Racial Differences in Trends and Prognosis of Guideline-Directed Medical Therapy for Heart Failure with Reduced Ejection Fraction: the Atherosclerosis Risk in Communities (ARIC) Surveillance Study

2022 ◽  
Author(s):  
Lena Mathews ◽  
Ning Ding ◽  
Yingying Sang ◽  
Laura R. Loehr ◽  
Jung-Im Shin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Racial Differences ◽  
Medical Therapy ◽  
Surveillance Study ◽  
Atherosclerosis Risk In Communities ◽  
Reduced Ejection Fraction ◽  
Atherosclerosis Risk

Abstract MP71: Socioeconomic Status, Guideline Directed Medical Therapy, and Prognosis in Heart Failure With Reduced Ejection Fraction: The Atherosclerosis Risk in Community (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Lena Mathews ◽  
Ning Ding ◽  
Amira Collison ◽  
Yejin Mok ◽  
Jung-Im Shin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Socioeconomic Status ◽  
Ejection Fraction ◽  
Racial Differences ◽  
Medical Therapy ◽  
Angiotensin Receptor Blockers ◽  
Area Deprivation ◽  
Aldosterone Antagonists ◽  
Reduced Ejection Fraction ◽  
Receptor Blockers

Introduction: Current research suggests racial differences exist in the utilization of guideline directed medical therapy (GDMT) and prognosis in heart failure with reduced ejection fraction (HFrEF). Whether individual and community level socioeconomic status (SES) impacts prescription patterns of GDMT and prognosis in HFrEF has not been studied. Methods: We studied 669 ARIC participants with incident HFrEF (EF<50%) (mean age 77.6 (SD 6.5) years; 39% black; 46% women) during 2005-2017 (median 1.8 years of follow-up). We assessed the proportion of patients on optimal GDMT (defined as ß-blockers [BB] and ACE inhibitors [ACEI] or angiotensin receptor blockers [ARB]) or adequate GDMT (one of either BB, ACEI/ARB, aldosterone antagonists [AA], or hydralazine and nitrates [H-ISDN]) at hospital discharge by individual SES (education and income), neighborhood SES (area deprivation index: ADI) and their combination (Table). We also examined the contribution of GDMT prescription to prognosis overall, and by SES. Subsequently, we quantified the association of SES with mortality and re-hospitalization for HFrEF. Results: The proportion of patients prescribed optimal and adequate GDMT was 54% and 81%, respectively. BB were most frequently prescribed (83%), followed by ACEI/ARB (61%), AA (11%), and H-ISDN (9%). Overall, BB were associated with lower mortality, while H-ISDN were associated with higher mortality, compared to their non-use counterparts. ACEI/ARB were associated with lower re-hospitalization, compared to non-users of ACEI/ARB. The prescription of GDMT and the effect of GDMT on prognosis did not significantly differ by SES. Despite that, lower SES was independently associated with higher risk of mortality and re-hospitalization (Table). Conclusions: Overall, optimal GDMT was low at discharge, but did not differ by SES. Despite that, there were significant differences in death and re-hospitalization by SES, suggesting a potential need for tailored approaches to HFrEF management for low SES individuals.

Factors associated with non-use and sub-target dosing of medical therapy for heart failure with reduced ejection fraction

2021 ◽  
Author(s):  
Stephen J. Greene ◽  
Xi Tan ◽  
Yu-Chen Yeh ◽  
Mark Bernauer ◽  
Omer Zaidi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Medical Therapy ◽  
Reduced Ejection Fraction ◽  
Factors Associated

scholarly journals MORTALITY AND GUIDELINE DIRECTED MEDICAL THERAPY IN HEART FAILURE PATIENTS WITH REDUCED EJECTION FRACTION: EVIDENCE FROM REAL WORLD DATA

2021 ◽  
Vol 77 (18) ◽  
pp. 670
Author(s):  
Peter A. McCullough ◽  
Hirsch Mehta ◽  
Colin Barker ◽  
Joanna Van Houten ◽  
Sarah Mollenkopf ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Medical Therapy ◽  
Real World ◽  
Real World Data ◽  
World Data ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients

scholarly journals Evaluation of a guideline directed medical therapy titration program in patients with heart failure with reduced ejection fraction

2019 ◽  
Vol 22 ◽  
pp. 1-5 ◽  
Author(s):  
Kathir Balakumaran ◽  
Aadhar Patil ◽  
Shannon Marsh ◽  
Joseph Ingrassia ◽  
Chia-Ling Kuo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Medical Therapy ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure
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