Use of disease-modifying therapies in patients hospitalized with heart failure: a population-based perspective
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Authors
Goldberg, Robert J.Spencer, Frederick A.
Farmer, Cheryl
Lessard, Darleen M.
Pezzella, Stephen M.
Meyer, Theo E.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2007-01-09Keywords
Adrenergic beta-AntagonistsAged
Analysis of Variance
Angiotensin-Converting Enzyme Inhibitors
Chi-Square Distribution
Diuretics
Female
Heart Failure
Hospitalization
Humans
Logistic Models
Male
Massachusetts
Prognosis
Retrospective Studies
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Little data are available about the hospital management of patients with decompensated heart failure (HF) with individual and combination medical therapies, particularly from the more generalizable perspective of a population-based investigation. The purpose of our study was to describe the use of different cardiac medications in 2463 patients with new-onset HF who were discharged from all greater Worcester, Massachusetts, hospitals during 2000. METHODS: On the basis of a review of medical records, we examined the prescribing of 2 classes of cardiac medications that have been shown to improve the long-term prognosis of patients with HF (angiotensin pathway inhibitors and beta-blockers). We also examined the use of 2 therapies commonly used to improve the symptomatic status of patients with acute HF (diuretics and digoxin). RESULTS: The mean age of the study sample was 76 years, and 57% were women. Approximately 1 in 5 patients were not prescribed beta-blockers or angiotensin inhibitors during their index hospitalization, whereas 1 in 3 patients were discharged with both of these effective cardiac medications. Diuretics were prescribed for virtually all patients (98%), followed by the use of digoxin in approximately half of patients (48%). The receipt of both beta-blockers and angiotensin pathway inhibitors was associated with several demographic, medical history, and clinical factors. Patients treated with both effective cardiac medications were also more likely to be counseled to monitor or modify several lifestyle factors that have been shown to be effective adjuncts to the medical management of patients with HF. CONCLUSIONS: Considerable opportunity remains for the more optimal hospital management of patients with decompensated HF.Source
Am J Med. 2007 Jan;120(1):98.e1-8. Link to article on publisher's siteDOI
10.1016/j.amjmed.2006.05.051Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47184PubMed ID
17208085Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.amjmed.2006.05.051