Evidence map›Paper›PMID 33471236›Full record

SynthesisHeart failure reviews2022

Factors associated with non-use and sub-target dosing of medical therapy for heart failure with reduced ejection fraction.

Stephen J Greene, Xi Tan, Yu-Chen Yeh, Mark Bernauer, Omer Zaidi, Mei Yang, Javed Butler

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Heart failure reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 37 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
  4. Target doses of guideline-directed medical therapeutic agents predicts response to cardiac resynchronization therapy.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  5. Article
  6. Review
  7. Review
  8. Article
  9. Article
  10. Review
  11. Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Review
  17. BMJ open · 2023
    Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Stephen J GreeneDuke Clinical Research Institute, Durham, NC, USA.
Xi TanMerck & Co., Inc, Kenilworth, NJ, USA.
Yu-Chen YehPharmerit - an OPEN Health Company, Newton, MA, USA.
Mark BernauerPharmerit - an OPEN Health Company, Newton, MA, USA.
Omer ZaidiPharmerit - an OPEN Health Company, Newton, MA, USA.
Mei YangMerck & Co., Inc, Kenilworth, NJ, USA.
Javed ButlerDepartment of Medicine, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA. jbutler4@umc.edu.
Pharmerit (United States) · USMerck & Co., Inc., Rahway, NJ, USA (United States) · USDuke University · USState Street (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In clinical practice, many patients with heart failure with reduced ejection fraction (HFrEF) are either not prescribed guideline-directed medical therapies for which they are eligible or are prescribed therapies at sub-target doses. The objective of this study was to examine the factors associated with not receiving guideline-directed medical therapies or receiving sub-target doses. We conducted a systematic review of articles published between January 2014 and May 2019 that described dosing patterns and factors associated with non-use and sub-target dosing of HFrEF therapies in clinical practice. Thirty-seven studies were included. The percentages of patients reaching target doses for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, sacubitril/valsartan, beta-blockers, and mineralocorticoid receptor antagonists ranged from 4 to 55%, 11 to 87%, 4 to 60%, and 22 to 80%, respectively. Older age and worsening renal function were associated with non-use and sub-target dosing, lower body mass index was commonly associated with non-use, and hyperkalemia and hypotension were commonly associated with sub-target dosing. In conclusion, several common patient characteristics are associated with non-use and sub-target dosing of medical therapy for HFrEF. These high-risk groups are in particular need of further studies to improve implementation of available medications and to define the role of novel therapies.

Indexed as

Heart FailureAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsHumansMineralocorticoid Receptor AntagonistsStroke VolumeAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsMineralocorticoid Receptor AntagonistssacubitrilDrug therapyGuideline adherenceHeart failureMaximum tolerated doseSystolic heart failure

Identifiers

PMID33471236
OpenAlexW3122966625

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.