Influence of the medical treatment schedule in new diagnoses patients with heart failure and reduced ejection fraction.

Autor: Esteban-Fernández A; Cardiology Service, Hospital Universitario Severo Ochoa, Universidad Internacional de Valencia, Madrid, Spain. athalbertus@gmail.com.; Valencian Internacional University, Valencia, Spain. athalbertus@gmail.com., Gómez-Otero I; Cardiology Service, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain., López-Fernández S; Cardiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain.; Instituto Investigación Biosanitaria Ibs.GRANADA, Granada, Spain., Santamarta MR; Cardiology Service, Hospital Universitario de León, León, Spain., Pastor-Pérez FJ; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.; Cardiology Service, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Fluvià-Brugués P; Cardiology Service, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain., Pérez-Rivera JÁ; Cardiology Service, Hospital Universitario de Burgos, Burgos, Spain.; Facultad de Ciencias de La Salud, Universidad Isabel I, Burgos, Spain., López López A; Cardiology Service, Hospital Universitario de Lugo, Lugo, Spain., García-Pinilla JM; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.; Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain.; Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain., Palomas JLB; Cardiology Service, Hospital Universitario San Juan de la Cruz, Jaén, Spain., Bonet LA; Cardiology Service, Hospital Universitario La Fe, Valencia, Spain., Cobo-Marcos M; Cardiology Service, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain., Mateo VM; Cardiology Service, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain., Llergo JT; Cardiology Service, Hospital Universitario de Jaén, Jaén, Spain., Fernández VA; Cardiology Service, Hospital Universitario Central de Asturias, Oviedo, Spain., Vives CG; Cardiology Service, Hospital de Mendaro, Mendaro, Gipuzkoa, Spain.; Instituto de Investigación Biodonostia, Donostia, Gipuzkoa, Spain., de Juan Bagudá J; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.; Cardiology Service, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain.; Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain., Benedicto AM; Cardiology Service, Hospital de la Santa Creu I Sant Pau, IIB SANT PAU, Barcelona, Spain., de Polavieja JIM; Cardiology Service, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain., Solla-Ruiz I; Cardiology Service, Hospital Universitario de Donostia, San Sebastián, Spain., Solé-González E; Cardiology Service, Hospital Clinic I Provincial de Barcelona, Barcelona, Spain., Cardona M; Cardiology Service, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain., Olaetxea JR; Cardiology Service, Hospital Universitario de Basurto, Bilbao, Spain., Cortés CO; Cardiology Service, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain., Dosantos VM; Cardiology Service, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., López AG; Cardiology Service, Hospital General de Valdepeñas, Valdepeñas, Ciudad Real, Spain., Amao E; Cardiology Service, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain., Sánchez BC; Cardiology Service, Hospital Universitario de Guadalajara, Guadalajara, Spain., Torres EA; Cardiology Service, Hospital Marina Salud, Dénia, Alicante, Spain., Carrillo VG; Cardiology Service, Hospital José Molina Orosa, Lanzarote, Spain., García-Fuertes D; Cardiology Service, Hospital Santa Bárbara, Puertollano, Ciudad Real, Spain., Ridocci-Soriano F; Cardiology Service, Hospital General Universitario de Valencia, Valencia, Spain.; Departamento de Medicina, Universitat de Valencia, Valencia, Spain.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Aug; Vol. 113 (8), pp. 1171-1182. Date of Electronic Publication: 2023 Jun 21.
DOI: 10.1007/s00392-023-02241-0
Abstrakt: Aims: Heart failure (HF) guidelines recommend treating all patients with HF and reduced ejection fraction (HFrEF) with quadruple therapy, although they do not establish how to start it. This study aimed to evaluate the implementation of these recommendations, analyzing the efficacy and safety of the different therapeutic schedules.
Methods and Results: Prospective, observational, and multicenter registry that evaluated the treatment initiated in patients with newly diagnosed HFrEF and its evolution at 3 months. Clinical and analytical data were collected, as well as adverse reactions and events during follow-up. Five hundred and thirty-three patients were included, selecting four hundred and ninety-seven, aged 65.5 ± 12.9 years (72% male). The most frequent etiologies were ischemic (25.5%) and idiopathic (21.1%), with a left ventricular ejection fraction of 28.7 ± 7.4%. Quadruple therapy was started in 314 (63.2%) patients, triple in 120 (24.1%), and double in 63 (12.7%). Follow-up was 112 days [IQI 91; 154], with 10 (2%) patients dying. At 3 months, 78.5% had quadruple therapy (p < 0.001). There were no differences in achieving maximum doses or reducing or withdrawing drugs (< 6%) depending on the starting scheme. Twenty-seven (5.7%) patients had any emergency room visits or admission for HF, less frequent in those with quadruple therapy (p = 0.02).
Conclusion: It is possible to achieve quadruple therapy in patients with newly diagnosed HFrEF early. This strategy makes it possible to reduce admissions and visits to the emergency room for HF without associating a more significant reduction or withdrawal of drugs or significant difficulty in achieving the target doses.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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