Key result
Recent medical and device therapies, including SGLT2 inhibitors, vericiguat, transcatheter mitral valve repair, and cardiac contractility modulation, effectively improve prognosis and reduce hospitalization and death in patients with HFrEF.
Why the study?
HFrEF remains a major public health problem with high mortality, but medical and device therapies have significantly improved in recent years.
Do new therapeutic strategies prevent hospitalization and death in patients with acute and chronic HFrEF?
Systematic Review
Do new therapeutic strategies prevent hospitalization and death in patients with acute and chronic HFrEF?
This systematic review summarizes evidence from 23 RCTs demonstrating the prognostic benefits of newer pharmacological and device therapies in HFrEF.
Updated HFrEF therapies may reduce hospitalizations; extends evidence on medical and device strategies in acute and chronic settings.
Acute and chronic heart failure with reduced ejection fraction (HFrEF) is a major public health problem, studies showing a 25% survival rate at 5 years after hospitalization. If left untreated, it is a common and potentially fatal disease. In recent years, the medical and device therapies of patients with HFrEF have significantly improved. The aim of our review is to provide an evidence-based update on new therapeutic strategies in acute and chronic settings, to prevent hospitalization and death in patients with HFrEF. We performed a systematic literature search on PubMed, EMBASE, and the Cochrane Database of Systemic Reviews, and we included a number of 23 randomized controlled trials published in the last 30 years. The benefit of beta-blockers and renin-angiotensin-aldosterone system inhibitors in patients with HFrEF is well known. Recent developments, such as sodium-glucose cotransporter 2 inhibitors, vericiguat, transcatheter mitral valve repair, wireless pulmonary artery pressure monitor and cardiac contractility modulation, have also proven effective in improving prognosis. In addition, other new therapeutic agents showed encouraging results, but they are currently being studied. The implementation of personalized disease management programs that directly target the cause of HFrEF is crucial in order to improve prognosis and quality of life for these patients.
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Stătescu et al. (2021) conducted a systematic review in Heart failure with reduced ejection fraction (HFrEF). Medical and device therapies (including SGLT2 inhibitors, vericiguat, ARNI, CRT, ICD, transcatheter mitral valve repair, and cardiac contractility modulation) vs. Placebo, no medication, or standard medical therapy was evaluated on All-cause mortality, sudden cardiac death, cardiovascular death, cardiovascular/HF hospitalization, or worsening HF event. Recent medical and device therapies, including SGLT2 inhibitors, vericiguat, transcatheter mitral valve repair, and cardiac contractility modulation, effectively improve prognosis and reduce hospitalization and death in patients with HFrEF.
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