Among commercially insured HFrEF patients <65 years, use of dual and triple HF therapy peaked at 0-3 months post-WHFE (41.5% and 17.4%) but declined by 10-12 months (34.6% and 13.9%).
Observational (n=4,460)
Guideline-directed medical therapy for HFrEF remains underutilized and adherence declines within a year following a worsening heart failure event, even among younger, commercially insured patients.
AIMS: Data regarding patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF) following a worsening HF event (WHFE) are largely driven by findings from elderly patients. Younger patients are not well studied. The aim of this study was to evaluate treatment patterns and clinical outcomes in commercially insured chronic HFrEF patients <65 years old during 1-year periods before and after a WHFE. METHODS AND RESULTS: A retrospective claims analysis was performed using the IBM® MarketScan® Commercial Database on HFrEF patients aged <65 years during the year before and after a WHFE, defined as HF hospitalization or outpatient intravenous diuretic use. Treatment patterns, rehospitalizations, health care resource utilization, and costs were assessed. A total of 4460 HFrEF patients with WHFE were included. Guideline-recommended HF therapy was initially underutilized, increased pre-WHFE, and peaked 0-3 months post-WHFE. The proportions of patients using dual and triple therapy were 31.5% and 9.8% pre-WHFE, 41.5% and 17.4% 0-3 months post-WHFE, and 34.6% and 13.9% 10-12 months post-WHFE, respectively. Within 30 and 90 days after a WHFE, 12% and 23% of patients had HF-related and 16% and 30% had all-cause rehospitalizations, respectively. HF-related and all-cause hospitalizations and outpatient visits peaked 0-3 months post-WHFE, whereas emergency department visits peaked 0-3 months pre-WHFE. CONCLUSIONS: Use of HF medications increased pre-WHFE but decreased post-WHFE, despite recurrent hospitalizations. These findings suggest that age and insurance status may not totally explain the suboptimal treatment of HFrEF patients before and after a WHFE. Reasons for these trends need further study.
Butler et al. (Sun,) conducted a observational in Chronic heart failure with reduced ejection fraction (HFrEF) following a worsening HF event (n=4,460). Guideline-recommended HF therapy was evaluated on Treatment patterns, rehospitalizations, health care resource utilization, and costs. Among commercially insured HFrEF patients <65 years, use of dual and triple HF therapy peaked at 0-3 months post-WHFE (41.5% and 17.4%) but declined by 10-12 months (34.6% and 13.9%).