The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction.

IF 4.2 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiac Failure Review Pub Date : 2021-11-26 eCollection Date: 2021-03-01 DOI:10.15420/cfr.2021.18
Nicholas K Brownell, Boback Ziaeian, Gregg C Fonarow
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引用次数: 19

Abstract

There are gaps in the use of therapies that save lives and improve quality of life for patients with heart failure with reduced ejection fraction, both in the US and abroad. The evidence is clear that initiation and titration of guideline-directed medical therapy (GDMT) and comprehensive disease-modifying medical therapy (CDMMT) to maximally tolerated doses improves patient-focused outcomes, yet observational data suggest this does not happen. The purpose of this review is to describe the gap in the use of optimal treatment worldwide and discuss the benefits of newer heart failure therapies including angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter 2 inhibitors. It will also cover the efficacy and safety of such treatments and provide potential pathways for the initiation and rapid titration of GDMT/CDMMT.

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空白填补:快速启动和最佳滴定综合疾病改善药物治疗心力衰竭与降低射血分数的基本原理。
无论是在美国还是在国外,在挽救心力衰竭患者的生命和提高其生活质量的治疗方法的使用方面都存在差距。有证据表明,指南导向药物治疗(GDMT)和综合疾病改善药物治疗(CDMMT)的起始和滴定达到最大耐受剂量可以改善以患者为中心的结果,但观察数据表明这种情况并未发生。本综述的目的是描述世界范围内使用最佳治疗方法的差距,并讨论包括血管紧张素受体-奈普利素抑制剂和钠-葡萄糖共转运蛋白2抑制剂在内的新型心力衰竭治疗方法的益处。它还将涵盖此类治疗的有效性和安全性,并为GDMT/CDMMT的启动和快速滴定提供潜在途径。
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来源期刊
CiteScore
5.60
自引率
0.00%
发文量
31
审稿时长
9 weeks
期刊最新文献
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