• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Nearly half of all HFrEF patients are not receiving therapy according to National guidelines, leading to poor outcomes

byDavy LauandAlex Chan
August 14, 2020
in Cardiology, Chronic Disease
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Receiving medications from a greater number of drug classes is linked to lower incidence of rehospitalization and death, for patients in heart failure with reduced ejection fraction (HFrEF).

2. Approximately half of HFrEF patients are not receiving medical therapies that follow clinical guidelines established by the American College of Cardiology Foundation/American Heart Association.

Evidence Rating Level: 2 (Good)

Study rundown: Heart failure (HF) is a debilitating condition most prevalent in elderly populations, characterized by the heart’s weakened abilities to fill the ventricles or eject blood. About 50% of HF patients have a reduced left-ejection fraction of less than 40% (HFrEF). Currently, American guidelines recommend therapy regimens containing at least two of three of: beta-blockers, angiotensin drugs, and mineralocorticoid receptor antagonists, with careful escalation of drug doses to target dosages tailored to the patient’s condition. Despite this however, it is believed that many clinicians do not have their practices aligned with these guidelines, contributing to significant morbidity and mortality associated with the disease, especially in the period following HF hospitalization, with 25% of patients readmitted and 10% of patients dying within 30 days. In this study, researchers attempted to quantify the adherence to clinical guidelines, and to investigate how medical therapy practices for HFrEF patients relate to all-cause mortality and rehospitalization.

The study analyzed outcomes retrospectively, using an existing health records database. The results showed that the greater number of drug classes prescribed, the lower the risk for death and rehospitalization. Despite this however, 45.4% of patients did not receive medical therapies in adherence with the recommended guidelines, receiving either monotherapy or no therapy at all.  As well, 46% of patients who received medical therapies did not receive any dose escalation post-discharge. These results show that the clinical guidelines in place appear to be effective at lowering death and rehospitalization rates, but are currently sub-optimally employed with poor adherence rates.

The central strength in this study is the elimination of performance bias, as its retrospective nature allows researchers to accurately quantify adherence without physicians altering their practice due to observation. Further extensions of the study should examine the relationship between the intensity of medical therapies received and a patient’s disease severity however, to better characterize current practices.

Click to read the study in JAHA

RELATED REPORTS

Provision of 1-year mortality data for patients hospitalized with heart failure does not influence clinical decision-making – The REVEAL-HF trial

Prior syncope presentation not associated with increased risk of motor vehicle collision

Postoperative and nonoperative atrial fibrillation have a similar risk of associated thromboembolism

Relevant Reading: Medical Therapy for Heart Failure With Reduced Ejection Fraction

In-depth [retrospective cohort study]: This study’s population and patient data came from the Humana Research Database in Louisville, Kentucky. Patients selected for the study were between 65 and 89 years of age, and were newly diagnosed with HFrEF, with a hospitalization date between 2008 and 2016. There were 17,106 patients in total: The mean age was 77 years, 60% were men, and 83% were white. The primary outcomes analyzed was the time between discharge and first rehospitalization or death, whichever came first, in a 1 year follow-up period. The study found that 23.3% of patients received no therapy, 22.1% received monotherapy, 41.2% of patients received dual therapy, and 13.4% received triple therapy. Altogether, 54.6% of patients received a level of intensity of medical therapy that adhered to clinical guidelines. Compared to patients with no HF medication, those receiving monotherapy had a 32% reduced incidence of death or rehospitalization (n=3777; HR=0.68, 95% CI=0.64-0.71). For dual therapy, it was a 44% reduced incidence (n=7056; HR=0.56, 95% Ci=0.53-0.59), and for triple therapy it was a 55% reduced incidence (n=2286; HR=0.45, 95% CI=0.41-0.50). Finally, 46% of patients who received medication did not receive a dose escalation during follow-up: This was more prevalent in more intense therapies, with 62.6% of monotherapy patients, not receiving dose escalation (41.8% of dual therapy patients, and 29.1% of triple therapy patients).

Image: PD

©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

 

Tags: cardiologyheart failurehfref
Previous Post

#VisualAbstract: Nemolizumab for pruritis in atopic dermatitis patients

Next Post

Robotic approach to paraesophageal hernia repair associated with positive patient outcomes

RelatedReports

Quick Take: Association of African Ancestry with Electrocardiographic Voltage and Concentric Left Ventricular Hypertrophy: The Dallas Heart Study
Cardiology

Provision of 1-year mortality data for patients hospitalized with heart failure does not influence clinical decision-making – The REVEAL-HF trial

August 13, 2022
Steroids and opioids often inappropriately prescribed in the emergency department for pediatric pneumonia and sinusitis
Cardiology

Prior syncope presentation not associated with increased risk of motor vehicle collision

August 11, 2022
Radiofrequency catheter ablation effective as first-line therapy for atrial fibrillation [RAAFT-2 trial]
Cardiology

Postoperative and nonoperative atrial fibrillation have a similar risk of associated thromboembolism

August 11, 2022
#VisualAbstract: Dapagliflozin associated with reduced risk of cardiovascular and kidney outcomes irrespective of background use of cardiovascular medications
StudyGraphics

#VisualAbstract: Dapagliflozin associated with reduced risk of cardiovascular and kidney outcomes irrespective of background use of cardiovascular medications

August 10, 2022
Next Post
Preoperative tumor embolization does not reduce operative blood loss

Robotic approach to paraesophageal hernia repair associated with positive patient outcomes

#VisualAbstract: Serum antibody testing for SARS-CoV-2

#VisualAbstract: Serum antibody testing for SARS-CoV-2

#VisualAbstract: Household transmissibility of SARS-CoV-2

#VisualAbstract: Household transmissibility of SARS-CoV-2

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Provision of 1-year mortality data for patients hospitalized with heart failure does not influence clinical decision-making – The REVEAL-HF trial
  • Genetic risk for hemochromatosis associated with abnormal iron deposition localized to motor circuits of the brain
  • Graded sensorimotor retraining may improve chronic lower back pain compared to sham procedure: The RESOLVE randomized clinical trial
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.