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Guidelines for HFrEF treatment

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https://www.readbyqxmd.com/read/29792395/how-are-patients-with-heart-failure-treated-in-primary-care
#1
Hélène Vaillant-Roussel, Bruno Pereira, Sylvaine Gibot-Boeuf, Romain Eschalier, Claude Dubray, Rémy Boussageon, Philippe Vorilhon
OBJECTIVE: The aim of this study was to assess the adherence of general practitioners (GPs) to guidelines in patients with heart failure with reduced ejection fraction (HFrEF) and to describe GPs' prescribing behavior regarding patients with heart failure with preserved ejection fraction (HFpEF). MATERIALS AND METHODS: Cross-sectional study as part of the ETIC trial. Five classes of drugs were described: angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs); β-blockers (BBs); mineralocorticoid receptor antagonists (MRAs); diuretics (thiazide or loop diuretics); and digoxin...
May 24, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29779951/is-the-paradigm-hf-cohort-representative-of-the-real-world-heart-failure-patient-population
#2
Gustavo Rodrigues, António Tralhão, Carlos Aguiar, Pedro Freitas, António Ventosa, Miguel Mendes
INTRODUCTION: A new drug with prognostic impact on heart failure, sacubitril/valsartan, has been introduced in current guidelines. However, randomized trial results can be compromised by lack of representativeness. We aimed to assess the representativeness of the PARADIGM-HF trial in a real-world population of patients with heart failure. METHODS: We reviewed the records of 196 outpatients followed in a heart failure clinic between January 2013 and December 2014...
May 17, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29777284/current-drug-therapy-for-heart-failure-with-reduced-ejection-fraction
#3
D Berliner, M Hallbaum, J Bauersachs
The prevalence of heart failure has been steadily increasing during the past few years, with a further increase predicted in the years to come. Without treatment, the syndrome of heart failure has a very poor prognosis. Advances in drug treatments and the consequent implementation of a guideline-recommended drug therapy have significantly improved the prognosis in heart failure with reduced ejection fraction (HFrEF). Besides angiotensin-converting enzyme (ACE) inhibitors (ACEi) or angiotensin receptor blockers, beta-blockers and diuretics treatment with mineralocorticoid receptor antagonists and ivabradine have become standard in the therapy of symptomatic patients with HFrEF...
May 18, 2018: Herz
https://www.readbyqxmd.com/read/29762337/real-life-indications-to-ivabradine-treatment-for-heart-rate-optimization-in-patients-with-chronic-systolic-heart-failure
#4
Lara Tondi, Gabriele Fragasso, Roberto Spoladore, Giuseppe Pinto, Marco Gemma, Massimo Slavich, Cosmo Godino, Anna Salerno, Claudia Montanaro, Alberto Margonato
: Ivabradine is a selective and specific inhibitor of If current. With its pure negative chronotropic action, it is recommended by European Society of Cardiology and American College of Cardiology/American Heart Association guidelines in symptomatic heart failure patients (NYHA ≥ 2) with ejection fraction 35% or less, sinus rhythm and heart rate (HR) at least 70 bpm, despite maximally titrated β-blocker therapy. Data supporting this indication mainly derive from the SHIFT study, in which ivabradine reduced the combined endpoint of mortality and hospitalization, despite the fact that only 26% of patients enrolled were on optimal β-blocker doses...
May 11, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29705650/baroreflex-activation-therapy-for-the-treatment-of-heart-failure-with-reduced-ejection-fraction-in-patients-with-and-without-coronary-artery-disease
#5
Marcel Halbach, William T Abraham, Christian Butter, Anique Ducharme, Didier Klug, William C Little, Hannes Reuter, Jill E Schafer, Michele Senni, Vijay Swarup, Rolf Wachter, Fred A Weaver, Seth J Wilks, Michael R Zile, Jochen Müller-Ehmsen
BACKGROUND: In a randomized trial, baroreflex activation therapy (BAT) improved exercise capacity, quality of life and NT-proBNP in patients with heart failure with reduced ejection fraction (HFrEF). In view of different mechanisms underlying HFrEF, we performed a post-hoc subgroup analysis of efficacy and safety of BAT in patients with and without coronary artery disease (CAD). METHODS AND RESULTS: Patients with left ventricular ejection fraction <35% and NYHA Class III were randomized 1:1 to guideline-directed medical and device therapy alone or plus BAT...
April 21, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29685696/does-natriuretic-peptide-monitoring-improve-outcomes-in-heart-failure-patients-a-systematic-review-and-meta-analysis
#6
Muhammad Shahzeb Khan, Tariq Jamal Siddiqi, Muhammad Shariq Usman, Jayakumar Sreenivasan, Setri Fugar, Haris Riaz, M H Murad, Farouk Mookadam, Vincent M Figueredo
BACKGROUND: Current guidelines do not support the use of serial natriuretic peptide (NP) monitoring for heart failure with preserved (HFpEF) or reduced ejection fraction (HFrEF) treatment, despite some studies showing benefit. We conducted an updated meta-analysis to address whether medical therapy in HFpEF or HFrEF should be titrated according to NP levels. METHODS: MEDLINE, Scopus and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) comparing NP versus guideline directed titration in HF patients through December 2017...
