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A Composite Score Summarizing Use and Dosing of Evidence-Based Medical Therapies in Heart Failure: A Nationwide Cohort Study.

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Johansen, ND; Vaduganathan, M; Zahir, D; Fiuzat, M; DeFilippis, EM; Januzzi, JL; Butler, J; O'Connor, CM; Abraham, WT; Psotka, MA; Dewan, P ...
Published in: Circ Heart Fail
February 2023

BACKGROUND: As heart failure therapeutic care becomes increasingly complex, a composite medical therapy score could be useful to conveniently summarize background medical therapy. We applied the composite medical therapy score developed by the Heart Failure Collaboratory (HFC) to the Danish heart failure with reduced ejection fraction population to evaluate its external validation including assessing the distribution of the score and its association with survival. METHODS: In a retrospective nationwide cohort study, we identified all Danish heart failure with reduced ejection fraction patients alive on July 1, 2018, and assessed their treatment doses. Patients were excluded if they did not have at least 365 days for up-titration of medical therapy prior to identification. The HFC score (range 0-8) accounts for use and dosing of multiple therapies prescribed to each patient. Risk-adjusted association between the composite score and all-cause mortality was examined. RESULTS: In total, 26 779 patients (mean age 71.9 years; 32% women) were identified. At baseline, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker was used in 77%, β-blocker in 81%, mineralocorticoid receptor antagonist in 30%, angiotensin receptor-neprilysin inhibitor in 2%, and ivabradine in 2%. The median HFC score was 4. After multivariable adjustment, higher HFC scores were independently associated with lower mortality (≥median versus

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Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

February 2023

Volume

16

Issue

2

Start / End Page

e009729

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Retrospective Studies
  • Mineralocorticoid Receptor Antagonists
  • Male
  • Humans
  • Heart Failure
  • Female
  • Cohort Studies
  • Cardiovascular System & Hematology
 

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Johansen, N. D., Vaduganathan, M., Zahir, D., Fiuzat, M., DeFilippis, E. M., Januzzi, J. L., … Biering-Sørensen, T. (2023). A Composite Score Summarizing Use and Dosing of Evidence-Based Medical Therapies in Heart Failure: A Nationwide Cohort Study. In Circ Heart Fail (Vol. 16, p. e009729). United States. https://doi.org/10.1161/CIRCHEARTFAILURE.122.009729
Johansen, Niklas Dyrby, Muthiah Vaduganathan, Deewa Zahir, Mona Fiuzat, Ersilia M. DeFilippis, James L. Januzzi, Javed Butler, et al. “A Composite Score Summarizing Use and Dosing of Evidence-Based Medical Therapies in Heart Failure: A Nationwide Cohort Study.” In Circ Heart Fail, 16:e009729, 2023. https://doi.org/10.1161/CIRCHEARTFAILURE.122.009729.
Johansen ND, Vaduganathan M, Zahir D, Fiuzat M, DeFilippis EM, Januzzi JL, et al. A Composite Score Summarizing Use and Dosing of Evidence-Based Medical Therapies in Heart Failure: A Nationwide Cohort Study. In: Circ Heart Fail. 2023. p. e009729.
Johansen, Niklas Dyrby, et al. “A Composite Score Summarizing Use and Dosing of Evidence-Based Medical Therapies in Heart Failure: A Nationwide Cohort Study.Circ Heart Fail, vol. 16, no. 2, 2023, p. e009729. Pubmed, doi:10.1161/CIRCHEARTFAILURE.122.009729.
Johansen ND, Vaduganathan M, Zahir D, Fiuzat M, DeFilippis EM, Januzzi JL, Butler J, O’Connor CM, Abraham WT, Psotka MA, McMurray JJV, Dewan P, Claggett BL, Solomon SD, Modin D, Butt JH, Jensen JUS, Schou M, Torp-Pedersen C, Køber L, Gislason GH, Biering-Sørensen T. A Composite Score Summarizing Use and Dosing of Evidence-Based Medical Therapies in Heart Failure: A Nationwide Cohort Study. Circ Heart Fail. 2023. p. e009729.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

February 2023

Volume

16

Issue

2

Start / End Page

e009729

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Retrospective Studies
  • Mineralocorticoid Receptor Antagonists
  • Male
  • Humans
  • Heart Failure
  • Female
  • Cohort Studies
  • Cardiovascular System & Hematology