41 research outputs found
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.
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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