Underutilization and clinical benefits of angiotensin-converting enzyme inhibitors in patients with asymptomatic left ventricular dysfunction

Kermani, M Sardari; Dua, Aashish; Gradman, Alan H.

doi:10.1016/s0002-9149(00)01045-6

Cited by 19 publications

(13 citation statements)

References 17 publications

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“…Doppler measurements provide important information to direct management of volume status, diagnose and characterize HF with preserved systolic function, and identify patients at high risk for cardiovascular morbidity and mortality. Not surprisingly, the underuse of echocardiography in populations at significant risk for HF is associated with adverse cardiovascular outcomes (139,140). Assessment of LVEF in clinical HF is one of the primary measures in a number of cardiovascular quality improvement initiatives, including the AHA's "Get with the Guidelines" and the ACC's "Guidelines Applied in Practice" (141,142).…”

Section: Discussionmentioning

confidence: 99%

Echocardiography in Heart Failure

Kirkpatrick

Vannan

Narula

et al. 2007

Journal of the American College of Cardiology

187

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Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure (HF) population. The recently-released American College of Cardiology/American Heart Association guidelines for the diagnosis and management of HF labeled echocardiography "the single most useful diagnostic test in the evaluation of patients with HF...," because of its ability to accurately and noninvasively provide measures of ventricular function and assess causes of structural heart disease. It can also detect and define the hemodynamic and morphologic changes in HF over time and might be equivalent to invasive measures in guiding therapy. In this article we will discuss: 1) the clinical uses of echocardiography in HF and their prognostic value; 2) the use of echocardiography to guide treatment in HF patients; and 3) promising future techniques for echocardiographic-based imaging in HF. In addition, we will highlight some of the limitations of echocardiography.

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Section: Discussionmentioning

confidence: 99%

Echocardiography in Heart Failure

Kirkpatrick

Vannan

Narula

et al. 2007

Journal of the American College of Cardiology

187

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“…It is possible to observe that, in patients using beta-blockers, the association of digoxin increased the proportion of adequate rate control from 59% to 70%, and this increment may have led to the observed superiority with beta-blocker therapy. Randomized studies have already demonstrated that the association of digoxin with beta-blockers is more effective than betablockers alone in this setting (2,3).…”

Section: Beta-blockers Versus Digoxin To Control Ventricular Rate Durmentioning

confidence: 99%

Angiotensin-Converting Enzyme Inhibitors and Outcome Among Patients With Heart Failure and Renal Insufficiency: Need for a Prospective Study

Smilde¹,

Hillege

Veldhuisen³

et al. 2005

Journal of the American College of Cardiology

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“…While multiple studies have reported low utilisation and little change in the use of ACE inhibitors for the treatment of heart failure, little is known regarding the way other drug groups such as the -blockers and digoxin are prescribed. 8,[14][15][16] The aim of this study is to explore changes in prescribing for CHF over a 5-year period (1996)(1997)(1998)(1999)(2000) focusing primarily on the incorporation of new scientific evidence from clinical trials into daily practice.…”

Section: Introductionmentioning

confidence: 99%

Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

Pont

Sturkenboom²,

Gilst

et al. 2003

Pharmacoepidemiology and Drug

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SUMMARYPurpose The aim of this study is to explore trends in primary care prescribing for chronic heart failure (CHF) over a 5-year period (1996)(1997)(1998)(1999)(2000). Methods This study consisted of repeated cross-sectional surveys in a dynamic cohort from the Integrated Primary Care Information (IPCI) primary care database. The cohort comprised all patients aged ! 55 years with a CHF diagnosis and prescribed a cardiovascular medication during the study period. The point prevalence per calendar year was determined for each of the main drug groups used to treat CHF. Results The study population consisted of 3121 CHF patients. Small increases were seen in the percentage of CHF patients prescribed spironolactone (4.6%, 95% CI: 2.3-6.9%), -blockers (6.1%, 95% CI: 2.6-9.5%) and angiotensin II antagonists (6.8%, 95% CI: 5.1-8.6%) during the study period, while the prescribing of digoxin decreased (À4.4%, 95% CI: À8.2 to À0.7). Prescribing of diuretics (difference: À0.7% 95% CI: À2.7-4.2) and ACE inhibitors (difference: 4.0% 95% CI: À0.1-8.2%) remained unchanged. Conclusions Prescription of some drug groups for CHF increased. However, given the new scientific evidence that has emerged in past 15 years regarding CHF pharmacotherapy, the changes observed were less than expected.

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Underutilization and clinical benefits of angiotensin-converting enzyme inhibitors in patients with asymptomatic left ventricular dysfunction

Cited by 19 publications

References 17 publications

Echocardiography in Heart Failure

Echocardiography in Heart Failure

Angiotensin-Converting Enzyme Inhibitors and Outcome Among Patients With Heart Failure and Renal Insufficiency: Need for a Prospective Study

Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

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