Publications by authors named "Sophia Brousas"
Introduction: Angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), angiotensin receptor-neprilysin inhibitor (ARNI), and mineralocorticoid receptor antagonists (MRA) reduce mortality and hospitalizations in heart failure with reduced ejection fraction (HFrEF) but their use is limited in advanced chronic kidney disease (CKD).
Methods: We carried out a systematic review of studies on HFrEF and CKD patients. The mean overall percentage of reported ACEI, ARB, MRA, and ARNI use, and the proportion of trials that included patients with advanced CKD grades 4-5 (estimated glomerular filtration rate (eGFR) <15-30 ml/min/1.
Article Synopsis
- Heart failure (HF) with reduced ejection fraction (HFrEF) has inconsistent definitions across clinical trials, which affects treatment outcomes.
- From 2010 to 2020, a study screened over 3000 articles, finding diverse EF criteria; 41% of studies used an EF cutoff of <40%, while many lacked clear definitions.
- The trend shows a decrease in studies focusing on HFrEF with EF ranges of 30-39%, highlighting the need for standardized definitions to better target treatment options in heart failure patients.
Patients with advanced chronic kidney disease (CKD) have largely been excluded from randomized control trials (RCTs) in heart failure (HF). This creates a paucity of high quality evidence for guideline directed medical therapy (GDMT), particularly in patients with heart failure with reduced ejection fraction (HFrEF) and CKD. This is a systematic review looking at the patterns and rates of inclusion of CKD in RCTs among patients with HFrEF.
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