Portal de investigação
Perceived risk profile and treatment optimization in heart failure: an analysis from BIOlogy Study to TAilored Treatment in chronic heart failure
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Kobayashi, M
- Voors, AA
- Ouwerkerk, W
- Duarte, K
- Girerd, N
- Rossignol, P
- Metra, M
- Lang, CC
- Ng, LL
- Filippatos, G
- Dickstein, K
- van Veldhuisen, DJ
- Zannad, F
Unidades de investigação
Abstract
Background Achieving target doses of angiotensin-converting-enzyme inhibitor/angiotensin-receptor blockers (ACEi/ARB) and beta-blockers in heart failure with reduced ejection fraction (HFrEF) is often underperformed. In BIOlogy Study to TAilored Treatment in chronic heart failure (BIOSTAT-CHF) study, many patients were not up-titrated for which no clear reason was reported. Therefore, we hypothesized that perceived-risk profile might influence treatment optimization. Methods We studied 2100 patients with HFrEF (LVEF <= 40%) to compare the clinical characteristics and adverse events associated with treatment up-titration (after a 3-month titration protocol) between; a) patients not reaching target doses for unclear reason; b) patients not reaching target doses due to symptoms and/or side effects; c) patients reaching target doses. Results For ACEi/ARB, (a), (b) and (c) was observed in 51.3%, 25.9% and 22.7% of patients, respectively. For beta-blockers, (a), (b) and (c) was observed in 67.5%, 20.2% and 12.3% of patients, respectively. By multinomial logistic regression analysis for ACEi/ARB, patients in group (a) and (b) had lower blood pressure and poorer renal function, and patients in group (a) were older and had lower ejection fraction. For beta-blockers, patients in group (a) and (b) had more severe congestion and lower heart rate. At 9 months, adverse events (i.e., hypotension, bradycardia, renal impairment, and hyperkalemia) occurred similarly among the three groups. Conclusions Patients in whom clinicians did not give a reason why up-titration was missed were older and had more co-morbidities. Patients in whom up-titration was achieved did not have excess adverse events. However, from these observational findings, the pattern of subsequent adverse events among patients in whom up-titration was missed cannot be determined.
Dados da publicação
- ISSN/ISSNe:
- 1932-8737, 0160-9289
- Tipo:
- Article
- Páginas:
- 780-788
- DOI:
- 10.1002/clc.23576
- Link para outro recurso:
- www.scopus.com
Clinical Cardiology Wiley-Blackwell
Citações Recebidas na Web of Science: 1
Citações Recebidas na Scopus: 2
Documentos
- Não há documentos
Filiações
Keywords
- ACE‐ inhibitor; adverse effects; ARB; beta‐ blocker; treatment up‐ titration
Financiamento
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Citar a publicação
Kobayashi M,Voors AA,Ouwerkerk W,Duarte K,Girerd N,Rossignol P,Metra M,Lang CC,Ng LL,Filippatos G,Dickstein K,van DJ,Zannad F,Ferreira J-. Perceived risk profile and treatment optimization in heart failure: an analysis from BIOlogy Study to TAilored Treatment in chronic heart failure. Clin. Cardiol. 2021. 44. (6):p. 780-788. IF:3,287. (3).
