Management of noncardiovascular comorbidities in patients with heart failure with reduced ejection fraction

Gale, Stormi E; Mardis, A.; Plazak, Michael E; Kukin, Alina; Reed, Brent N.

doi:10.1002/phar.2528

Cited by 6 publications

(4 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with CRD have a high risk of hospitalization and death [ 2 , 3 ]. Previous data from cardiorenal patients report hospitalization rates similar to ours [25].…”

Section: Discussionmentioning

confidence: 99%

“…Chronic kidney disease (CKD) is one of the most prevalent comorbidities in patients with heart failure (HF): up to 50% of chronic heart failure (CHF) patients develop CKD to some degree [ 1 ]. In addition, concomitant heart and kidney disease encompass a bidirectional relationship associated with a high burden of comorbidities that worsens prognosis [ 2 , 3 ] and may complicate the implementation of therapies, with a significant impact on prognosis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multidisciplinary approach to patients with heart failure and kidney disease: preliminary experience of an integrated cardiorenal unit

Marques,

Cobo,

López-Sánchez

et al. 2023

Clinical Kidney Journal

View full text Add to dashboard Cite

Background Cardiorenal programs have emerged to improve the management of cardiorenal disease (CRD). Evidence about the benefits of these programs is still scarce. This work aims to evaluate the performance of a novel cardiorenal program and describe the clinical profile and outcomes of patients with CRD. Methods Retrospective observational study of patients with CRD attended in a Cardiorenal Unit (CRU) from February 2021 to February 2022. Demographics and laboratory tests were collected, and events (all-cause death and cardiovascular hospitalizations) were evaluated. Optimization of comorbidities and protective therapies was also assessed. Results Eighty-two patients were included, with a mean age of 76.8 (SD 8.5) and 72% men. 58.5% (n = 47) had left ventricular ejection fraction less than 50%. The mean follow-up was 11 months (standard deviation (SD) 4.0). Almost fifty-four % of the patients (n = 44) required hospitalization, 30.5% for heart failure (HF) decompensation. Total hospitalizations significantly decreased after CRU inclusion: 0.70 admissions/year vs. 0.45 admissions/year (P < 0.02). Global mortality was 17.1% (n = 14). The percentage of patients with HF with reduced ejection fraction (HFrEF) on quadruple therapy increased by 20%, and up to 60% of the patients were on three drugs. 39% of the patients with HF and preserved ejection fraction started treatment with sodium-glucose cotransporter inhibitors. Hyperkaliemia required the use of potassium binders in 12.2% of the patients, treatment of secondary hyperparathyroidism was started in 42.7%, and renal anemia in 23.2%. Renal replacement therapy was initiated in 10% of the patients (n = 8). Conclusion CRD confers a considerable risk of adverse outcomes. Cardiorenal programs may improve cardiorenal syndrome (CRS) management by optimizing therapies, treating comorbidities, and reducing hospitalizations.

show abstract

“…Patients with CRD have a high risk of hospitalization and death [ 2 , 3 ]. Previous data from cardiorenal patients report hospitalization rates similar to ours [25].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multidisciplinary approach to patients with heart failure and kidney disease: preliminary experience of an integrated cardiorenal unit

Marques,

Cobo,

López-Sánchez

et al. 2023

Clinical Kidney Journal

View full text Add to dashboard Cite

show abstract

“…While deprescribing may reduce inappropriate drug use but its impact on clinical outcomes remains unclear 38 . Finally, the management of cardiovascular and non-cardiovascular comorbidities in HF should also be based on appropriate treatment selection and recent advances 39 , 40 .…”

Section: Discussionmentioning

confidence: 99%

Polypharmacy and risk of mortality among patients with heart failure following hospitalization: a nested case–control study

