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https://www.readbyqxmd.com/read/30103979/prescribing-patterns-of-evidence-based-heart-failure-pharmacotherapy-and-outcomes-in-the-asian-hf-registry-a-cohort-study
#1
Tiew-Hwa K Teng, Jasper Tromp, Wan Ting Tay, Inder Anand, Wouter Ouwerkerk, Vijay Chopra, Gurpreet S Wander, Jonathan Jl Yap, Michael R MacDonald, Chang Fen Xu, Yvonne Mf Chia, Wataru Shimizu, A Mark Richards, Adriaan Voors, Carolyn Sp Lam
BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists (MRAs) are of proven benefit and are recommended by guidelines for management of patients with heart failure and reduced ejection fraction (HFrEF). We aimed to examine the first prospective multinational data from Asia on prescribing patterns of guideline-directed medical therapies and analyse its effect on outcomes. METHODS: In the prospective multinational ASIAN-HF registry (with enrolment from 46 centres in 11 countries in Asia), we enrolled patients aged 18 years or older, with symptomatic heart failure (stage C, with at least one episode of decompensated heart failure in the past 6 months that resulted in admission to hospital or was treated in an outpatient clinic) and left ventricular systolic dysfunction (ejection fraction ≤40% on baseline echocardiography, consistent with 2016 European Society of Cardiology guidelines)...
September 2018: Lancet Global Health
https://www.readbyqxmd.com/read/30056380/effectiveness-of-drug-interventions-to-prevent-sudden-cardiac-death-in-patients-with-heart-failure-and-reduced-ejection-fraction-an-overview-of-systematic-reviews
#2
Muaamar Al-Gobari, Sinaa Al-Aqeel, François Gueyffier, Bernard Burnand
OBJECTIVES: To summarise and synthesise the current evidence regarding the effectiveness of drug interventions to prevent sudden cardiac death (SCD) and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). DESIGN: Overview of systematic reviews. DATA SOURCES: MEDLINE, Embase, ISI Web of Science and Cochrane Library from inception to May 2017; manual search of references of included studies for potentially relevant reviews...
July 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/30025570/medical-therapy-for-heart-failure-with-reduced-ejection-fraction-the-champ-hf-registry
#3
Stephen J Greene, Javed Butler, Nancy M Albert, Adam D DeVore, Puza P Sharma, Carol I Duffy, C Larry Hill, Kevin McCague, Xiaojuan Mi, J Herbert Patterson, John A Spertus, Laine Thomas, Fredonia B Williams, Adrian F Hernandez, Gregg C Fonarow
BACKGROUND: Guidelines strongly recommend patients with heart failure with reduced ejection fraction (HFrEF) be treated with multiple medications proven to improve clinical outcomes, as tolerated. The degree to which gaps in medication use and dosing persist in contemporary outpatient practice is unclear. OBJECTIVES: This study sought to characterize patterns and factors associated with use and dose of HFrEF medications in current practice. METHODS: The CHAMP-HF (Change the Management of Patients with Heart Failure) registry included outpatients in the United States with chronic HFrEF receiving at least 1 oral medication for management of HF...
July 24, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29980453/adherence-to-treatment-guidelines-in-heart-failure-patients-in-the-top-end-region-of-northern-territory
#4
Monica Mu, Sandawana William Majoni, Pupalan Iyngkaran, Mark Haste, Nadarajah Kangaharan
BACKGROUND: Heart failure (HF) is associated with significant morbidity and mortality and recurrent hospitalisations, particularly in the Indigenous Australians of the Northern Territory. In remote Northern Australia, the epidemiology is less clear but anecdotal evidence suggests it may be worse. In addition, some anecdotal evidence suggests that prognostic pharmacological therapy could also be underutilised. Minimal HF data exists in the remote and Indigenous settings, making this study unique...
