Pacientes elegibles para las nuevas terapias de la insuficiencia cardíaca en un policlínico especializado / Proportion of patients with heart failure in a specialized clinic eligible for novel therapies
Rev. méd. Chile
;
147(3): 330-333, mar. 2019. tab
Article
in Spanish
| LILACS
| ID: biblio-1043154
ABSTRACT
Background:
Pharmacological treatment improves survival in patients with heart failure with reduced ejection fraction. The use of sacubutril/valsartan and ivabradine has been recently approved and incorporated in the latest guidelines.Aim:
To identify candidates eligible for these therapies among patients treated in a heart failure clinic, considering the inclusion criteria for the PARADIGM-HF and SHIFT trials. Material andMethods:
Cross-sectional study on 158 patients aged 62 ± 11 years (67% male) with heart failure and reduced ejection fraction, with at least three months of follow-up and without decompensation. The percentage of patients complying for the inclusion criteria for the PARADIGM-HF y SHIFT trials was determined.Results:
In 37%, the etiology of heart failure was ischemic, 49% were in functional class I, their ejection fraction was 33 ± 11% and their median Pro-brain natriuretic peptide was 800 pg/mL. Ninety five percent were treated with vasodilators, 97% with beta-blockers and 82% with aldosterone antagonists. Using PARADIGM-HF and SHIFT criteria, 11 patients (7%) were eligible for sacubitril / valsartan and 21 patients (13.3%) for ivabradine. Among the main causes of non-eligibility for sacubitril / valsartan were being functional class I (48.7%) and not achieving a stable dose of enalapril ≥ 20 mg / day or losartan ≥ 100 mg / day (24.7%). In the case of ivabradine, apart from those in functional class I, the absence of sinus rhythm and a heart rate < 70 / min when receiving a maximal tolerated dose of beta-blockers, were present in 22%.Conclusions:
A low percentage of our patients were eligible for these therapies. Among the causes that explain these results were clinical stability, a high percentage of patients in functional class I and being in a disease modifying treatment.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Tetrazoles
/
Cardiovascular Agents
/
Angiotensin Receptor Antagonists
/
Ivabradine
/
Aminobutyrates
/
Heart Failure
Type of study:
Practice guideline
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2019
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Hospital del Salvador/CL
/
Universidad de Chile/CL
/
Universidad de los Andes/CL
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