Why the study?
Atrial fibrillation is common in chronic heart failure and influences therapy choices, but whether it affects the prescription of guideline-recommended heart failure therapy in real-world practice needed evaluation.
Does the presence of atrial fibrillation affect the prescription of guideline-recommended heart failure therapy in patients with chronic HFrEF?
Population
8253 chronic HFrEF patients from 34 Dutch outpatient clinics
Comparison
Patients with AF vs patients without AF
Design
Registry-based cross-sectional cohort study
Key result
Atrial fibrillation in HFrEF patients was associated with lower prescription of RAS-inhibitors (76.1% vs 83.1%, p<0.01) but similar rates of achieving ≥50% target dose for triple therapy.
Authors
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AF presence may reduce RAS-inhibitor initiation in HFrEF; leaves open effects on outcomes and optimal GDMT strategies.
Cohort (n=8,253)
Yes
Does the presence of atrial fibrillation affect the prescription of guideline-recommended heart failure therapy in patients with chronic HFrEF?
Absolute Event Rate: 16.6% vs 15.2%
p-value: p=0.07
In patients with chronic HFrEF, the presence of atrial fibrillation is associated with significant differences in the prescription of guideline-recommended heart failure therapies, including higher use of beta-blockers, MRAs, and digoxin, but lower use of RAS-inhibitors.
Veenis et al. (2020) conducted a cohort in Chronic heart failure with reduced ejection fraction (HFrEF) (n=8,253). Atrial fibrillation vs. No atrial fibrillation was evaluated on Receipt of beta-blockers, RAS-inhibitor and MRA at ≥50% of the recommended target dose (p=0.07). Atrial fibrillation in HFrEF patients was associated with lower prescription of RAS-inhibitors (76.1% vs 83.1%, p<0.01) but similar rates of achieving ≥50% target dose for triple therapy.
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