June 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29952095/beta-blockers-and-inhibitors-of-the-renin-angiotensin-aldosterone-system-for-chronic-heart-failure-with-preserved-ejection-fraction
#5
REVIEW
Nicole Martin, Karthick Manoharan, James Thomas, Ceri Davies, R Thomas Lumbers
BACKGROUND: Beta-blockers and inhibitors of the renin-angiotensin aldosterone system improve survival and reduce morbidity in people with heart failure with reduced left ventricular ejection fraction. There is uncertainty whether these treatments are beneficial for people with heart failure with preserved ejection fraction and a comprehensive review of the evidence is required. OBJECTIVES: To assess the effects of beta-blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, angiotensin receptor neprilysin inhibitors, and mineralocorticoid receptor antagonists in people with heart failure with preserved ejection fraction...
June 28, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29943849/prescription-patterns-of-angiotensin-converting-enzyme-inhibitors-for-various-indications-a-uk-population-based-study
#6
Seyed Hamidreza Mahmoudpour, Folkert W Asselbergs, Patrick C Souverein, Anthonius de Boer, Anke H Maitland-van der Zee
AIM: Angiotensin-converting enzyme inhibitors (ACEIs) are widely prescribed for several cardiovascular indications. This study investigated patterns of ACEI use for various indications. METHODS: A descriptive, retrospective population-based study was conducted using data from the UK Clinical Practice Research Datalink. Patients starting ACEIs (2007-2014) were selected and ACEI indications were retrieved from electronically recorded medical records. Stratified by indication, we distinguished between persistent and nonpersistent ACEI use, considering a 6-month interval between two prescription periods as a maximum for persistent use...
June 26, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29943232/prognostic-benefit-of-acute-heart-failure-associated-with-atherosclerosis-the-importance-of-prehospital-medication-in-patients-with-severely-decompensated-acute-heart-failure
#7
Hirotake Okazaki, Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Masato Matsushita, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kazutaka Kiuchi, Kuniya Asai, Wataru Shimizu
Atherosclerotic diseases sometimes contribute to acute heart failure (AHF). The aim of the present study is to elucidate the prognostic impact of AHF with atherosclerosis. A total of 1226 AHF patients admitted to the intensive care unit were analyzed. AHF associated with atherosclerosis was defined by the etiology: atherosclerosis-AHF group (n = 708) (patients whose etiologies were ischemic heart disease or hypertensive heart disease) or AHF not associated with atherosclerosis (non-atherosclerosis-AHF) group (n = 518)...
June 26, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29908131/low-body-mass-index-is-a-risk-factor-for-hyperkalaemia-associated-with-angiotensin-converting-enzyme-inhibitors-and-angiotensin-ii-receptor-blockers-treatments
#8
T Hirai, R Yamaga, A Fujita, T Itoh
WHAT IS KNOWN AND OBJECTIVE: Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) represent the cornerstones of hypertension and congestive heart failure treatment. Risk factors for hyperkalaemia associated with ACEI and ARB are chronic kidney disease and concomitant medications which increase serum potassium level. Body mass index (BMI) also affects pharmacokinetics of ACEI and ARB and potassium disposition. We evaluated the relationship between BMI and hyperkalaemia associated with ACEI and ARB treatments...
June 16, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29889841/fixed-dose-combination-antihypertensive-medications-adherence-and-clinical-outcomes-a-population-based-retrospective-cohort-study
#9
Amol A Verma, Wayne Khuu, Mina Tadrous, Tara Gomes, Muhammad M Mamdani
BACKGROUND: The majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases...
June 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29850980/focused-treatment-of-heart-failure-with-reduced-ejection-fraction-using-sacubitril-valsartan
#10
REVIEW
Rex C Liu
The clinical syndrome of heart failure (HF) can be described as the reduced capacity of the heart to deliver blood throughout the body. To compensate for inadequate tissue perfusion, the renin-angiotensin aldosterone system (RAAS) and the sympathetic nervous system (SNS) become activated, resulting in increased blood pressure, heart rate, and blood volume. Consequent activation of the natriuretic peptide system (NPS) typically balances these effects; however, the NPS is unable to sustain compensation for excessive neurohormonal activation over time...
