ArticleJournal of the American Heart Association2023
Physical Frailty and Use of Guideline-Recommended Drugs in Patients With Heart Failure and Reduced Ejection Fraction.
Article in Journal of the American Heart Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
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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.
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
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Efficacy and Safety of Heart Failure Treatment According to Frailty Status: A Systematic Review.Journal of the American Heart Association · 2025Pooled it
- Length of stay and prior heart failure admission in frailty and heart failure: A systematic review and meta-analysis.ESC heart failure · 2025Pooled it
- Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis.Aging clinical and experimental research · 2024Pooled it
- Observational
- Body Mass Index Category and the Association Between Polypharmacy and Functional Recovery in Stroke Patients: A Retrospective Cohort Study.Drugs & aging · 2026Article
- Guideline-Directed Heart Failure Pharmacotherapy in Adults Aged ≥75 Years: Evidence Gaps, Tolerability, and Implications for Clinical Practice.Drugs & aging · 2026Review
- Optimizing cardiovascular pharmacotherapy in older adults with frailty.Nature reviews. Cardiology · 2026Review
- Rehabilitative intervention of frailty for patients with chronic respiratory disease (REINFORCE study): research protocol for a multicentre, randomised controlled trial.Journal of thoracic disease · 2026Article
- Clinical Pharmacology of Heart Failure in Frailty.European cardiology · 2026Review
- Prognostic Value of Frailty Assessment Combining the Frailty Index Based on Laboratory Tests With the Clinical Frailty Scale in Patients With Acute Heart Failure.Journal of the American Heart Association · 2025Observational
- Effectiveness of Guideline-Directed Medical Therapy for Acute Heart Failure With Reduced Ejection Fraction in Frail Elderly Patients With Malnutrition.Circulation reports · 2025Article
- Heart failure treatment in the last years of life: A nationwide study of 364 000 individuals.European journal of heart failure · 2024Article
- Frailty, Sarcopenia, Cachexia, and Malnutrition in Heart Failure.Korean circulation journal · 2024Review
- Assessment and Management of Atrial Fibrillation in Older Adults with Frailty.Geriatrics (Basel, Switzerland) · 2024Review
- The Reasons for the Low Uptake of New Antidiabetic Drugs with Cardiovascular Effects-A Family Doctor Perspective.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND Guideline-recommended therapies that improve prognosis remain underused in clinical practice. Physical frailty may lead to underprescription of life-saving therapy. We aimed to investigate the association between physical frailty and the use of evidence-based pharmacological therapy for heart failure with reduced ejection fraction and the impact of this on prognosis. METHODS AND RESULTS The FLAGSHIP (Multicentre Prospective Cohort Study to Develop Frailty-Based Prognostic Criteria for Heart Failure Patients) included patients hospitalized for acute heart failure, and data on physical frailty were collected prospectively. We analyzed 1041 patients with heart failure with reduced ejection fraction (aged 70 years; 73% male) and divided them by physical frailty categories using grip strength, walking speed, Self-Efficacy for Walking-7 score, and Performance Measures for Activities of Daily Living-8 score: categories I (n=371; least frail), II (n=275), III (n=224), and IV (n=171). Overall prescription rates of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, and mineralocorticoid receptor antagonists were 69.7%, 87.8%, and 51.9%, respectively. The proportion of patients receiving all 3 drugs decreased as physical frailty increased (in category I patients, 40.2%; IV patients, 23.4%;
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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.