Újdonságok a krónikus szívelégtelenség gyógyszeres terápiájában | Novelties in the pharmacological treatment of chronic heart failure

Absztrakt A krónikus szívelégtelenség gyógyszeres kezelését illetően számos új vizsgálat eredményét publikálták az elmúlt években, és 2016-ban megjelent az Európai Kardiológiai Társaság (ESC) akut és krónikus szívelégtelenség diagnózisára és terápiájára vonatkozó legújabb irányelve, illetve az amerikai kardiológus társaságoknak (ACC/AHA/HFSA) a szívelégtelenség gyógyszeres kezelésére vonatkozó irányelv megújítása is. A közlemény az új irányelvek tükrében kíván áttekintést adni a krónikus szívelégtelenség gyógyszeres kezelésének aktuális helyzetéről, magába foglalva az új klinikai vizsgálatok eredményeit. Orv. Hetil., 2016, 157(38), 1517–1521. | Abstract Recently, results of several novel clinical trials on the pharmacological treatment of chronic heart failure have been published. In addition, the new European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure and a focused update by the ACC/AHA/HFSA on new pharmacological therapy for heart failure has been reported in 2016. This paper intends to provide an overview of the current state of the pharmacological treatment of chronic heart failure in the light of the new guidelines which incorporate the results of the new clinical trials. Orv. Hetil., 2016, 157(38), 1517–1521

The Impact of Specialised Heart Failure Outpatient Care on the Long-Term Application of Guideline-Directed Medical Therapy and on Prognosis in Heart Failure with Reduced Ejection Fraction

(1) Background: Besides the use of guideline-directed medical therapy (GDMT), multidisciplinary heart failure (HF) outpatient care (HFOC) is of strategic importance in HFrEF. (2) Methods: Data from 257 hospitalised HFrEF patients between 2019 and 2021 were retrospectively analysed. Application and target doses of GDMT were compared between HFOC and non-HFOC patients at discharge and at 1 year. 1-year all-cause mortality (ACM) and rehospitalisation (ACH) rates were compared using the Cox proportional hazard model. The effect of HFOC on GDMT and on prognosis after propensity score matching (PSM) of 168 patients and the independent predictors of 1-year ACM and ACH were also evaluated. (3) Results: At 1 year, the application of RASi, MRA and triple therapy (TT: RASi + βB + MRA) was higher (p < 0.05) in the HFOC group, as was the proportion of target doses of ARNI, βB, MRA and TT. After PSM, the composite of 1-year ACM or ACH was more favourable with HFOC (propensity-adjusted HR = 0.625, 95% CI = 0.401–0.974, p = 0.038). Independent predictors of 1-year ACM were age, systolic blood pressure, application of TT and HFOC, while 1-year ACH was influenced by the application of TT. (4) Conclusions: HFOC may positively impact GDMT use and prognosis in HFrEF even within the first year of its initiation

Magyar Szívelégtelenség Regiszter 2015?2016:Kezdeti eredmények

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