An Observational Study of Evidence-Based Therapies in Older Patients with Heart Failure with Reduced Ejection Fraction: Insights from a Dedicated Heart Failure Clinic DOI Open Access
Catarina Silva Araújo, Irene Marco Clement, Maria Alejandra Restrepo‐Córdoba

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7171 - 7171

Published: Nov. 26, 2024

Background/Objectives: Despite significant advances in the management of heart failure with reduced ejection fraction (HFrEF), data concerning older patients remain limited. The purpose this study was to evaluate implementation guideline-directed medical therapy (GDMT) HFrEF along cardiac events and variation clinical echocardiographic parameters during follow-up a (HF) clinic. Methods: We conducted retrospective observational analysis aged ≥ 80 years who attended an HF clinic between March 2022 February 2023. primary outcome composite first episode worsening or cardiovascular death. All-cause death also recorded. Results: included 110 (30.9% females; mean age 82.9 years). After median 25.5 months, left ventricular (LVEF) improved (mean difference 12.5% (p < 0.001)). New York Heart Association class 37% patients, N-terminal pro-B-type natriuretic peptide levels decreased (3091 (158–53354) 1802 (145–19509), p 0.001). occurred 34 (30.9%). Patients without were more likely receive sodium-glucose co-transporter-2 inhibitors (SGLT2i) (23.5% versus 67.1%, 0.001) angiotensin receptor-neprilysin inhibitors, angiotensin-converting enzyme angiotensin-receptor blockers (67.6% 84.2%, 0.05). These received greater number GDMT medications (2 (0–4) 3 (1–4), 0.01) demonstrated higher LVEF at last visit (41.2 ± 10.2% 47.1 9.4%, Survival association recovery (hazard ratio (HR) 0.35, 0.01), treatment two (HR 0.29, vasodilator use 0.36, SGLT2i prescription 0.17, risk endpoint. Conclusions: optimization is achievable may be associated reduction events.

Language: Английский

Use and Benefit of Sacubitril/Valsartan in Elderly Patients with Heart Failure with Reduced Ejection Fraction DOI Open Access
Luis Nieto Roca, Marcelino Cortés,

Jorge Balaguer Germán

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(16), P. 4772 - 4772

Published: Aug. 14, 2024

Background: Heart failure (HF) is a highly prevalent syndrome in elderly subjects. Currently, multiple drugs have shown clinical benefits patients with HF and reduced ejection fraction (HFrEF). However, evidence scarce (beyond 75 years old), even more so for the latest drugs, such as angiotensin receptor-neprilysin inhibitors (ARNIs). This study aims to evaluate use of ARNIs HFrEF. Methods: A prospective observational cohort was designed. Patients left ventricular systolic dysfunction (defined by [LVEF] < 40%) age ≥ from January 2016 December 2020 were prospectively included. an indication at inclusion or throughout follow-up selected. Clinical, electrocardiographic echocardiographic variables collected. Results: total 616 included, 34.4% them female, mean 83.3 years, LVEF 28.5% ischemic etiology 53.9% patients. Only 14.3% taking ARNIs. After 34 months, 50.2% died, 62.2% had cardiac event (total mortality hospital admission due HF). Multivariate Cox regression analysis showed that independently significantly associated lower rates [HR 0.36 (95% CI 0.21–0.61)], similar results relation all-cause propensity-score-matched 0.33 0.19–0.57)]. Conclusions: We observed important underuse HFrEF patients, which treatment significant reduction mortality. Greater implementation practice guidelines this group could improve their prognosis.

Language: Английский

Citations

2
An Observational Study of Evidence-Based Therapies in Older Patients with Heart Failure with Reduced Ejection Fraction: Insights from a Dedicated Heart Failure Clinic DOI Open Access
Catarina Silva Araújo, Irene Marco Clement, Maria Alejandra Restrepo‐Córdoba

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7171 - 7171

Published: Nov. 26, 2024

Background/Objectives: Despite significant advances in the management of heart failure with reduced ejection fraction (HFrEF), data concerning older patients remain limited. The purpose this study was to evaluate implementation guideline-directed medical therapy (GDMT) HFrEF along cardiac events and variation clinical echocardiographic parameters during follow-up a (HF) clinic. Methods: We conducted retrospective observational analysis aged ≥ 80 years who attended an HF clinic between March 2022 February 2023. primary outcome composite first episode worsening or cardiovascular death. All-cause death also recorded. Results: included 110 (30.9% females; mean age 82.9 years). After median 25.5 months, left ventricular (LVEF) improved (mean difference 12.5% (p < 0.001)). New York Heart Association class 37% patients, N-terminal pro-B-type natriuretic peptide levels decreased (3091 (158–53354) 1802 (145–19509), p 0.001). occurred 34 (30.9%). Patients without were more likely receive sodium-glucose co-transporter-2 inhibitors (SGLT2i) (23.5% versus 67.1%, 0.001) angiotensin receptor-neprilysin inhibitors, angiotensin-converting enzyme angiotensin-receptor blockers (67.6% 84.2%, 0.05). These received greater number GDMT medications (2 (0–4) 3 (1–4), 0.01) demonstrated higher LVEF at last visit (41.2 ± 10.2% 47.1 9.4%, Survival association recovery (hazard ratio (HR) 0.35, 0.01), treatment two (HR 0.29, vasodilator use 0.36, SGLT2i prescription 0.17, risk endpoint. Conclusions: optimization is achievable may be associated reduction events.

Language: Английский

Citations

0