Patient-Centered Heart Failure Therapy - 06/12/23

Abstract |
Simultaneous initiation of quadruple therapy with angiotensin receptor-neprilysin inhibitor, beta-adrenergic receptor blocker, mineralocorticoid receptor antagonist, and sodium glucose cotransporter 2 inhibitor aims at prompt improvement and prevention of readmission in patients hospitalized for heart failure with reduced ejection fraction. However, titration of quadruple therapy is time consuming. Lengthy up-titration of quadruple therapy may negate the benefit of early initiation. Quadruple therapy should start with a sodium glucose cotransporter 2 inhibition and a mineralocorticoid antagonist, as both enable safe decongestion and require minimal or no titration. Depending on the level of decongestion and clinical characteristics, patients receive an angiotensin receptor-neprilysin inhibitor or a beta-adrenergic receptor blocker to be titrated after hospital discharge. Outpatient addition of an angiotensin receptor-neprilysin inhibitor to a beta-adrenergic receptor blocker or vice versa completes the quadruple therapy scheme. By focusing on decongestion and matching intervention to patients’ profile, the present therapeutic sequence allows rapid implementation of quadruple therapy at fully recommended doses.
El texto completo de este artículo está disponible en PDF.Keywords : Guideline-directed medical therapy, Heart failure with reduced ejection fraction, Quadruple therapy, Titration
Esquema
| Funding: None. |
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| Authorship: All authors had access to the data, and contributed to the authorship. |
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| Declaration of Competing Interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
Vol 137 - N° 1
P. 23-29 - janvier 2024 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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