May 31, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29806165/incremental-benefit-of-drug-therapies-for-chronic-heart-failure-with-reduced-ejection-fraction-a-network-meta-analysis
#11
Michel Komajda, Michael Böhm, Jeffrey S Borer, Ian Ford, Luigi Tavazzi, Matthieu Pannaux, Karl Swedberg
AIMS: A network meta-analysis (NMA) of all recommended drug groups for the treatment of heart failure with reduced ejection fraction (HFrEF), including their combinations, was performed to assess the relative efficacy and incremental benefit. METHODS AND RESULTS: A search was made in biomedical databases for randomized controlled trials published between 1987 and 2017 on angiotensin-converting enzyme inhibitors (ACEIs), beta-blockers (BBs), angiotensin receptor blockers (ARBs), mineralocorticoid receptor antagonists (MRAs), ivabradine (IVA), or angiotensin receptor-neprilysin inhibitors (ARNI)...
May 27, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29792395/how-are-patients-with-heart-failure-treated-in-primary-care
#12
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...
August 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29789916/two-dimensional-speckle-tracking-echocardiography-derived-strain-measurements-in-survivors-of-childhood-cancer-on-angiotensin-converting-enzyme-inhibition-or-receptor-blockade
#13
Jamie K Harrington, Marc E Richmond, Arielle W Fein, Serge Kobsa, Prakash Satwani, Amee Shah
Speckle tracking echocardiography (STE)-derived strain indices are believed to detect early cardiac dysfunction in survivors of childhood cancer and have potential to identify patients who may benefit from early heart failure treatment. However, effects of heart failure treatment on STE-derived strain measurements in this population are unknown. The aim of this study was to assess STE-derived strain measurements in survivors of childhood cancer treated with angiotensin converting enzyme inhibition or receptor blockade (ACEi/ARB)...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29786183/-hyperkalemia-as-a-limiting-factor-in-the-use-of-drugs-that-block-the-renin-angiotensin-aldosterone-system-raas
#14
Antonio Santoro, Marcora Mandreoli
Angiotensin-converting enzyme (ACE-I) inhibitors and ARBs have shown real efficacy in reducing blood pressure, proteinuria, in slowing the progression of chronic kidney disease (MRC) and in clinical improvement. in patients with heart failure, diabetes mellitus and ischemic heart disease. However, their use is limited by some side effects such as the increase in serum potassium (K), which can be particularly severe in patients with renal insufficiency. In the 23,000 patients followed by the PIRP project of the Emilia-Romagna Region, hyperkalaemia at the first visit (K> 5...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29767459/long-term-effects-of-patiromer-for-hyperkalaemia-treatment-in-patients-with-mild-heart-failure-and-diabetic-nephropathy-on-angiotensin-converting-enzymes-angiotensin-receptor-blockers-results-from-amethyst-dn
#15
Bertram Pitt, George L Bakris, Matthew R Weir, Mason W Freeman, Mitja Lainscak, Martha R Mayo, Dahlia Garza, Rezi Zawadzki, Lance Berman, David A Bushinsky
AIMS: Chronic kidney disease (CKD) in heart failure (HF) increases the risk of hyperkalaemia (HK), limiting angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use. Patiromer is a sodium-free, non-absorbed potassium binder approved for HK treatment. We retrospectively evaluated patiromer's long-term safety and efficacy in HF patients from AMETHYST-DN. METHODS AND RESULTS: Patients with Type 2 diabetes, CKD, and HK [baseline serum potassium >5...
