scholarly journals THE PARASAIL STUDY: PATIENT REPORTED OUTCOMES FROM THE CANADIAN REAL WORLD EXPERIENCE USE OF SACUBITRIL/VALSARTAN IN PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION

2017 ◽  
Vol 33 (10) ◽  
pp. S162-S163
Author(s):  
N. Bastien ◽  
H. Haddad ◽  
S. Bergeron ◽  
A. Ignaszewski ◽  
G. Searles
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Real World ◽  
Patient Reported Outcomes ◽  
Study Patient ◽  
Reduced Ejection Fraction ◽  
Patient Reported ◽  
Patients With Heart Failure

An Early View of Real-World Patient Response to Sacubitril/Valsartan: A Retrospective Study of Patients with Heart Failure with Reduced Ejection Fraction

2018 ◽  
Vol 35 (6) ◽  
pp. 785-795 ◽  
Author(s):  
Dana Drzayich Antol ◽  
Adrianne Waldman Casebeer ◽  
Richard W. DeClue ◽  
Stephen Stemkowski ◽  
Patricia A. Russo
Keyword(s):  
Heart Failure ◽  
Retrospective Study ◽  
Ejection Fraction ◽  
Real World ◽  
Patient Response ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Early View

Dapagliflozin in a Real-World Chronic Heart Failure Population: How Many Are Actually Eligible?

Cardiology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Sérgio Maltês ◽  
Gonçalo J.L. Cunha ◽  
Bruno M.L. Rocha ◽  
João Presume ◽  
Renato Guerreiro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Real World ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Disease Modifying Drugs ◽  
Reduced Ejection Fraction ◽  
Sodium Glucose Cotransporter ◽  
Patients With Heart Failure

<b><i>Background:</i></b> In patients with heart failure (HF) and reduced ejection fraction (HFrEF) with or without type 2 diabetes mellitus, the sodium-glucose cotransporter 2 inhibitor (SGLT2i) dapagliflozin was recently shown to reduce the risk of worsening HF or death from cardiovascular causes in the dapagliflozin in patients with heart failure and reduced ejection fraction (DAPA-HF) trial. Our goal was to investigate how many patients in a real-world setting would be eligible for dapagliflozin according to the DAPA-HF enrolment criteria. <b><i>Methods:</i></b> This is a single-center retrospective study enrolling consecutive, unselected patients followed up in an HF clinic from 2013 to 2019. Key DAPA-HF inclusion criteria (i.e., left ventricular ejection fraction [LVEF] ≤40% and NT-proBNP ≥600 pg/mL [or ≥900 pg/mL if atrial fibrillation]) and exclusion criteria (estimated glomerular filtration rate [eGFR] &#x3c;30 mL/kg/1.73 m<sup>2</sup> and systolic blood pressure [SBP] &#x3c;95 mm Hg) were considered. <b><i>Results:</i></b> Overall, 479 patients (age 76 ± 13 years; 50.5% male; 78.9% hypertensive; 45.1% with an eGFR &#x3c;60 mL/min/1.73 m<sup>2</sup>; 36.5% with TD2M; and 33.5% with ischaemic HF) were assessed. The median SBP was 128.5 (112.0–146.0) mm Hg, mean eGFR was 50.8 ± 23.7 mL/min/1.73 m<sup>2</sup>, and median NT-proBNP was 2,183 (IQR 1,010–5,310) pg/mL. Overall, 155 (32.4%) patients had LVEF ≤40%. According to the DAPA-HF trial key criteria, 90 patients (18.8%) would be eligible for dapagliflozin. The remainder would be excluded due to LVEF &#x3e;40% (67.6%), eGFR &#x3c;30 mL/min/1.73 m<sup>2</sup> (19.4%), NT-proBNP below the cutoff (16.7%), and/or SBP &#x3c;95 mm Hg (6.5%). If we center the analysis to those with LVEF ≤40%, 58.1% would be eligible for dapagliflozin. The remainder would be excluded due to an eGFR &#x3c;30 mL/min/1.73 m<sup>2</sup> (20%), NT-proBNP below the cutoff (16.1%), and/or SBP &#x3c;95 mm Hg (8.4%). <b><i>Conclusion:</i></b> Roughly half of our real-world HFrEF cohort would be eligible for dapagliflozin according to the key criteria of the DAPA-HF trial. The main reason for non-eligibility was an eGFR &#x3c;30 mL/min/1.73 m<sup>2</sup>. However, two-thirds of patients had LVEF &#x3e;40%. These findings show that dapagliflozin is a promising complementary new drug in the therapeutic armamentarium of most patients with HFrEF, while highlighting the urgent need for disease-modifying drugs in mid-range and preserved LVEF and the need to assess the efficacy and safety of SLGT2i in advanced kidney disease patients. The results of ongoing SGLT2i trials in these LVEF subgroups are eagerly awaited.

scholarly journals Characteristics of patients with heart failure with preserved ejection fraction in primary care: Cross-sectional analysis

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0094
Author(s):  
Faye Forsyth ◽  
James Brimicombe ◽  
Joseph Cheriyan ◽  
Duncan Edwards ◽  
Richard Hobbs ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Ejection Fraction ◽  
Physical Function ◽  
Well Being ◽  
Preserved Ejection Fraction ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Patient Reported ◽  
Patients With Heart Failure

BackgroundMany patients with heart failure with preserved ejection fraction (HFpEF) are undiagnosed, and UK general practice registers do not typically record HF sub-type. Improvements in management of HFpEF is dependent on improved identification and characterisation of patients in primary care.AimsTo describe a cohort of patients recruited from primary care with suspected HFpEF and compare patients in whom HFpEF was confirmed and refuted.Design and SettingBaseline data from a longitudinal cohort study of patients with suspected HFpEF recruited from primary care in two areas of England.MethodsA screening algorithm and review were used to find patients on HF registers without a record of reduced ejection fraction. Baseline evaluation included cardiac, mental and physical function, clinical characteristics and patient reported outcomes. Confirmation of HFpEF was clinically adjudicated by a cardiologist.ResultsNinety-three (61%) of 152 patients were confirmed HFpEF. The mean age of patients with HFpEF was 79.3, 46% were female, 80% had hypertension, and 37% took 10 or more medications. Patients with HFpEF were more likely to be obese, pre-frail/frail, report more dyspnoea and fatigue, were more functionally impaired, and less active than patients in whom HFpEF was refuted. Few had attended cardiac rehabilitation.ConclusionsPatients with confirmed HFpEF had frequent multimorbidity, functional impairment, frailty and polypharmacy. Although comorbid conditions were similar between people with and without HFpEF, the former had more obesity, symptoms and worse physical function. These findings highlight the potential to optimise well-being through comorbidity management, medication rationalisation, rehabilitation, and supported self-management.

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