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Treatment practices in heart failure with preserved left ventricular ejection fraction: a prospective observational study.
Int J Cardiol. 2007 Jun 12; 118(3):363-9.IJ

Abstract

BACKGROUND

Current guidelines for treatment of patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF) are empirical. One of the objectives of the ETICS study was to evaluate medical treatment at discharge and after 1 year in patients hospitalised for a first episode of HF in 2000. We report the results concerning treatment of patients with preserved LVEF at discharge and at 1 year.

METHODS

Two hundred and sixty three consecutive patients (75+/-10 years, 47 males) with LVEF >50% hospitalised for a first episode of HF were prospectively included. Mean LVEF was 63+/-8%. The main aetiology was hypertension (61%) followed by ischaemic heart disease (29%). Atrial fibrillation and diabetes were present in 34% and 27% of cases, respectively. Medical treatment records were complete at discharge and at 1 year after discharge.

RESULTS

At discharge, as at 1 year after discharge, diuretics were the drugs most commonly prescribed (81% and 78%), followed by ACE inhibitors (49% and 46%), amiodarone (32% and 28%), beta-blockers (27% and 29%), nitrates (28% and 27%), calcium channel blockers (27% and 26%), spironolactone (21% and 25%), cardiac glycosides (19% and 24%), and angiotensin II receptor antagonists (4% and 6%). Once prescribed at hospital discharge, drug prescription rates and daily doses did not change significantly over time. Age did not influence drug prescription rates at discharge or at 1 year, except for the spironolactone prescription rate, which decreased at 1 year in patients > or =75 years of age. At discharge, ACE inhibitor and beta-blocker daily doses were lower in older patients, while, at 1 year, no differences in daily doses of these drugs were observed between patients above and below the age of 75 years.

CONCLUSION

Loops diuretics are largely prescribed in HF with preserved LVEF, followed by ACE inhibitors. Future large multicentre trials are required to define the background standard treatment in addition to treatment of aetiological factors.

Authors+Show Affiliations

INSERM, ERI 12, South Hospital, Amiens, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17049391

Citation

Peltier, M, et al. "Treatment Practices in Heart Failure With Preserved Left Ventricular Ejection Fraction: a Prospective Observational Study." International Journal of Cardiology, vol. 118, no. 3, 2007, pp. 363-9.
Peltier M, Houpe D, Cohen-Solal A, et al. Treatment practices in heart failure with preserved left ventricular ejection fraction: a prospective observational study. Int J Cardiol. 2007;118(3):363-9.
Peltier, M., Houpe, D., Cohen-Solal, A., Béguin, M., Levy, F., & Tribouilloy, C. (2007). Treatment practices in heart failure with preserved left ventricular ejection fraction: a prospective observational study. International Journal of Cardiology, 118(3), 363-9.
Peltier M, et al. Treatment Practices in Heart Failure With Preserved Left Ventricular Ejection Fraction: a Prospective Observational Study. Int J Cardiol. 2007 Jun 12;118(3):363-9. PubMed PMID: 17049391.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment practices in heart failure with preserved left ventricular ejection fraction: a prospective observational study. AU - Peltier,M, AU - Houpe,D, AU - Cohen-Solal,A, AU - Béguin,M, AU - Levy,F, AU - Tribouilloy,C, Y1 - 2006/10/16/ PY - 2006/03/23/received PY - 2006/07/13/accepted PY - 2006/10/20/pubmed PY - 2007/7/24/medline PY - 2006/10/20/entrez SP - 363 EP - 9 JF - International journal of cardiology JO - Int J Cardiol VL - 118 IS - 3 N2 - BACKGROUND: Current guidelines for treatment of patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF) are empirical. One of the objectives of the ETICS study was to evaluate medical treatment at discharge and after 1 year in patients hospitalised for a first episode of HF in 2000. We report the results concerning treatment of patients with preserved LVEF at discharge and at 1 year. METHODS: Two hundred and sixty three consecutive patients (75+/-10 years, 47 males) with LVEF >50% hospitalised for a first episode of HF were prospectively included. Mean LVEF was 63+/-8%. The main aetiology was hypertension (61%) followed by ischaemic heart disease (29%). Atrial fibrillation and diabetes were present in 34% and 27% of cases, respectively. Medical treatment records were complete at discharge and at 1 year after discharge. RESULTS: At discharge, as at 1 year after discharge, diuretics were the drugs most commonly prescribed (81% and 78%), followed by ACE inhibitors (49% and 46%), amiodarone (32% and 28%), beta-blockers (27% and 29%), nitrates (28% and 27%), calcium channel blockers (27% and 26%), spironolactone (21% and 25%), cardiac glycosides (19% and 24%), and angiotensin II receptor antagonists (4% and 6%). Once prescribed at hospital discharge, drug prescription rates and daily doses did not change significantly over time. Age did not influence drug prescription rates at discharge or at 1 year, except for the spironolactone prescription rate, which decreased at 1 year in patients > or =75 years of age. At discharge, ACE inhibitor and beta-blocker daily doses were lower in older patients, while, at 1 year, no differences in daily doses of these drugs were observed between patients above and below the age of 75 years. CONCLUSION: Loops diuretics are largely prescribed in HF with preserved LVEF, followed by ACE inhibitors. Future large multicentre trials are required to define the background standard treatment in addition to treatment of aetiological factors. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/17049391/Treatment_practices_in_heart_failure_with_preserved_left_ventricular_ejection_fraction:_a_prospective_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(06)00865-5 DB - PRIME DP - Unbound Medicine ER -