ArticleCirculation. Heart failure2021
Association of Hyper-Polypharmacy With Clinical Outcomes in Heart Failure With Preserved Ejection Fraction.
Article in Circulation. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Cardiovascular risk associated with polypharmacy in heart failure: a systematic review and meta-analysis.ESC heart failure · 2026Pooled it
- Semaglutide and diuretic use in obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF-DM trials.European heart journal · 2024Trial
- Prognostic effect of polypharmacy in ambulatory patients with heart failure: a machine learning-based analysis.BMC cardiovascular disorders · 2026Article
- Article
- Polypharmacy, determinants, and adverse outcomes in elderly patients with heart failure: a multicenter retrospective cohort study of 7,361 subjects.BMC geriatrics · 2026Article
- Global patterns of polypharmacy after acute heart failure hospitalization: Prevalence and outcomes from the REPORT-HF registry.European journal of heart failure · 2025Article
- Outcomes and drug-related admissions of cardiovascular patients in the emergency department at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.International journal of emergency medicine · 2025Article
- Healthy ageing in older adults with cardiovascular disease.European heart journal · 2025Review
- Renal denervation in the setting of heart failure.Heart failure reviews · 2025Review
- Review
- Impact of polypharmacy on clinical outcomes in patients with advanced heart failure undergoing cardiac resynchronization therapy.Journal of arrhythmia · 2025Article
- Impact of polypharmacy on 3-year mortality in patients with heart failure: a retrospective study.Journal of pharmaceutical health care and sciences · 2024Article
- Prognostic impact of polypharmacy and discharge medications in octogenarians and nonagenarian patients with acute heart failure.Heart and vessels · 2024Article
- Use of Sodium-Glucose Cotransporter-2 Inhibitors and Angiotensin Receptor-Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real-World Data.Journal of the American Heart Association · 2024Article
- Underuse of heart failure medications and poor long-term prognosis in chronic heart failure patients with polypharmacy - A report from the CHART-2 study.International journal of cardiology. Heart & vasculature · 2024Article
- Prevalence of polypharmacy in heart failure patients: A retrospective cross-sectional study in a tertiary hospital in Saudi Arabia.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2023Article
- Phenotype-Specific Outcome and Treatment Response in Heart Failure with Preserved Ejection Fraction with Comorbid Hypertension and Diabetes: A 12-Month Multicentered Prospective Cohort Study.Journal of personalized medicine · 2023Article
- Value assessment of deprescribing interventions: Suggestions for improvement.Journal of the American Geriatrics Society · 2023Article
- Prognostic Impact of Polypharmacy following Trans-Catheter Aortic Valve Replacement.Journal of clinical medicine · 2023Article
- Update on Atrial Shunt Therapy for Treatment of Heart Failure.Structural heart : the journal of the Heart Team · 2022Review
Corrections and comments
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Authors and funding
17 authors at 9 institutions in 4 countries.
Funding
Abstract
backgroundPolypharmacy is associated with a poor prognosis in the elderly, however, information on the association of polypharmacy with cardiovascular outcomes in heart failure with preserved ejection fraction is sparse. This study sought to investigate the relationship between polypharmacy and adverse cardiovascular events in patients with heart failure with preserved ejection fraction.
methodsBaseline total number of medications was determined in 1758 patients with heart failure with preserved ejection fraction enrolled in the Americas regions of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist), by 3 categories: nonpolypharmacy (<5 medications), polypharmacy (5-9), and hyper-polypharmacy (≥10). We examined the relationship of polypharmacy status with the primary outcome (cardiovascular death, HF hospitalization, or aborted cardiac arrest), hospitalizations for any reason, and serious adverse events.
resultsThe proportion of patients taking 5 or more medications was 92.5% (inclusive of polypharmacy [38.7%] and hyper-polypharmacy [53.8%]). Over a 2.9-year median follow-up, compared with patients with polypharmacy, hyper-polypharmacy was associated with an increased risk for the primary outcome, hospitalization for any reason and any serious adverse events in the univariable analysis, but not significantly associated with mortality. After multivariable adjustment for demographic and comorbidities, hyper-polypharmacy remained significantly associated with an increased risk for hospitalization for any reason (hazard ratio, 1.22 [95% CI, 1.05-1.41];
conclusionsHyper-polypharmacy was common and associated with an elevated risk of hospitalization for any reason and any serious adverse events in patients with heart failure with preserved ejection fraction. There were no significant associations between polypharmacy status and mortality.
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Registered trials
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.