April 12, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#7
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29621054/the-importance-of-heart-rate-in-heart-failure-and-reduced-ejection-fraction
#8
Marilyn A Prasun, Nancy M Albert
BACKGROUND: Heart failure with reduced ejection fraction (HFrEF) is a progressive, chronic, and burdensome cardiovascular condition. It is associated with limiting symptoms, such as dyspnea and fatigue; a decline in functional capacity; and premature mortality and hospitalization. In heart failure (HF) management, heart rate is commonly assessed yet frequently overlooked as a modifiable risk factor and a predictor of mortality. An elevated heart rate increases myocardial demand and decreases diastolic filling time...
April 4, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29557071/current-management-and-future-directions-of-heart-failure-with-preserved-ejection-fraction-a-contemporary-review
#9
REVIEW
Chayakrit Krittanawong, Marrick L Kukin
Heart failure with preserved ejection fraction (HFpEF), a complex and debilitating syndrome, is commonly seen in elderly populations. Exacerbation of HFpEF is among the most common reasons for hospital admission in the USA. The high rate of morbidity and mortality from this condition underscores the fact that HFpEF is heterogeneous, complex, and poorly characterized. Randomized, controlled trials have been very successful at identifying treatments for HF with reduced ejection fraction (HFrEF), but effective treatment options for HFpEF are lacking...
March 20, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29549927/assessing-guideline-directed-medication-therapy-for-heart-failure-in-end-stage-renal-disease
#10
B Tate Cutshall, Benjamin T Duhart, Jagannath Saikumar, Michael Samarin, Lydia Hutchison, Joanna Q Hudson
BACKGROUND: Treatment of heart failure with reduced ejection fraction (HFrEF) requires guideline-directed medication therapy (GDMT) consisting of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker in combination with an indicated beta-blocker. There is concern that end-stage renal disease (ESRD) patients are not being prescribed GDMT. The study aim was to determine whether outcomes differ for patients with HFrEF and ESRD receiving GDMT compared to those not receiving GDMT...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29520964/type-2-diabetes-mellitus-and-heart-failure-a-position-statement-from-the-heart-failure-association-of-the-european-society-of-cardiology
#11
REVIEW
Petar M Seferović, Mark C Petrie, Gerasimos S Filippatos, Stefan D Anker, Giuseppe Rosano, Johann Bauersachs, Walter J Paulus, Michel Komajda, Francesco Cosentino, Rudolf A de Boer, Dimitrios Farmakis, Wolfram Doehner, Ekaterini Lambrinou, Yuri Lopatin, Massimo F Piepoli, Michael J Theodorakis, Henrik Wiggers, John Lekakis, Alexandre Mebazaa, Mamas A Mamas, Carsten Tschöpe, Arno W Hoes, Jelena P Seferović, Jennifer Logue, Theresa McDonagh, Jillian P Riley, Ivan Milinković, Marija Polovina, Dirk J van Veldhuisen, Mitja Lainscak, Aldo P Maggioni, Frank Ruschitzka, John J V McMurray
The coexistence of type 2 diabetes mellitus (T2DM) and heart failure (HF), either with reduced (HFrEF) or preserved ejection fraction (HFpEF), is frequent (30-40% of patients) and associated with a higher risk of HF hospitalization, all-cause and cardiovascular (CV) mortality. The most important causes of HF in T2DM are coronary artery disease, arterial hypertension and a direct detrimental effect of T2DM on the myocardium. T2DM is often unrecognized in HF patients, and vice versa, which emphasizes the importance of an active search for both disorders in the clinical practice...
May 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29498023/treatment-of-heart-failure-with-preserved-ejection-fraction
#12
Adriana Mihaela Ilieșiu, Andreea Simona Hodorogea
Heart failure with preserved ejection fraction (HFpEF) is a growing epidemiologic problem affecting more than half of the patients with heart failure (HF). HFpEF has a significant morbidity and mortality and so far no treatment has been clearly demonstrated to improve the outcomes in HFpEF, in contrast to the efficacy of treatment in heart failure with reduced ejection fraction (HFrEF).The failure of proven beneficial drugs in HFrEF to influence the outcome of patients with HFpEF could be related to the heterogeneity of the disease, its various phenotypes and multifactorial pathophysiology, incompletely elucidated yet...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29476617/digoxin-is-associated-with-increased-risk-of-death-in-heart-failure-patients-treated-with-beta-blockers-results-from-polish-part-of-esc-hf-long-term-registry
#13
Jacek Migaj, Marta Kałużna-Oleksy, Jadwiga Nessler, Grzegorz Opolski, Marisa Crespo-Leiro, Aldo P Maggioni, Stefan Grajek, Piotr Ponikowski, Jarosław Drożdż, Ewa Straburzyńska-Migaj
BACKGROUND: Digoxin is used in treatment of atrial fibrillation and heart failure (HF). It was reported to increase the risk of death in HF. Studies of digoxin base mainly on patients treated some years ago, before the era of common beta-blocker use. AIM: This study aims to show the influence of digoxin in a modern cohort of HF patients on top of the contemporary guideline-directed treatment. METHODS: This study analyzes retrospectively the Polish portion of the ESC HF Long-Term Registry...
