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Age differences in contemporary treatment of patients with chronic heart failure and reduced ejection fraction.


ABSTRACT:

Background

Elderly patients are underrepresented in clinical trials but comprise the majority of heart failure patients. Data on age-specific use of heart failure therapy are limited. The European Society of Cardiology heart failure guidelines provide no age-specific treatment recommendations. We investigated practice-based heart failure management in a large registry at heart failure outpatient clinics.

Design and methods

We studied 8351 heart failure with reduced ejection fraction patients at 34 Dutch outpatient clinics between 2013 and 2016. The mean age was 72.3?±?11.8 years and we divided age into three categories: less than 60 years (13.9%); 60-74 years (36.0%); and 75 years and over (50.2%).

Results

Elderly heart failure with reduced ejection fraction patients (?75 years) received significantly fewer beta-blockers (77.8% vs. 84.2%), renin-angiotensin system inhibitors (75.2% vs. 89.7%), mineralocorticoid receptor antagonists (50.6% vs. 59.6%) and ivabradine (2.9% vs. 9.3%), but significantly more diuretics (88.1% vs. 72.6%) compared to patients aged less than 60 years (Pfor all trends?ConclusionWith increasing age, heart failure with reduced ejection fraction patients less often received guideline-recommended medication prescriptions and also in a lower dosage. In addition, a lower percentage of implantable cardioverter defibrillator and cardiac resynchronisation therapy device implantation in elderly patients was observed.

SUBMITTER: Veenis JF 

PROVIDER: S-EPMC6696738 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Age differences in contemporary treatment of patients with chronic heart failure and reduced ejection fraction.

Veenis Jesse F JF   Brunner-La Rocca Hans-Peter HP   Linssen Gerard Cm GC   Geerlings Peter R PR   Van Gent Marco Wf MW   Aksoy Ismail I   Oosterom Liane L   Moons Arno Hm AH   Hoes Arno W AW   Brugts Jasper J JJ  

European journal of preventive cardiology 20190313 13


<h4>Background</h4>Elderly patients are underrepresented in clinical trials but comprise the majority of heart failure patients. Data on age-specific use of heart failure therapy are limited. The European Society of Cardiology heart failure guidelines provide no age-specific treatment recommendations. We investigated practice-based heart failure management in a large registry at heart failure outpatient clinics.<h4>Design and methods</h4>We studied 8351 heart failure with reduced ejection fracti  ...[more]

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