Perceived risk profile and treatment optimization in heart failure: an analysis from BIOlogy Study to TAilored Treatment in chronic heart failure
dc.contributor.author | Kobayashi, Masatake | |
dc.contributor.author | Voors, Adriaan A. | |
dc.contributor.author | Ouwerkerk, Wouter | |
dc.contributor.author | Duarte, Kevin | |
dc.contributor.author | Girerd, Nicolas | |
dc.contributor.author | Rossignol, Patrick | |
dc.contributor.author | Metra, Marco | |
dc.contributor.author | Lang, Chim C. | |
dc.contributor.author | Ng, Leong L. | |
dc.contributor.author | Filippatos, Gerasimos | |
dc.contributor.author | Dickstein, Kenneth | |
dc.contributor.author | van Veldhuisen, Dirk J. | |
dc.contributor.author | Zannad, Faiez | |
dc.contributor.author | Ferreira, João Pedro | |
dc.date.accessioned | 2022-04-21T09:23:27Z | |
dc.date.available | 2022-04-21T09:23:27Z | |
dc.date.created | 2022-01-24T09:19:32Z | |
dc.date.issued | 2021 | |
dc.identifier.issn | 0160-9289 | |
dc.identifier.uri | https://hdl.handle.net/11250/2991887 | |
dc.description.abstract | Background Achieving target doses of angiotensin-converting-enzyme inhibitor/angiotensin-receptor blockers (ACEi/ARB) and beta-blockers in heart failure with reduced ejection fraction (HFrEF) is often underperformed. In BIOlogy Study to TAilored Treatment in chronic heart failure (BIOSTAT-CHF) study, many patients were not up-titrated for which no clear reason was reported. Therefore, we hypothesized that perceived-risk profile might influence treatment optimization. Methods We studied 2100 patients with HFrEF (LVEF≤40%) to compare the clinical characteristics and adverse events associated with treatment up-titration (after a 3-month titration protocol) between; a) patients not reaching target doses for unclear reason; b) patients not reaching target doses due to symptoms and/or side effects; c) patients reaching target doses. Results For ACEi/ARB, (a), (b) and (c) was observed in 51.3%, 25.9% and 22.7% of patients, respectively. For beta-blockers, (a), (b) and (c) was observed in 67.5%, 20.2% and 12.3% of patients, respectively. By multinomial logistic regression analysis for ACEi/ARB, patients in group (a) and (b) had lower blood pressure and poorer renal function, and patients in group (a) were older and had lower ejection fraction. For beta-blockers, patients in group (a) and (b) had more severe congestion and lower heart rate. At 9 months, adverse events (i.e., hypotension, bradycardia, renal impairment, and hyperkalemia) occurred similarly among the three groups. Conclusions Patients in whom clinicians did not give a reason why up-titration was missed were older and had more co-morbidities. Patients in whom up-titration was achieved did not have excess adverse events. However, from these observational findings, the pattern of subsequent adverse events among patients in whom up-titration was missed cannot be determined. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Wiley | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Perceived risk profile and treatment optimization in heart failure: an analysis from BIOlogy Study to TAilored Treatment in chronic heart failure | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2021 The Author(s) | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1002/clc.23576 | |
dc.identifier.cristin | 1988236 | |
dc.source.journal | Clinical Cardiology | en_US |
dc.source.pagenumber | 780-788 | en_US |
dc.identifier.citation | Clinical Cardiology. 2021, 44 (6), 780-788. | en_US |
dc.source.volume | 44 | en_US |
dc.source.issue | 6 | en_US |
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