What is the clinical evidence from this study?

Study design: Review. Population: Heart failure. Intervention: Pharmacological and technological management strategies.

What does this research mean for the field?

Recent innovations in pharmacological, hemodynamic monitoring, and device therapies over the past decade have significantly improved clinical outcomes for patients with heart failure. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To review recent advances in pharmacotherapy, outpatient hemodynamic monitoring, and device therapies designed to improve morbidity, mortality, and readmission rates in heart failure.

March 1, 2017Vascular Health and Risk ManagementOpen Access

New pharmacological and technological management strategies in heart failure

View Full Paper

Ask AI

Bookmark

Key result

Modern drugs and device therapies improve morbidity and mortality in heart failure.

Key Points

To review recent advances in pharmacotherapy, outpatient hemodynamic monitoring, and device therapies designed to improve morbidity, mortality, and readmission rates in heart failure.
Synthesized historical shifts across nonpharmacological, pharmacological, and device management eras.
Reviewed landmark clinical trial evidence evaluating neurohormonal agents, including the PARADIGM-HF trial in 8,442 patients with reduced ejection fraction comparing sacubitril–valsartan to enalapril.
Examined clinical outcomes associated with novel device-based interventions and outpatient hemodynamic monitoring systems.
In the PARADIGM-HF trial, sacubitril–valsartan achieved a 20% relative reduction in the primary composite outcome of cardiovascular death or heart failure hospitalization compared with enalapril.
Sacubitril–valsartan also demonstrated a 20% relative reduction in both cardiovascular death and heart failure hospitalization individually, along with a 38% reduction in 30-day readmissions.
Foundational neurohormonal therapies historically reduced systolic heart failure mortality by 17% for ACE inhibitors, 34% for beta blockers, and 30% for mineralocorticoid receptor antagonists.

Structured PICO

Population

Patients with heart failure

Intervention

New pharmacological therapies (sacubitril-valsartan, ivabradine), hemodynamic monitoring (CardioMems), and device therapies (LVADs)

This review highlights the paradigm shift in heart failure management with the introduction of ARNIs, ivabradine, implantable hemodynamic monitors, and continuous-flow LVADs.

Implication

Supports consideration of new HF strategies; leaves open need for confirmatory randomized trials.

Abstract

Heart failure is a complex clinical syndrome resulting from impairment of ventricular filling or ejection of blood associated with symptoms of dyspnea, fatigue, as well as peripheral and/or pulmonary edema. This syndrome is progressive and characterized by worsening quality of life despite escalating levels of care, affecting 5.7 million Americans with an annual cost of over ≥30 billion US dollars. Treatment for this syndrome has evolved over three distinct eras: the nonpharmacological era, the pharmacological era, and the device era, with the focus shifting from symptomatic relief to decreasing morbidity and mortality. Over the past 10 years, the field has undergone a renaissance, with the development of new pharmacologic, hemodynamic monitoring, and device therapies proven to improve outcomes in patients with heart failure. This article will review several recent innovations in the management of patients with heart failure.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Chaudhry et al. (2017) conducted a review in Heart failure. Pharmacological and technological management strategies was evaluated. New pharmacological and technological management strategies, including sacubitril-valsartan, ivabradine, hemodynamic monitoring, and left ventricular assist devices, improve morbidity and mortality in patients with heart failure.

synapsesocial.com/papers/6a1da0445b7fddc352058694 https://doi.org/10.2147/vhrm.s106841