Evidence map›Paper›PMID 35278267›Full record

ArticleEuropean journal of heart failure2022

Use of evidence-based therapy in heart failure with reduced ejection fraction across age strata.

Davide Stolfo, Lars H Lund, Peter Moritz Becher, Nicola Orsini, Tonje Thorvaldsen, Lina Benson, Camilla Hage, Ulf Dahlström, Gianfranco Sinagra, Gianluigi Savarese

Erratum issuedOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 42 papers.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed
12.8field-weighted citation impact, top 1% 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

42 citing papers in PubMed, 78 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Review
  8. Observational
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Observational
  16. Article
  17. Review
  18. Review
  19. Observational
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Davide StolfoDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Lars H LundDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Peter Moritz BecherDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Nicola OrsiniDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Tonje ThorvaldsenDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Lina BensonDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Camilla HageDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Ulf DahlströmDepartment of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Gianfranco SinagraCardiothoracovascular Department and University of Trieste, Trieste, Italy.
Gianluigi SavareseDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet · SEKarolinska University Hospital · SEGerman Centre for Cardiovascular Research · DELinköping University · SEUniversity of Trieste · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIn older patients, guideline-directed medical therapy (GDMT) for heart failure (HF) with reduced ejection fraction (<40%; HFrEF) is not contraindicated, but adherence to guidelines is limited. We investigated the implementation of GDMT in HFrEF across different age strata in a large nationwide cohort. METHODS AND

resultsPatients with HFrEF and HF duration ≥3 months registered in the Swedish HF Registry between 2000-2018 were analysed according to age. Multivariable logistic and multinomial regressions were fitted to investigate factors associated with underuse/underdosing. Of 27 430 patients, 31% were <70 years old, 34% 70-79 years old, and 35% ≥80 years old. Use of treatments progressively decreased with increasing age. Use of renin-angiotensin system/angiotensin receptor-neprilysin inhibitors, beta-blockers and mineralocorticoid receptor antagonists was 80%, 88% and 35% in age ≥80 years; 90%, 93% and 47% in age 70-79 years; and 95%, 95% and 54% in age <70 years, respectively. Among patients with an indication, use of implantable cardioverter defibrillator and cardiac resynchronization therapy (CRT) was 7% and 23% in age ≥ 80 years; 22% and 42% in age 70-79 years; and 29% and 50% in age <70 years, respectively. Older patients were less likely treated with target doses or combinations of HF medications. Except for CRT, after extensive adjustments, age was inversely associated with the likelihood of GDMT use and target dose achievement.

conclusionIn HFrEF, gaps persist in the use of medications and devices. In disagreement with current recommendations, older patients remain undertreated. Improving strategies and a more individualized approach for implementing use of GDMT in HFrEF are required, particularly in older patients.

Indexed as

Cardiac Resynchronization TherapyHeart FailureVentricular Dysfunction, LeftAdrenergic beta-AntagonistsAgedAged, 80 and overAngiotensin Receptor AntagonistsHumansMineralocorticoid Receptor AntagonistsStroke VolumeAdrenergic beta-AntagonistsAngiotensin Receptor AntagonistsMineralocorticoid Receptor AntagonistsElderlyGuideline-directed medical therapyHeart failure with reduced ejection fraction

Identifiers

PMID35278267
PMCPMC9546348
OpenAlexW4220949605

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.