Optimization of heart FailUre medical Treatment after hospital discharge according to left ventricUlaR Ejection fraction: the FUTURE survey

Autor: Maxime Genoun, Patrick Assyag, Alain Cohen Solal, Jean-François Thébaut, Christine Contre, Pierre Clerson, Florence Beauvais, I. Leurs
Rok vydání: 2011
Předmět:
Male
Ejection fraction
ACE inhibitors
Time Factors
Epidemiology
Fraction d’éjection
Angiotensin-Converting Enzyme Inhibitors
Ventricular Function
Left
Beta-blockers
Ventricular Dysfunction
Left
Prevalence
IEC
Practice Patterns
Physicians'
Diuretics
Referral and Consultation
Mineralocorticoid Receptor Antagonists
Aged
80 and over
COPD
Drug Substitution
General Medicine
Loop diuretic
Middle Aged
Patient Discharge
Épidémiologie
Treatment Outcome
Predictive value of tests
Practice Guidelines as Topic
Cardiology
Female
Private Sector
France
Guideline Adherence
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Bêtabloquants
medicine.drug_class
Adrenergic beta-Antagonists
Predictive Value of Tests
Internal medicine
medicine
Humans
cardiovascular diseases
Adverse effect
Aged
Retrospective Studies
Heart Failure
Chi-Square Distribution
business.industry
Retrospective cohort study
Cardiovascular Agents
Stroke Volume
medicine.disease
Drug Utilization
Insuffisance cardiaque
Cross-Sectional Studies
Logistic Models
Heart failure
Health Care Surveys
business
Chi-squared distribution
Angiotensin II Type 1 Receptor Blockers
Zdroj: Archives of cardiovascular diseases. 105(6-7)
ISSN: 1875-2128
Popis: Summary 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.
Databáze: OpenAIRE
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