AI Article Synopsis
- The study investigates how having multiple medications (polypharmacy) affects the use of guideline-directed medical therapy (GDMT) in patients with heart failure (HF).
- Researchers analyzed data from 545 hospitalized participants with reduced ejection fraction HF from a specific study covering 2003 to 2017 and looked at their medication counts and GDMT usage.
- Results showed that a significant portion of patients were not receiving recommended medications, and higher medication counts were linked to lower rates of initiation for these needed therapies.
Article Abstract
Background: Underprescribing of guideline-directed medical therapy (GDMT) for heart failure (HF) persists.
Objectives: The purpose of this study was to assess polypharmacy as a barrier to GDMT.
Methods: We examined participants hospitalized for HF with reduced ejection fraction and HF with mildly reduced ejection fraction between 2003 and 2017 from the Reasons for Geographic and Racial Differences in Stroke study. Participants were stratified by admission medication count-0 to 4, 5 to 9, and ≥10 medications. We examined GDMT use at admission, GDMT contraindications, and initiation of eligible indicated GDMT by medication count. We conducted a multivariable Poisson regression with robust standard errors to examine the association between medication count and GDMT initiation. GDMT included agents for HF with reduced ejection fraction/HF with mildly reduced ejection fraction, antiplatelet agents and statins for coronary artery disease, and anticoagulants for atrial fibrillation.
Results: Among 545 participants with HF, 34% were not taking a beta-blocker, 39% were not taking an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor, or hydralazine-isosorbide dinitrate, and 90% were not taking a mineralocorticoid receptor antagonist at admission; among participants with coronary artery disease, 36% were not taking an antiplatelet agent, and 38% were not taking a statin; and among participants with atrial fibrillation, 49% were not taking an anticoagulant. Polypharmacy was inversely associated with initiation of at least one indicated medication (5-9 medications: relative risk [RR]: 0.67; 95% CI: 0.56-0.82; < 0.001; ≥10 medications: RR: 0.50; 95% CI: 0.39-0.64; < 0.001) and initiation of at least half of indicated medications (5-9 medications: RR: 0.64; 95% CI: 0.51-0.81; < 0.001; ≥10 medications: RR: 0.50; 95% CI: 0.38-0.67; < 0.001).
Conclusions: Polypharmacy is an important barrier to GDMT.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11357976 | PMC |
| http://dx.doi.org/10.1016/j.jacadv.2024.101126 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Finerenone in Heart Failure-A Novel Therapeutic Approach.
Int J Mol Sci
December 2024
Department of Microgravity and Translational Regenerative Medicine, Otto von Guericke University, 39106 Magdeburg, Germany.
This review will discuss heart failure, introduce a new drug finerenone, and discuss clinical studies with a focus on its effects on heart failure. Heart failure is a condition or syndrome characterized by an impairment of the pumping ability of the heart, thus no longer keeping up with the demands of the body. There are several types of heart failure; among them are heart failure with reduced ejection fraction, with mildly reduced ejection fraction and with preserved ejection fraction.
View Article and Find Full Text PDFImpact of Exercise on Physiological, Biochemical, and Analytical Parameters in Patients with Heart Failure with Reduced Ejection Fraction.
Medicina (Kaunas)
December 2024
Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, 08208 Sabadell, Spain.
Heart failure with reduced ejection fraction (HFrEF) is a condition marked by diminished cardiac output and impaired oxygen delivery to tissues. Exercise, once avoided in HFrEF patients due to safety concerns, is now recognized as an important therapeutic intervention. Structured exercise improves various physiological, biochemical, and analytical parameters, including cardiac output, endothelial function, skeletal muscle performance, and autonomic regulation.
View Article and Find Full Text PDFIdentifying Risk Factors for Lower Extremity Artery Disease (LEAD) in Cardiology Patients: The Role of Ankle-Brachial Index Measurement.
J Clin Med
December 2024
Department of Cardiology and Internal Medicine with Cardiac Intensive Care Unit, Medical University of Białystok, ul. M. Skłodowskiej-Curie 24A, 15-276 Białystok, Poland.
Lower Extremity Artery Disease (LEAD) is a predictor of atherosclerotic plaques in other locations and significantly increases the risk of death from cardiovascular events. This study aimed to identify cardiology patient subpopulations that should undergo Ankle-Brachial Index (ABI) measurement. A total of 800 patients hospitalized in the Department of Cardiology were included.
View Article and Find Full Text PDFHis108Arg Transthyretin Amyloidosis-Shedding Light on a Distinctively Malignant Variant.
J Clin Med
December 2024
Department of Internal Medicine, Division of Cardiology, Medical University of Vienna, 1090 Wien, Austria.
Variant transthyretin amyloidosis cardiomyopathy (ATTRv-CM) is a rare form of cardiac amyloidosis associated with many possible mutations in the transthyretin gene, presenting as various distinct clinical phenotypes. Among these, the His108Arg mutation is the most prevalent TTR variant in Austria. However, data describing its clinical phenotype are lacking.
View Article and Find Full Text PDFNo Obesity Paradox for Health-Related Quality of Life in Patients with Heart Failure and Reduced Ejection Fraction: Insights from the VIDA Multicenter Study.
J Clin Med
December 2024
Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
Previous studies showed that, paradoxically, obese patients with heart failure (HF) have better clinical outcomes compared to overweight, normal, or underweight patients. Scientific societies emphasize the importance of integrating quality of life (QoL) assessment in cardiovascular care. However, the association between QoL and weight remains understudied.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!