Heart failure with mid-range ejection fraction in patients admitted to internal medicine departments: Findings from the RICA Registry

Espartero, María Esther Guisado; Salamanca‐Bautista, Prado; Aramburu‐Bodas, Óscar; Conde-Martel, Alicia; Arias‐Jiménez, José Luis; Llácer-Iborra, Pau; Dávila‐Ramos, Melitón Francisco; Cabanes-Hernández, Yolanda; Manzano, Luís; Montero-Pérez-Barquero, Manuel

doi:10.1016/j.ijcard.2017.07.101

Cited by 35 publications

(49 citation statements)

References 23 publications

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“…In the present study, patients with HFmrEF accounted for 19.1% of the total cohort in JCARE‐CARD, which was consistent with previous studies . We have previously reported characteristics of HFrEF and HFpEF .…”

Section: Discussionsupporting

confidence: 92%

“…The 2016 European Society of Cardiology HF guidelines defined HFmrEF in patients with EF of 40–49% . Recent observational studies extensively described characteristics of patients with HFmrEF in comparison with HFpEF and HFrEF; however, it remains unknown whether patients with HFmrEF represent a transitional phenotype between HFpEF and HFrEF or a distinct pathophysiological entity. Furthermore, effective treatment strategies for these patients have not been established.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, patients with HFmrEF accounted for 19.1% of the total cohort in JCARE-CARD, which was consistent with previous studies. 3,4,[11][12][13][14][15][16] We have previously reported characteristics of HFrEF and HFpEF. 17 In comparison with the present study and our previous study, the characteristics of patients with HFmrEF were, in part, similar to those of patients with HFrEF.…”

Section: Discussionmentioning

confidence: 99%

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Spironolactone use is associated with improved outcomes in heart failure with mid‐range ejection fraction

et al. 2020

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Aims Spironolactone has been shown to improve outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). We investigated whether the discharge use of spironolactone could be associated with better long‐term outcomes among patients with HF with mid‐range EF (HFmrEF). Methods and results We analysed HFmrEF (left ventricular EF 40–49%) patients enrolled in the Japanese Cardiac Registry of Heart Failure in Cardiology, which prospectively studied the clinical characteristics, treatments, and long‐term outcomes of patients hospitalized due to HF. Patients were divided into two groups according to the use of spironolactone at discharge. The primary outcome was a composite of all‐cause death or HF rehospitalization. A total of 457 patients had HFmrEF. The mean age was 69.3 years and 286 (62.6%) were male. Among them, spironolactone was prescribed at discharge in 158 patients (34.6%). Chronic kidney disease (7.6% vs. 16.8%, P = 0.007) was less prevalent and loop diuretics (89.2% vs. 70.2%, P < 0.001) were more often prescribed in patients with spironolactone. During a mean follow‐up of 2.2 years, patients with spironolactone had a lower incidence rate of the primary outcome than those without it (171.5 vs. 278.8 primary outcome per 1000 patient‐years, incidence rate ratio 0.61, 95% confidence interval 0.44–0.86; P = 0.004). After multivariable adjustment, spironolactone use at discharge was associated with a significant reduction in the composite of all‐cause death or HF rehospitalization (adjusted hazard ratio 0.63, 95% confidence interval 0.44–0.90, P = 0.010). Conclusions Among patients with HF hospitalized for HFmrEF, spironolactone use at discharge was associated with better long‐term outcomes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spironolactone use is associated with improved outcomes in heart failure with mid‐range ejection fraction

et al. 2020

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“…RICA registry included 2753 patients with HFrEF, HFmrEF and HFpEF. In this study, the median age of the patients with HFmrEF was 80 and patients with HFpEF were 81 years . Compared with patients with HFmrEF and HFpEF in RICA population, the use of ACE‐Is/ARBs, β‐blockers, aldosterone antagonists, digoxin and loop diuretics was lower in our octogenarian population.…”

Section: Discussionmentioning

confidence: 66%

“…Compared with patients with HFmrEF and HFpEF in RICA population, the use of ACE‐Is/ARBs, β‐blockers, aldosterone antagonists, digoxin and loop diuretics was lower in our octogenarian population. However, in this analysis of RICA study, patients were not evaluated separately according to age, and patients younger than 80 were not compared with octogenarians . The results of APOLLON study revealed that prescription rates of HF drugs were similar in octogenarians compared with younger patients both in patients with HFpEF and HFmrEF.…”

Section: Discussionmentioning

confidence: 94%

Clinical features of heart failure with mid‐range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

Özlek

Tekinalp

et al. 2019

Int J Clin Pract

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Summary Objectives To compare real‐world characteristics and management of individuals aged 80 and older with heart failure (HF) and mid‐range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) derived from a large cohort of survey and to compare them with those younger than 80 from the same survey. Methods This is an observational, multicentre and cross‐sectional study conducted in Turkey (NCT03026114). Consecutive 1065 (mean age of 67.1 ± 10.6 years) patients admitted to the cardiology outpatient units with HFmrEF and HFpEF were included. Results Participants aged 80 and older (n = 123, 11.5%) were more likely to be female (66.7% vs 52.5%, P = 0.003), had a higher prevalence of atrial fibrillation (49.6% vs 34%, P = 0.001), and anaemia (46.3% vs 33.4%, P = 0.005) than those who were younger than 80. N‐terminal pro B‐type natriuretic peptide levels were higher in those aged 80 and older than in those younger than 80 (1037 vs 550 pg/ml, P < 0.001). The prescription rates of HF medications (including in ACE‐Is/ARBs, β‐blockers, MRAs, digoxin, ivabradine and diuretics) were similar (P > 0.05) in both groups. Octogenarians did not significantly differ from younger patients in the prevalence of HFmrEF (24.4% vs 22.9%) and HFpEF (75.6% vs 77.1%). Coronary artery disease was associated with HFmrEF (P < 0.05), whereas atrial fibrillation was associated with HFpEF (P < 0.05) in octogenarians. Conclusions This study revealed that nearly 12% of the individuals with HFmrEF and HFpEF in this real‐world sample were aged 80 and older. Participants aged 80 and older are more likely to be female and have more comorbidities than those who were younger than 80. However, HF medication profiles were similar in both groups. This study also showed that associated factors with HFmrEF and HFpEF were differ in octogenarians.

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The prognosis of mid‐range ejection fraction heart failure: a systematic review and meta‐analysis

Altaie

Khalife

2018

ESC Heart Failure

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Heart failure with mid-range ejection fraction in patients admitted to internal medicine departments: Findings from the RICA Registry

Cited by 35 publications

References 23 publications

Spironolactone use is associated with improved outcomes in heart failure with mid‐range ejection fraction

Spironolactone use is associated with improved outcomes in heart failure with mid‐range ejection fraction

Clinical features of heart failure with mid‐range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

The prognosis of mid‐range ejection fraction heart failure: a systematic review and meta‐analysis

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