ArticleInternational journal of heart failure2025
Worsening Heart Failure and Medication Use in HFrEF: A Finnish Retrospective Registry Study and Patient Survey.
Article in International journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Mind the Gap: Bridging Guideline Recommendations and Real-World Practice in Heart Failure Management.International journal of heart failure · 2025Article
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8 authors.
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Abstract
Background and Objectives: Understanding worsening heart failure events (WHFEs) and clinical practices in the real world is essential in heart failure (HF) management. The primary objective of this single-center, retrospective, observational study, including a patient survey, was to characterize WHFEs and associated factors during the first year after the incident HF diagnosis in Finnish patients. Secondly, implementation and adherence to guideline-directed medical therapy (GDMT) and mortality during the whole follow-up were assessed. Methods: Incident HF patients (International Classification of Diseases, 10th Revision: I50) with reduced ejection fraction (HFrEF; <40%) were identified between 2013-2019 from the hospital data lake of Southwest Finland. Clinical characteristics, healthcare resource utilization, medication prescriptions and purchases, and deaths were collected from hospital records and national registers between 2011-2021. A survey was linked with register data for a subgroup of patients. Associations between explanatory factors, WHFEs, and mortality were studied using logistic and Cox regression models. Results: Among 570 HFrEF patients, 23% (n=133) experienced a WHFE within the first year after the incident diagnosis. During this 1-year period, 85% used angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, 90% beta-blockers, and 44% mineralocorticoid receptor antagonists, and >80% of patients were adherent to these medications. WHFEs were associated with higher risk of mortality (hazard ratio [HR], 1.82; 95% confidence interval [CI], 1.31-2.53; p<0.001), whereas adherence was associated with a lower risk of WHFEs (odds ratio, 0.31; 95% CI, 0.20-0.48; p<0.001) and mortality (HR, 0.66; 95% CI, 0.47-0.94; p=0.021) in multivariate models. Quality of life was lower in patients with (n=47) than without WHFEs (n=100). Conclusions: Improving adherence is crucial for mitigating adverse outcomes in HF.
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