May 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29766216/impact-of-angiotensin-converting-enzyme-inhibitors-or-receptor-blockers-on-post-icu-discharge-outcome-in-patients-with-acute-kidney-injury
#16
Etienne Gayat, Alexa Hollinger, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Benjamin G Chousterman, Qin Lu, Pierre François Laterre, Xavier Monnet, Michael Darmon, Marc Leone, Bertrand Guidet, Romain Sonneville, Jean-Yves Lefrant, Marie-Céline Fournier, Matthieu Resche-Rigon, Alexandre Mebazaa, Matthieu Legrand
PURPOSE: Acute kidney injury (AKI) is associated with the activation of the renin-angiotensin system. Whether angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB) improve outcome in patients recovering from AKI remains unexplored. The purpose was to investigate the association between prescription of ACEi/ARB at intensive care unit (ICU) discharge and 1-year outcome in patients recovering from AKI. METHODS: Association between ACEi/ARB and 1-year mortality rate was explored in 1551 patients discharged from 21 European ICUs in an observational cohort...
May 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29726982/a-real-world-cohort-study-on-the-quality-of-potassium-and-creatinine-monitoring-during-initiation-of-mineralocorticoid-receptor-antagonists-in-patients-with-heart-failure
#17
Erik Nilsson, Pietro De Deco, Marco Trevisan, Rino Bellocco, Bengt Lindholm, Lars H Lund, Josef Coresh, Juan J Carrero
AIMS: Clinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our healthcare. METHODS AND RESULTS: Observational study in 2007-2010 HF patients starting MRA therapy in Stockholm, Sweden. Outcomes included potassium and creatinine laboratory testing before MRA initiation and in the early (days 1-10) and extended (days 11-90) post-initiation periods...
May 2, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29724164/signs-symptoms-and-treatment-patterns-across-serial-ambulatory-cardiology-visits-in-patients-with-heart-failure-insights-from-the-ncdr-pinnacle%C3%A2-registry
#18
Larry A Allen, Fengming Tang, Philip Jones, Tracie Breeding, Angelo Ponirakis, Stuart J Turner
BACKGROUND: Due to a relative lack of outpatient heart failure (HF) clinical registries, we aimed to describe symptoms, signs, and medication treatment among ambulatory patients with heart failure (HF) over time. METHODS: Using health records from 234 PINNACLE (Practice Innovation and Clinical Excellence) U.S. cardiology practices (2008-2014), serial visits for patients with HF were characterized. Symptoms, signs, and HF medications (angiotensin-converting enzyme inhibitors [ACEI], angiotensin receptor blockers [ARB], beta blockers [BB], and diuretics) were compared between visits...
May 3, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29704920/hypertension-in-patients-with-type-2-diabetes-mellitus-targets-and-management
#19
REVIEW
Dimitra I Pavlou, Stavroula A Paschou, Panagiotis Anagnostis, Michael Spartalis, Eleftherios Spartalis, Andromachi Vryonidou, Nicholas Tentolouris, Gerasimos Siasos
Two-thirds of patients with type 2 diabetes mellitus (T2DM) have arterial hypertension. Hypertension increases the incidence of both micro- and macrovascular complications in these patients, while the co-existence of these two major risk factors leads to a four-fold increased risk for cardiovascular disease (CVD) compared with normotensive non-diabetic controls. The aim of this article is to comprehensively review the literature and present updated information on targets for blood pressure (BP) and on the management of hypertension in patients with T2DM...
June 2018: Maturitas
https://www.readbyqxmd.com/read/29687191/sacubitril-valsartan-from-clinical-trials-to-real-world-experience
#20
REVIEW
Joanna M Joly, Akshay S Desai
PURPOSE OF REVIEW: Compared to enalapril, use of angiotensin-receptor blocker and neprilysin inhibitor sacubitril/valsartan to treat patients with heart failure and reduced ejection fraction (HFrEF) is associated with substantial reductions in both cardiovascular mortality and heart failure progression. The purpose of this review is to discuss the real-world experience of sacubitril/valsartan. RECENT FINDINGS: In the years following the publication of the landmark PARADIGM-HF trial in 2014 and its subsequent FDA approval, a growing evidence base supports the safety and efficacy of sacubitril/valsartan in a broad spectrum of patients with HFrEF...
April 23, 2018: Current Treatment Options in Cardiovascular Medicine
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