Perreault

Schnitzer

Eliane

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Heart failure (HF) is associated with morbidity, rehospitalization and polypharmacy. The incidence rate of mortality in HF patients with polypharmacy is poorly studied. We examine the association of polypharmacy with mortality risk in incident hospitalized HF patients with a primary diagnosis after discharge from the hospital using Quebec administrative databases, Canada from 1999 to 2015. Polypharmacy, cardiovascular (CV) polypharmacy and non-CV polypharmacy were respectively defined as exposure to ≥ 10 drugs, ≥ 5 CV drugs and ≥ 5 non-CV drugs within three months prior to the case or the control selection date. We conducted a nested case–control study to estimate rate ratios (RR) of all-cause mortality using a multivariate conditional logistic regression during one-year of follow-up. We identified 12,242 HF patients with a mean age of 81.6 years. Neither CV polypharmacy (RR 0.97, 95%CI 0.82–1.15) nor non-CV polypharmacy (RR 0.93, 95%CI 0.77–1.12) were associated with lower mortality risk. However, all polypharmacy (RR 1.31, 95%CI 1.07–1.61) showed an association with mortality risk. Myocardial infarction, valvular disease, peripheral artery disease, diabetes, major bleeding, chronic kidney disease, high comorbidity score, high Frailty score, hydralazine and spironolactone users were associated with increasing mortality risk, ranging from 15 to 61%, while use of angiotensin II inhibitors, beta-blockers, statins, anticoagulant, and antiplatelets were associated with lower risk, ranging from 23 to 32%.

show abstract

“…Another critical issue in HF is represented by comorbidities that show a crucial role on diagnosis, treatment, and prognosis. Among non-cardiovascular (CV) comorbidities malnutrition and frailty, often under-diagnosed and undertreated, have particular relevance affecting clinical prognosis especially in elderly [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of serum albumin levels in patients with chronic heart failure

Armentaro,

Condoleo,

Pastura

et al. 2024

Intern Emerg Med

View full text Add to dashboard Cite

Background Hypoalbuminemia is common in heart failure (HF) patients; however, there are no data regarding the possible long-term prognostic role of serum albumin (SA) in the younger population with chronic HF without malnutrition. The aim of this study was to examine the long-term prognostic role of SA levels in predicting major adverse cardiac events (MACE) in middle-aged outpatients with chronic HF. Methods In the present retrospective analysis, 378 subjects with HF were enrolled. MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, cardiac revascularization or coronary bypass surgery, and cardiovascular death), total mortality, and HF hospitalizations (hHF) occurrence were evaluated during a median follow-up of 6.1 years. Results In all population, 152 patients had a SA value < 3.5 g/dL and 226 had a SA value ≥ 3.5 g/dL. In patients with SA ≥ 3.5 g/dL, the observed MACE were 2.1 events/100 patient-year; while in the group with a worse SA levels, there were 7.0 events/100 patient-year (p < 0.001). The multivariate analysis model confirmed that low levels of SA increase the risk of MACE by a factor of 3.1. In addition, the presence of ischemic heart disease, serum uric acid levels > 6.0 mg/dL, chronic kidney disease, and a 10-year age rise, increased the risk of MACE in study participants. Finally, patients with SA < 3.5 g/dl had a higher incidence of hHF (p < 0.001) and total mortality (p < 0.001) than patients with SA ≥ 3.5 g/dl. Conclusions Patients with chronic HF that exhibits low SA levels show a higher risk of MACE, hHF and total mortality.

show abstract

Management of noncardiovascular comorbidities in patients with heart failure with reduced ejection fraction

Cited by 6 publications

References 63 publications

Multidisciplinary approach to patients with heart failure and kidney disease: preliminary experience of an integrated cardiorenal unit

Multidisciplinary approach to patients with heart failure and kidney disease: preliminary experience of an integrated cardiorenal unit

Polypharmacy and risk of mortality among patients with heart failure following hospitalization: a nested case–control study

Prognostic role of serum albumin levels in patients with chronic heart failure

Contact Info

Product

Resources

About