Journal of Clinical Medicine,
Год журнала:
2024,
Номер
14(1), С. 139 - 139
Опубликована: Дек. 29, 2024
Background/Objectives:
In
heart
failure
(HF)
with
reduced
ejection
fraction
(HFrEF),
the
early
diagnosis
and
proper
treatment
of
comorbidities
(CMs)
are
fundamental
relevance.
Our
aim
was
to
assess
prevalence
CMs
among
real-world
patients
requiring
hospitalisation
for
HFrEF
investigate
effect
on
implementation
guideline-directed
medical
therapy
(GDMT)
all-cause
mortality
(ACM).
Methods:
The
data
a
consecutive
patient
cohort
hospitalised
HF
between
2021
2024
were
analysed
retrospectively.
Sixteen
(6
CV
10
non-CV)
considered.
Patients
divided
into
three
categories:
0–3
vs.
4–6
≥7
CMs.
GDMT
at
discharge
ACM
compared
CM
categories.
predictors
1-year
also
evaluated.
Results:
From
388
(male:
76%,
age:
61
[50–70]
years;
NT-proBNP:
5286
[2570–9923]
pg/mL;
≥2
cardiovascular–kidney–metabolic
disease
overlap:
46%),
large
proportion
received
(RASi:
91%;
βB:
85%;
MRA:
95%;
SGLT2i:
59%;
triple
[TT:
RASi+βB+MRA]:
82%;
quadruple
[QT:
TT
+
SGLT2i]:
54%)
discharge.
Multimorbidity
accompanied
(p
<
0.05)
lower
application
ratio
RASi
(96%
92%
CMs)
βB
(94%
85%
78%),
while
MRA
(99%
94%
94%)
SGTL2i
use
(61%
59%
57%)
did
not
differ
>
0.05).
multimorbidity
less
likely
be
treated
(93%
82%
73%,
p
=
0.001),
no
difference
detected
in
QT
(56%
54%
50%,
0.685).
an
increased
burden
higher
(9%
13%
25%,
0.003).
risk
favourably
affected
by
TT/QT
severe
left
ventricular
systolic
dysfunction,
having
≥5
had
unfavourable
impact
prognosis.
Conclusions:
According
our
analysis,
can
expect
favourable
outcome.
However,
modern
even
applied
this
population,
resulting
significantly
improved
Thus,
clinicians
should
insist
early,
conscious
prognosis-modifying
drug
regime
multimorbid
as
well.
BMJ Open,
Год журнала:
2025,
Номер
15(2), С. e088998 - e088998
Опубликована: Фев. 1, 2025
To
evaluate
the
trend
of
prescription
four
foundational
therapies,
and
their
impact
on
30-day
urgent
re-admissions
all-cause
death
in
patients
with
heart
failure
reduced
ejection
fraction
(HFrEF)
following
an
acute
decompensation
event.
Retrospective.
One
tertiary
referral
centre.
999
consecutively
admitted
a
primary
diagnosis
HFrEF
between
January
2020
June
2023
were
identified
through
validated,
high-performance
technology
infrastructure
based
artificial
intelligence.
The
entire
cohort
was
divided
into
three
time
periods
two
points:
September
2021
(ie,
release
latest
European
guidelines)
2022
reimbursement
for
sodium-glucose
cotransporter
2
(SGLT2)
inhibitors).
Trends
predictors
each
therapies
composite
rehospitalisation
causes
at
30
days.
Among
included
patients,
β-blockers
prescribed
93%
ACE
inhibitor
(ACEi)/angiotensin
receptor
blocker
(ARB)/angiotensin-neprilysin
(ARNi)
73%,
mineralocorticoid
antagonist
30%
SGLT2
inhibitors
18%.
Over
time,
increase
rate
occurred
only
(3%
vs
10%
32%,
p<0.001),
whereas
days
remained
stable
(9.9%
10.3%
8.4%;
p=ns).
In
multivariate
analysis,
use
ACEi/ARB/ARNi
associated
lower
risk
(adjusted
OR
0.38;
95%
CI
0.24
to
0.59;
p<0.01).
Conversely,
furosemide
discharge
2.25;
1.29
3.94;
p<0.01)
previous
genitourinary
infection
4.02;
1.67
9.68;
higher
rehospitalisation.
our
study,
early
adoption
guideline-recommended
medical
therapy
is
still
limited,
significant
rise
SGLT2i
prescriptions
after
readmissions
restricted
ACEi/ARB/ARNi.
Journal of Cardiovascular Development and Disease,
Год журнала:
2025,
Номер
12(2), С. 50 - 50
Опубликована: Янв. 28, 2025
The
management
of
heart
failure
(HF)
has
undergone
a
paradigm
shift
from
conventional
stepwise
methods
initiation
and
the
up-titration
HF
therapy
towards
an
early,
more
intensive
pharmacotherapy
to
improve
prognosis.
aim
this
study
was
compare
outcomes
patients
at
Liverpool
Heart
Chest
Hospital
(LHCH),
with
new
diagnosis
HF,
who
were
reviewed
by
inpatient
team
(HFT),
compared
that
not
reviewed.
A
retrospective
review
electronic
records
admitted
LHCH
May
December
2023
performed.
Admission
drugs
similar,
apart
betablockers,
which
frequent
in
non-HFT
group
(58%
vs.
24.2%;
p
=
0.002).
length
stay
longer
HFT
(median
5.5
days
3
days;
0.001)
likely
be
on
all
four
pillars
medical
(96.8%
0;
<
within
30
discharge.
30-day
6-month
mortality
significantly
different.
Patients
receive
their
counterparts
expense
stay.
Circulation Heart Failure,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 21, 2025
BACKGROUND:
Despite
randomized
data
for
survival
benefit
(with
class
1
recommendations)
treating
heart
failure
(HF)
with
reduced
ejection
fraction
using
quadruple
medical
therapy
(QMT)—defined
as
evidence-based
β-blockers,
sodium-glucose
cotransporter
2
inhibitor,
preferably
angiotensin
receptor/neprilysin
and
mineralocorticoid
receptor
antagonist—it
is
underutilized.
IMPLEMENT-HF
a
multiregional
HF
quality
improvement
initiative
to
improve
care
outcomes
patients
by
enhancing
the
use
of
QMT
in
routine
practice.
METHODS:
This
analysis
treatment
from
hospitals
participating
American
Heart
Association’s
Get
With
The
Guidelines–HF
who
volunteered
participate
7
US
regions.
included
multidisciplinary
learning
share
strategies
formulary
changes,
electronic
health
record
tools,
patient
resources
site-level
feedback
reports.
Participants
gathered
at
discharge
30
days
after
discharge.
We
evaluated
utilization
variation,
addition
other
prespecified
performance
measures,
Q1
2021
Q2
2023.
RESULTS:
median
(interquartile
range)
age
43
558
admitted
61
was
74
(63–83)
years;
16
530
(38%)
belonged
racial
ethnic
minorities,
22
228
(51%)
were
women.
Between
2023,
defect-free
improved
4.7%
44.6%
0%
44.8%
(both
P
<0.0001).
There
also
substantially
incorporation
health-related
social
needs
assessments.
magnitude
improvements
similar
when
stratified
sex
or
race
ethnicity,
yet
there
significant
regional
variation.
CONCLUSIONS:
Among
healthcare
systems
IMPLEMENT-HF,
marked
increase
among
eligible
over
course
initiative.
supports
collaborative
model
promote
use.