February 24, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29471572/-cardiovascular-medication-in-elderly-patients
#14
Robert H G Schwinger
Elderly people show increased probability to develop atherosclerotic diseases; in consequence heart failure - most often following coronary heart disease - as well as atrial fibrillation is more common. Following guidelines may lead to polypharmacy, i. e. use of more than 5 drugs daily. Thus, drug interactions as well as side effects become more likely; especially in elderly patients reduced kidney function has to be taken into account. Only drugs which have shown to prolong life or to reduce symptoms in controlled clinical trials should be used...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29455335/evaluating-the-safety-and-tolerability-of-sacubitril-valsartan-for-hfref-managed-within-a-pharmacist-clinic
#15
Elizabeth K Pogge, Lindsay E Davis
OBJECTIVE: The objective of this research was to describe the use of pharmacist-managed sacubitril/valsartan therapy in a multi-center, outpatient cardiac group. BACKGROUND: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNi), is a novel agent for the treatment of heart failure. An ARNi is recommended by national guidelines to be used in place of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy for patients who remain symptomatic...
April 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29305071/effectiveness-of-guideline-consistent-heart-failure-drug-prescriptions-at-hospital-discharge-on-1-year-mortality-results-from-the-epical2-cohort-study
#16
Amandine Busson, Nathalie Thilly, Hervé Laborde-Castérot, François Alla, Ziyad Messikh, Isabelle Clerc-Urmes, Alexandre Mebazaa, Marc Soudant, Nelly Agrinier
BACKGROUND: We aimed to assess the effectiveness of recommended drug prescriptions at hospital discharge on 1-year mortality in patients with heart failure (HF) and reduced ejection fraction (HFREF). MATERIALS AND METHODS: We used data from the EPICAL2 cohort study. HF patients ≥18years old with left ventricular ejection fraction (LVEF) <40% and alive at discharge were included and followed up for mortality. Socio-demographic, clinical and therapeutic data were collected at admission...
January 2, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29232274/the-diuretic-potential-of-sacubitril-valsartan-a-tale-of-2-patients
#17
Sabrina M Hormann, Lindsay E Davis, Elizabeth K Pogge
BACKGROUND: Heart failure prevalence continues to rise in the United States causing significant morbidity and mortality and costing billions in healthcare expenditures. Consensus guidelines updated in 2016 recommend an angiotensin receptor-neprilysin inhibitor (ARNi) as a therapeutic option in lieu of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker for the management of stage C heart failure with reduced ejection fraction (HFrEF). For chronic HFrEF patients with New York Heart Association class II or III symptoms tolerating an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, a change in therapy to an ARNi is recommended to further reduce morbidity and mortality...
March 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29192956/initial-clinical-experience-with-the-first-drug-sacubitril-valsartan-in-a-new-class-angiotensin-receptor-neprilysin-inhibitors-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-in-poland
#18
Marta Kałużna-Oleksy, Jolanta Kolasa, Jacek Migaj, Agnieszka Pawlak, Małgorzata Lelonek, Jadwiga Nessler, Ewa Straburzyńska-Migaj
BACKGROUND: Sacubitril/valsartan is the first drug from a new class of angiotensin receptor neprilysin inhibitors (ARNIs) recommended in the new European Society of Cardiology guidelines instead of angiotensin converting enzyme inhibitors (ACEI), or angiotensin receptor blockers (ARB) that are used if ACEI are not tolerated. Sacubitril/valsartan is recommended for further reduction in the risk of hospitalisation or death in outpatients with heart failure with reduced ejection fraction (HFrEF) if symptoms continue despite optimal treatment with ACEI/ARB, beta-blockers, and mineralocorticoid antagonists...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29181610/barriers-to-beta-blocker-use-and-up-titration-among-patients-with-heart-failure-with-reduced-ejection-fraction
#19
Emily B Levitan, Melissa K Van Dyke, Matthew Shane Loop, Ronan O'Beirne, Monika M Safford
PURPOSE: For patients with heart failure with reduced ejection fraction (HFrEF), guidelines recommend use of beta-blockers with gradual up-titration. However, many patients with HFrEF do not use beta-blockers and up-titration is rare. Our purpose was to identify and rank barriers to beta-blocker use and up-titration from the perspective of primary care physicians. METHODS: We conducted 4 moderated, structured group discussions among 19 primary care physicians using the nominal group technique; 16 participants also completed a survey...
December 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29141781/heart-failure-with-preserved-borderline-and-reduced-ejection-fraction-5-year-outcomes
#20
Kevin S Shah, Haolin Xu, Roland A Matsouaka, Deepak L Bhatt, Paul A Heidenreich, Adrian F Hernandez, Adam D Devore, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up...
November 14, 2017: Journal of the American College of Cardiology
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