Heart failure pharmacological treatments and outcomes in heart failure with mildly reduced ejection fraction
Why the study?
Guideline recommendations for treating HFmrEF derive from small subgroups in post-hoc analyses of randomized trials, leaving a need for large real-world evidence.
Does the use of RASI/ARNI and beta-blockers reduce cardiovascular mortality, heart failure hospitalization, and all-cause mortality in patients with HFmrEF?
Population
12 421 patients with HFmrEF (EF 40-49%) from the Swedish HF Registry
Comparison
Use vs non-use of RASI/ARNI and beta-blockers
Design
Propensity score-matched registry-based cohort study
Authors
Discussion
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Member takes
Implication
May support RASI/ARNI and beta-blockers in HFmrEF; extends evidence but leaves open need for RCTs.
Structured PICO
Does the use of RASI/ARNI and beta-blockers reduce cardiovascular mortality, heart failure hospitalization, and all-cause mortality in patients with HFmrEF?
P
Population
12,421 patients with heart failure with mildly reduced ejection fraction (HFmrEF, EF 40-49%) from the Swedish HF Registry.
I
Intervention
Renin-angiotensin system inhibitors/angiotensin receptor neprilysin inhibitors (RASI/ARNI) and beta-blockers.
C
Comparator
Propensity score-matched cohort (implied non-users of the respective medications).
O
Outcome
Cardiovascular (CV) mortality/HF hospitalization (HFH), and all-cause mortality.composite
In a large real-world cohort of patients with HFmrEF, the use of RASI/ARNI and beta-blockers was associated with significantly lower risks of cardiovascular mortality, heart failure hospitalization, and all-cause mortality.
Cite This Study
Stolfo et al. (2023) studied this question.