Evidence map›Paper›PMID 36647925›Full record

ArticleJACC. Heart failure2023

Treatment Differences in Medical Therapy for Heart Failure With Reduced Ejection Fraction Between Sociodemographic Groups.

Celeste Witting, Jimmy Zheng, Rebecca L Tisdale, Evan Shannon, Shun Kohsaka, Eldrin F Lewis, Paul Heidenreich, Alexander Sandhu

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
5.4field-weighted citation impact, top 3% 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

16 citing papers in PubMed, 35 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Celeste WittingDepartment of Medicine, Stanford University, Stanford, California, USA.
Jimmy ZhengSchool of Medicine, Stanford University, Stanford, California, USA.
Rebecca L TisdaleVA Palo Alto Health Care System, Palo Alto, California, USA; Department of Health Policy, Stanford University, Stanford, California, USA.
Evan ShannonDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine, Los Angeles, California, USA.
Shun KohsakaDepartment of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Eldrin F LewisDepartment of Medicine, Stanford University, Stanford, California, USA.
Paul HeidenreichDepartment of Medicine, Stanford University, Stanford, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA.
Alexander SandhuDepartment of Medicine, Stanford University, Stanford, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA. Electronic address: ats114@stanford.edu.
Stanford University · USVA Palo Alto Health Care System · USKeio University · JPLos Angeles County Department of Health Services · US

Funding

The Effect of Value-based Payment on Heart Failure Quality of Care (Value-HF)K23HL151672 · NHLBI · STANFORD UNIVERSITY · PI SANDHU, ALEXANDER · 2020 to 2024
$854k
NHLBI NIH HHS K23 HL151672
6 · The paper itself

Abstract

backgroundThere are sociodemographic disparities in outcomes of heart failure with reduced ejection fraction (HFrEF), but disparities in guideline-directed medical therapy (GDMT) remain poorly characterized.

objectivesThis study aimed to analyze GDMT treatment rates in eligible patients with recently diagnosed HFrEF, and to determine how rates vary by sociodemographic characteristics.

methodsThis retrospective cohort study included patients diagnosed with HFrEF at Veterans Affairs (VA) hospitals from 2013 to 2019. The authors analyzed GDMT treatment rates and doses, excluding patients with contraindications. Therapies of interest were evidence-based beta-blockers (BBs), renin-angiotensin system inhibitors (RASIs), angiotensin receptor-neprilysin inhibitors (ARNIs), and mineralocorticoid antagonists (MRAs). The authors compared adjusted treatment rates by race and ethnicity, neighborhood social vulnerability, rurality, distance to medical care, and sex.

resultsThe cohort comprised 126,670 VA patients with recently diagnosed HFrEF. The study found that racial and ethnic minorities had similar or higher treatment rates than White patients. Patients residing in socially vulnerable neighborhoods had 3.4% lower ARNI (95% CI: 1.9%-5.0%) treatment rates. Patients residing farther from specialty care had similar rates of GDMT therapy overall, but were less likely to be taking at least 50% of the target doses of either BBs (4.0% less likely; 95% CI: 3.1%-5.0%) or RASIs (5.0% less likely; 95% CI: 4.1%-6.0%) compared with those closer to care.

conclusionsAmong VA patients with recently diagnosed HFrEF, the authors did not find that racial and ethnic minority patients were less likely to receive GDMT. However, appropriate dose up-titration may occur less frequently in more remote patients.

Indexed as

Heart FailureVentricular Dysfunction, LeftAdrenergic beta-AntagonistsAngiotensin Receptor AntagonistsEthnicityHumansMineralocorticoid Receptor AntagonistsMinority GroupsRetrospective StudiesStroke VolumeAdrenergic beta-AntagonistsAngiotensin Receptor AntagonistsMineralocorticoid Receptor Antagonistsdisparitiesguideline-directed medical therapy (GDMT)heart failurequality

Identifiers

PMID36647925
PMCPMC10069379
OpenAlexW4308741143

What OpenQuestion holds

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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.