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Pharmacological treatment of patients with HFrEF: is it really optimized in case of CRT and/or ICD implantation?

Abstract : Background Cardiac resynchronization (CRT) as well as implantable cardiac defibrillator (ICD) in primary prevention should be considered in patients with heart failure and reduced ejection fraction (HFrEF) only when pharmacological treatment has been optimized. Purpose we sought to analyze pharmacological treatments according to the presence or not of CRT-P, CRT-D or ICD in real life HFrEF patients by using a multicenter survey. Methods the survey (NCT01956539) was carried out between 2015 and 2018 in 32 hospitals and included 2735 patients with HF who gave their consent during consultation or hospitalization. In this study, we analyzed only outpatients with chronic HFrEF treated for more than 6 months. Results among 1061 patients studied, 138 had CRT-P or CRT-D and 215 had ICD for primary prevention. The main clinical characteristics were: age 65±13 years, ischemic heart disease in, NYHA classes 1, 2, 3 and 4 in 15%, 52%, 23% and 10% cases respectively, systolic blood pressure 115mmHg [IQR 104–129], heart rate 70bpm [IQR 60–80], eGFR 64ml/min/1.73m2 [IQR 46–83]and LVEF was 30% [IQR 24–34]. The table shows the rate of use of evidence-based drugs and the dose for ACEi/ARB and betablockers, according to the presence of ICD or CRT. Conclusion these results suggest that pharmacological treatment remains poorly optimized in a number of patients with HFrEF who received ICD or CRT
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Soumis le : vendredi 18 février 2022 - 14:01:45
Dernière modification le : vendredi 9 septembre 2022 - 10:20:08

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D. Logeart, R. Isnard, T. Damy, M. Salvat, J. C. Eicher, et al.. Pharmacological treatment of patients with HFrEF: is it really optimized in case of CRT and/or ICD implantation?. European Heart Journal, Oxford University Press (OUP), 2019, ESC Congress 2019 together with World Congress of Cardiology, 40 (1 (Suppl.)), pp.959. ⟨10.1093/eurheartj/ehz748.0416⟩. ⟨hal-03579996⟩

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