Does the target dose of neurohormonal blockade matter for outcome in Systolic heart failure in octogenarians?

Barywani, Salim Bary; Ergatoudes, Constantinos; Schaufelberger, Maria; Petzold, Max; Fu, Michael

doi:10.1016/j.ijcard.2015.03.428

Cited by 15 publications

(24 citation statements)

References 20 publications

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“…The increasing proportion of high GAI rates reported from 2005 to 2016 supports this. However, there is still room for optimising target dose prescribing as the combined levels of target dose achievement in this review were lower than those reported recently by Barywani et al…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that underprescribing of evidence‐based therapies is associated with worsening HF and higher rates of HF hospital admissions and mortality . Furthermore, where these disease‐modifying agents are prescribed but at lower than target dose, patients may not obtain the full beneficial effect of the agent . Thus, HF care could be vastly improved with optimal use of guideline‐directed therapy …”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, where these disease‐modifying agents are prescribed but at lower than target dose, patients may not obtain the full beneficial effect of the agent . Thus, HF care could be vastly improved with optimal use of guideline‐directed therapy …”

Section: Introductionmentioning

confidence: 99%

“…patients may not obtain the full beneficial effect of the agent. 5,10 Thus, HF care could be vastly improved with optimal use of guideline-directed therapy. 10,11 Guideline adherence refers to the adoption of clinical guidelines by clinicians, rather than to the patient's own adherence.…”

mentioning

confidence: 99%

“…5,10 Thus, HF care could be vastly improved with optimal use of guideline-directed therapy. 10,11 Guideline adherence refers to the adoption of clinical guidelines by clinicians, rather than to the patient's own adherence. There remains a wide variation in HF prescribing patterns and quality internationally, 5,12,13 and several barriers to guideline adherence have been described.…”

mentioning

confidence: 99%

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A tool for assessment of heart failure prescribing quality: A systematic review and meta‐analysis

Hadidi

Darweesh

Byrne

et al. 2018

Pharmacoepidemiology and Drug

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A tool for assessment of heart failure prescribing quality: A systematic review and meta‐analysis

Hadidi

Darweesh

Byrne

et al. 2018

Pharmacoepidemiology and Drug

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Heart failure treatment up‐titration and outcome and age: an analysis of BIOSTAT‐CHF

Mordi

Ouwerkerk

Anker

et al. 2020

European J of Heart Fail

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AimsSeveral studies have shown that older patients with heart failure with reduced ejection fraction (HFrEF) are under-treated. The aim of this study was to evaluate the association of uptitration of angiotensinconverting enzyme inhibitors (ACEI) angiotensin-receptor blockers (ARB) and beta-blockers on outcome across the age spectrum in HFrEF patients. Methods and ResultsWe analysed HFrEF patients on sub-optimal doses of ACEI/ARB and/or beta-blockers from the BIOSTAT-CHF study stratified by age. Patients underwent a 3-month uptitration period. We used inverse probability weighting to adjust for the likelihood of successful uptitration to determine the association of achieved dose with mortality and/or HF hospitalisation, testing for an interaction with age.Over the median follow-up of 21 months in 1,720 HFrEF patients (mean age 76.5% male, mean age 67 years) the primary outcome occurred in 558 patients. Increased percentage of target dose of ACEI/ARB and beta-blocker achieved at 3 months were both significantly associated with reduced incidence of the primary outcome, (ACEI-ARB: HR per 12.5% increase in dose 0.92; 95% CI 0.91-0.94, p<0.001; betablocker HR 0.98; 95% CI 0.95-1.00, p=0.046), with a significant interaction with age seen for betablockers but not ACEI/ARB (p=0.034 and 0.22 respectively).. ConclusionsAchieving higher doses of ACEI/ARB was associated with improved outcome regardless of age, however achieving higher doses of beta-blockers was only associated with improved outcome in younger, but not in older patients.

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Factors associated with non-use and sub-target dosing of medical therapy for heart failure with reduced ejection fraction

et al. 2021

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Does the target dose of neurohormonal blockade matter for outcome in Systolic heart failure in octogenarians?

Cited by 15 publications

References 20 publications

A tool for assessment of heart failure prescribing quality: A systematic review and meta‐analysis

A tool for assessment of heart failure prescribing quality: A systematic review and meta‐analysis

Heart failure treatment up‐titration and outcome and age: an analysis of BIOSTAT‐CHF

Factors associated with non-use and sub-target dosing of medical therapy for heart failure with reduced ejection fraction

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