Alteration of medical therapy in patients with heart failure relative to change in symptom severity

ESC Heart Fail. 2019 Oct;6(5):1085-1087. doi: 10.1002/ehf2.12480. Epub 2019 Jul 3.

Abstract

In this observational analysis from the Practice Innovation and Clinical Excellence Registry®, we examined changes in guideline-directed medical therapies relative to changes in symptom severity in ambulatory patients with heart failure with reduced ejection fraction, finding change in medication more often occurring when patients were changing their New York Heart Association symptom severity, rather than during periods of stable symptoms. Additionally, despite being available for a year during the time of our analysis, the use of sacubitril/valsartan was extremely low, and most often added in the context of worsening symptoms, not how this drug was studied and not how the guidelines articulate its use.

Keywords: Guidelines; Heart failure; Medications; Therapy.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aminobutyrates / therapeutic use*
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Biphenyl Compounds
  • Diuretics / therapeutic use
  • Drug Combinations
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Practice Guidelines as Topic
  • Registries
  • Severity of Illness Index
  • Stroke Volume / drug effects
  • Stroke Volume / physiology
  • Tetrazoles / therapeutic use*
  • Treatment Outcome
  • Valsartan
  • Ventricular Dysfunction, Left / physiopathology

Substances

  • Adrenergic beta-Antagonists
  • Aminobutyrates
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Biphenyl Compounds
  • Diuretics
  • Drug Combinations
  • Tetrazoles
  • Valsartan
  • sacubitril and valsartan sodium hydrate drug combination