Incidence And Demographics Of Transthyretin Amyloidosis-Positive Subjects Identified By Histologic Analysis Of Tenosynovial Tissue Obtained During Carpal Tunnel Surgery
HFSA ePoster Library. Nandi S. 09/12/21; 343598; 43
Saheli Nandi
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Abstract
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Introduction: Beta-blocker (BB) therapy is an essential component of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF). Use of guideline specified target dose or the maximum tolerable BB dose is associated with beneficial effects that might extend beyond those related to heart rate (HR) reduction and is, therefore, strongly recommended. We aim to explore BB utilization patterns, predictors of BB dose uptitration, and its association with resting HR in a newly established heart failure program in the Middle East.
Methods: HFrEF patients seen in our outpatient clinic and treated with a BB (n=152) were identified using retrospective chart review. Data on patient characteristics and medication use at baseline and 12-month follow-up were collected and compared between patients who did and those who did not achieve BB target dose using appropriate tests. Predictors of receiving guideline-specified target dose of BB were determined using multivariable logistic regression.
Results: A total of 152 HFrEF patients received a BB at 12-month follow-up, most commonly with bisoprolol (63.1%), followed by carvedilol (24.3%) and metoprolol (12.5%). More patients achieved BB target dose from baseline to follow-up (32% to 54.6%, p<0.01). However, proportion of patients achieving resting HR<70 bpm did not change significantly over time (35.5% vs. 34.9%, p=0.9). Patients receiving BB target dose at follow-up (n=83) were younger and more likely to be diabetic (Table 1). Age, baseline systolic blood pressure, and diabetes mellites were independent predictors of achieving BB target dose at follow-up, but baseline resting HR was not (Table 2). In addition, being treated with an ACEI, ARB, or ARNI at baseline was associated with more likelihood of achieving BB target dose at 1-year follow-up.
Conclusion: In our young program, nearly half of HFrEF patients did not achieve BB target dose over a year of follow-up, with the majority of them having inadequately controlled resting HR. Identifying other patient-related factors that prevent escalation of GDMT may help efforts to achieve recommended target doses.
Methods: HFrEF patients seen in our outpatient clinic and treated with a BB (n=152) were identified using retrospective chart review. Data on patient characteristics and medication use at baseline and 12-month follow-up were collected and compared between patients who did and those who did not achieve BB target dose using appropriate tests. Predictors of receiving guideline-specified target dose of BB were determined using multivariable logistic regression.
Results: A total of 152 HFrEF patients received a BB at 12-month follow-up, most commonly with bisoprolol (63.1%), followed by carvedilol (24.3%) and metoprolol (12.5%). More patients achieved BB target dose from baseline to follow-up (32% to 54.6%, p<0.01). However, proportion of patients achieving resting HR<70 bpm did not change significantly over time (35.5% vs. 34.9%, p=0.9). Patients receiving BB target dose at follow-up (n=83) were younger and more likely to be diabetic (Table 1). Age, baseline systolic blood pressure, and diabetes mellites were independent predictors of achieving BB target dose at follow-up, but baseline resting HR was not (Table 2). In addition, being treated with an ACEI, ARB, or ARNI at baseline was associated with more likelihood of achieving BB target dose at 1-year follow-up.
Conclusion: In our young program, nearly half of HFrEF patients did not achieve BB target dose over a year of follow-up, with the majority of them having inadequately controlled resting HR. Identifying other patient-related factors that prevent escalation of GDMT may help efforts to achieve recommended target doses.
Introduction: Beta-blocker (BB) therapy is an essential component of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF). Use of guideline specified target dose or the maximum tolerable BB dose is associated with beneficial effects that might extend beyond those related to heart rate (HR) reduction and is, therefore, strongly recommended. We aim to explore BB utilization patterns, predictors of BB dose uptitration, and its association with resting HR in a newly established heart failure program in the Middle East.
Methods: HFrEF patients seen in our outpatient clinic and treated with a BB (n=152) were identified using retrospective chart review. Data on patient characteristics and medication use at baseline and 12-month follow-up were collected and compared between patients who did and those who did not achieve BB target dose using appropriate tests. Predictors of receiving guideline-specified target dose of BB were determined using multivariable logistic regression.
Results: A total of 152 HFrEF patients received a BB at 12-month follow-up, most commonly with bisoprolol (63.1%), followed by carvedilol (24.3%) and metoprolol (12.5%). More patients achieved BB target dose from baseline to follow-up (32% to 54.6%, p<0.01). However, proportion of patients achieving resting HR<70 bpm did not change significantly over time (35.5% vs. 34.9%, p=0.9). Patients receiving BB target dose at follow-up (n=83) were younger and more likely to be diabetic (Table 1). Age, baseline systolic blood pressure, and diabetes mellites were independent predictors of achieving BB target dose at follow-up, but baseline resting HR was not (Table 2). In addition, being treated with an ACEI, ARB, or ARNI at baseline was associated with more likelihood of achieving BB target dose at 1-year follow-up.
Conclusion: In our young program, nearly half of HFrEF patients did not achieve BB target dose over a year of follow-up, with the majority of them having inadequately controlled resting HR. Identifying other patient-related factors that prevent escalation of GDMT may help efforts to achieve recommended target doses.
Methods: HFrEF patients seen in our outpatient clinic and treated with a BB (n=152) were identified using retrospective chart review. Data on patient characteristics and medication use at baseline and 12-month follow-up were collected and compared between patients who did and those who did not achieve BB target dose using appropriate tests. Predictors of receiving guideline-specified target dose of BB were determined using multivariable logistic regression.
Results: A total of 152 HFrEF patients received a BB at 12-month follow-up, most commonly with bisoprolol (63.1%), followed by carvedilol (24.3%) and metoprolol (12.5%). More patients achieved BB target dose from baseline to follow-up (32% to 54.6%, p<0.01). However, proportion of patients achieving resting HR<70 bpm did not change significantly over time (35.5% vs. 34.9%, p=0.9). Patients receiving BB target dose at follow-up (n=83) were younger and more likely to be diabetic (Table 1). Age, baseline systolic blood pressure, and diabetes mellites were independent predictors of achieving BB target dose at follow-up, but baseline resting HR was not (Table 2). In addition, being treated with an ACEI, ARB, or ARNI at baseline was associated with more likelihood of achieving BB target dose at 1-year follow-up.
Conclusion: In our young program, nearly half of HFrEF patients did not achieve BB target dose over a year of follow-up, with the majority of them having inadequately controlled resting HR. Identifying other patient-related factors that prevent escalation of GDMT may help efforts to achieve recommended target doses.
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