; Francisco Javier Martín-Sánchez; Héctor Bueno; Alexander Mebazaa; Pablo Herrero; Javier Jacob; Víctor Gil; Rosa Escoda; Pere Llorens Journal: Clin Res Cardiol Date: 2016-07-05 Impact factor: 5.460
Authors: M Arcopinto; A Salzano; F Ferrara; E Bobbio; A M Marra; R Abete; F Stagnaro; R Polizzi; F Giallauria; M Illario; E Menditto; C Vigorito; E Bossone; A Cittadini Journal: Transl Med UniSa Date: 2016-05-16
Authors: Emily B Levitan; Melissa K Van Dyke; Ligong Chen; Raegan W Durant; Todd M Brown; J David Rhodes; Olusola Olubowale; Oluwole Muyiwa Adegbala; Meredith L Kilgore; Justin Blackburn; Karen C Albright; Monika M Safford Journal: BMC Cardiovasc Disord Date: 2017-09-16 Impact factor: 2.298
Authors: Caroline Morbach; Martin Wagner; Stefan Güntner; Carolin Malsch; Mehmet Oezkur; David Wood; Kornelia Kotseva; Rainer Leyh; Georg Ertl; Wolfgang Karmann; Peter U Heuschmann; Stefan Störk Journal: BMC Cardiovasc Disord Date: 2017-05-05 Impact factor: 2.298
Authors: Michael J Diamant; Sean A Virani; Winston J MacKenzie; Andrew Ignaszewski; Mustafa Toma; Nathaniel M Hawkins Journal: ESC Heart Fail Date: 2019-06-20