Trends in Calcium Channel Blocker Use in Patients with Heart Failure with Reduced Ejection Fraction and Comorbid Atrial Fibrillation

Cholack, George; Garfein, Joshua; Krallman, Rachel; Montgomery, Daniel; Kline–Rogers, Eva; Rubenfire, Melvyn; Bumpus, Sherry M; Cascino, Thomas; Barnes, Geoffrey D.

doi:10.1016/j.amjmed.2021.06.013

Cited by 7 publications

(9 citation statements)

References 36 publications

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We thank Dr Reiffel for his letter regarding our recently published article in The American Journal of Medicine. 1 We agree with many of his comments when considering how to apply the study results to clinical practice.Due to how data was collected in the registry, we do not have specifics about individual patients' heart failure etiology. We agree that atrioventricular (AV) nodal blockade is an important strategy for managing tachycardic-induced cardiomyopathy.

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confidence: 53%

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Cholack

Barnes

2022

The American Journal of Medicine

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supporting

confidence: 53%

“…We thank Dr Reiffel for his letter regarding our recently published article in The American Journal of Medicine. 1 We agree with many of his comments when considering how to apply the study results to clinical practice.…”

supporting

confidence: 53%

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Cholack

Barnes

2022

The American Journal of Medicine

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“… 12 Even in patients with HFrEF, it was reported that 4.7–7.3% were discharged on contraindicated CCB. 13 , 14 Our study found that the proportion of patients with CCB gradually increased after LVAD and reached a plateau of ~20% after 18 months. Besides, there was also an increase in CCB treatment at different follow‐up time points from 2011 to 2017.…”

Section: Discussionmentioning

confidence: 61%

“…Besides, CCBs had exceeded angiotensin II receptor blockers (ARBs) as the most prescribed first‐line antihypertensive drugs in these patients, with 26.0–26.8% after 2013 12 . Even in patients with HFrEF, it was reported that 4.7–7.3% were discharged on contraindicated CCB 13,14 . Our study found that the proportion of patients with CCB gradually increased after LVAD and reached a plateau of ~20% after 18 months.…”

Section: Discussionmentioning

confidence: 67%

Calcium channel blockers and clinical outcomes in patients with continuous‐flow left ventricular assist devices

Tie,

Li,

Welp

et al. 2023

ESC Heart Failure

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AimsCurrent guidelines suggest calcium channel blockers (CCBs) as the second or third option for blood pressure management in patients with left ventricular assist device (LVAD). However, the clinical outcomes of patients with LVAD who receive CCBs remain unclear. Our study aims to analyse the association of CCBs with clinical outcomes in patients after LVAD implantation.Methods and resultsThis is a retrospective analysis based on the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) from 2006 to 2017, and adult patients who were alive with LVAD and CCB treatment information at 6 months after implantation were included. Among 10 717 patients, 1369 received CCBs 6 months after implantation, and there was an increasing trend of CCB use after LVAD. Patients receiving CCB therapy at 6 months had a similar 5 year survival rate to those not receiving CCB [49.6%, 95% confidence interval (CI): 47.5–51.7% vs. 51.1%, 95% CI: 45.3–56.7%]. In both Cox and competing risk regressions after adjusting for confounding factors, CCB treatment at 6 months after implantation was not associated with long‐term mortality [hazard ratio (HR): 1.03, 95% CI: 0.91–1.17, P = 0.624 and subdistribution HR (SHR): 1.07, 95% CI: 0.95–1.22, P = 0.260]. Consistently, in time‐varying models, CCB treatment was not linked to long‐term mortality (HR: 0.97, 95% CI: 0.87–1.09, P = 0.682 and SHR: 1.05, 95% CI: 0.94–1.18, P = 0.359). This null association remained in subgroup analysis according to device strategy and propensity‐matching analyses. Neurological dysfunction, stroke, bleeding, rehospitalization, and renal dysfunction were more likely to occur among those with CCB when compared with those without CCB treatment.ConclusionsIn patients with LVAD, CCB therapy fails to show benefits in long‐term survival and is associated with increased incidences of neurological dysfunction, bleeding, renal dysfunction, and rehospitalization.

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“…Percezione e gestione della salute -Comprendere la causa della loro HF, i sintomi e la scelta del trattamento. [11,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] -Comprendere la prognosi e le diverse possibili fasi della traiettoria HF.…”

Section: Modelli Funzionali Topic Educativo Per L'assistitounclassified

La prevenzione delle riammissioni nella persona con scompenso cardiaco grazie all’educazione secondo i Modelli Funzionali di Gordon. Revisione narrativa di letteratura

Feletto,

Mazzariol,

Moschetta

2024

Scenario

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Introduzione: lo scompenso cardiaco porta ad alti tassi di riammissione ospedaliera: quasi il 60% dei soggetti dimessi viene re-ospedalizzato entro un anno dal primo ricovero. L’educazione alla gestione della patologia alla dimissione diventa essenziale per prevenire questo fenomeno. Obiettivi: descrivere i topic educativi, secondo i Modelli Funzionali di Gordon, da includere nell’intervento educativo, al fine di prevenire la riammissione in ospedale dell’assistito con scompenso cardiaco. Materiali e Metodi: è stata condotta una revisione narrativa della letteratura consultando le banche dati MEDLINE e CINHAL. Risultati: sono stati inclusi 28 articoli nella revisione. Dall’analisi dei materiali rispetto ai Modelli Funzionali, la letteratura reperita ne indaga 9 su 11. I modelli che non vengono attenzionati dall’educazione alla dimissione risultano Sessualità e Riproduzione e Valori e Convinzioni. Inoltre, la letteratura ha sottolineato come un processo educativo personalizzato alla dimissione sia utile nel prevenire le riammissioni ospedaliere per riacutizzazione della patologia. Conclusioni: l’educazione terapeutica organizzata secondo i Modelli di Gordon, potrebbe migliorare l’efficacia dell’intervento nella prevenzione delle riammissioni per scompenso cardiaco. Il fatto di includere tutti gli aspetti della persona migliora la qualità di vita e permette un’efficace convivenza con la malattia.

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Trends in Calcium Channel Blocker Use in Patients with Heart Failure with Reduced Ejection Fraction and Comorbid Atrial Fibrillation

Cited by 7 publications

References 36 publications

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Calcium channel blockers and clinical outcomes in patients with continuous‐flow left ventricular assist devices

La prevenzione delle riammissioni nella persona con scompenso cardiaco grazie all’educazione secondo i Modelli Funzionali di Gordon. Revisione narrativa di letteratura

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