ArticleESC heart failure2019
Medical therapy doses at hospital discharge in patients with existing and de novo heart failure.
Article in ESC heart failure, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Pooled it
- Systematic Literature Review of the Impact of Type 2 Diabetes and Heart Failure Guideline Adherence on Clinical and Economic Outcomes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Review
- Guideline-directed medical therapy in heart failure patients with reduced ejection fraction in Palestine: Retrospective clinical audit study.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2024Article
- 'Acute Heart Failure': Should We Abandon the Term Altogether?Current heart failure reports · 2022Review
- Heart failure treatment in patients with cardiac implantable electronic devices: Opportunity for improvement.Heart rhythm O2 · 2021Article
- Clinical inertia in the treatment of heart failure: a major issue to tackle.Heart failure reviews · 2021Review
- Physician Financial Incentives to Reduce Unplanned Hospital Readmissions: an Interrupted Time Series Analysis.Journal of general internal medicine · 2021Observational
- Evaluation of guideline-based cardiovascular medications and their respective doses in heart failure patients in Oman.International journal of clinical pharmacy · 2021Article
- ANMCO POSITION PAPER: Use of sacubitril/valsartan in hospitalized patients with acute heart failure.European heart journal supplements : journal of the European Society of Cardiology · 2021Article
- Adherence and optimization of angiotensin converting enzyme inhibitor/angiotensin II receptors blockers and beta-blockers in patients hospitalized for acute heart failure.ESC heart failure · 2021Article
- Representativeness of the PIONEER-HF Clinical Trial Population in Patients Hospitalized With Heart Failure and Reduced Ejection Fraction.Circulation. Heart failure · 2020Article
- Usefulness of a Nurse-Led Program of Care for Management of Patients with Chronic Heart Failure.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Medical therapy doses at hospital discharge in patients with existing and de novo heart failure.ESC heart failure · 2019Article
- Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsUptitrating angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACE-I/ARBs), beta-blockers, and mineralocorticoid receptor antagonists (MRAs) to optimal doses in heart failure with reduced ejection fraction (HFrEF) is associated with improved outcomes and recommended in guidelines. Studies of ambulatory patients found that a minority are prescribed optimal doses. However, dose at hospital discharge has rarely been reported. This information may guide quality improvement initiatives during and following discharge. METHODS AND
resultsWe assessed 370 consecutive patients with HFrEF hospitalized at two centres in Vancouver, Canada. Of those without contraindications, 86.4%, 93.4%, and 44.7% were prescribed an ACE-I/ARB/sacubitril-valsartan, beta-blocker, or MRA, respectively. The proportion of eligible patients prescribed target dose was respectively 28.6%, 31.7%, and 4.1%. Forty-two of 248 eligible patients (16.9%) were prescribed ≥50% of target dose, and only three patients received target dosing of all three medication classes. In multivariate regression models, cardiologist involvement in care was independently associated with increased dose and prescription of ≥50% of target dose for all medications, whereas a history of HF was only predictive for beta-blockers.
conclusionsIn a single-region experience of hospitalized HFrEF patients, a high proportion of eligible patients were discharged on ACE-I/ARB or beta-blocker. Less than half were prescribed MRAs, and few were prescribed ≥50% or target dosing of all medications. Further exploration into barriers to medication uptitration, and improvement in processes of care, is needed.
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