Please use this identifier to cite or link to this item:
doi:10.22028/D291-39806
Title: | Patient factors associated with titration of medical therapy in patients with heart failure with reduced ejection fraction: data from the QUALIFY international registry |
Author(s): | Cowie, Martin R Schöpe, Jakob Wagenpfeil, Stefan Tavazzi, Luigi Böhm, Michael Ponikowski, Piotr Anker, Stefan D Filippatos, Gerasimos S Komajda, Michel |
Language: | English |
Title: | ESC heart failure |
Volume: | 8 |
Issue: | 2 |
Pages: | 861–871 |
Publisher/Platform: | Wiley |
Year of Publication: | 2021 |
Free key words: | Heart failure Guidelines Adherence Medication Dosage |
DDC notations: | 610 Medicine and health |
Publikation type: | Journal Article |
Abstract: | Aims: Failure to prescribe key medicines at evidence-based doses is associated with increased mortality and hospitalization forpatients with Heart Failure with reduced Ejection Fraction (HFrEF). We assessed titration patterns of guideline-recommendedHFrEF medicines internationally and explored associations with patient characteristics in the global, prospective, observational,longitudinal registry. Methods and results: Data were collected from September 2013 through December 2014, with 7095 patients from 36 coun-tries [>18 years, previous HF hospitalization within 1–15 months, left ventricular ejection fraction (LVEF)≤40%] enrolled, withdosage data at baseline and up to 18 months from 4368 patients. In 4368 patients (mean age 63 ± 17 years, 75% male)≥100%target doses at baseline: 30.6% (ACEIs), 2.9% (ARBs), 13.9% (BBs), 53.8% (MRAs), 26.2% (ivabradine). Atfinal follow-up,≥100%target doses achieved in more patients for ACEI (34.8%), BB (18.0%), and ivabradine (30.5%) but unchanged for ARBs (3.2%)and MRAs (53.7%). Adjusting for baseline dosage, uptitration during follow-up was more likely with younger age, highersystolic blood pressure, and in absence of chronic kidney disease or diabetes for ACEIs/ARBs; younger age, higher body massindex, higher heart rate, lower LVEF, and absence of coronary artery disease for BBs. For ivabradine, uptitration was morelikely with higher resting heart rate. Conclusions: The international QUALIFY Registry suggests that few patients with HFrEF achieve target doses ofdisease-modifying medication, especially older patients and those with co-morbidity. Quality improvement initiatives are ur-gently required. |
DOI of the first publication: | 10.1002/ehf2.13237 |
URL of the first publication: | https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.13237 |
Link to this record: | urn:nbn:de:bsz:291--ds-398065 hdl:20.500.11880/35859 http://dx.doi.org/10.22028/D291-39806 |
ISSN: | 2055-5822 |
Date of registration: | 22-May-2023 |
Faculty: | M - Medizinische Fakultät |
Department: | M - Medizinische Biometrie, Epidemiologie und medizinische Informatik |
Professorship: | M - Prof. Dr. Stefan Wagenpfeil M - Keiner Professur zugeordnet |
Collections: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Files for this record:
File | Description | Size | Format | |
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ESC Heart Failure - 2021 - Cowie - Patient factors associated with titration of medical therapy in patients with heart.pdf | 2,56 MB | Adobe PDF | View/Open |
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