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Patient profiling in heart failure for tailoring medical therapy: a consensus document of the Heart Failure Association of the European Society of Cardiology

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dc.contributor.authorRosano, Giuseppe M. C.
dc.contributor.authorMoura, Brenda
dc.contributor.authorMetra, Marco
dc.contributor.authorBöhm, Michael
dc.contributor.authorBauersachs, Johann
dc.contributor.authorBen Gal, Tuvia
dc.contributor.authorAdamopoulos, Stamatis
dc.contributor.authorAbdelhamid, Magdy
dc.contributor.authorBistola, Vasiliki
dc.contributor.authorČelutkienė, Jelena
dc.contributor.authorChioncel, Ovidiu
dc.contributor.authorFarmakis, Dimitrios
dc.contributor.authorFerrari, Roberto
dc.contributor.authorFilippatos, Gerasimos
dc.contributor.authorHill, Loreena
dc.contributor.authorJankowska, Ewa A.
dc.contributor.authorJaarsma, Tiny
dc.contributor.authorJhund, Pardeep
dc.contributor.authorLainscak, Mitja
dc.contributor.authorLopatin, Yuri
dc.contributor.authorLund, Lars H.
dc.contributor.authorMilicic, Davor
dc.contributor.authorMullens, Wilfried
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorPonikowski, Piotr
dc.contributor.authorSavarese, Gianluigi
dc.contributor.authorThum, Thomas
dc.contributor.authorVolterrani, Maurizio
dc.contributor.authorAnker, Stefan D.
dc.contributor.authorSeferovic, Petar M.
dc.contributor.authorCoats, Andrew J. S.
dc.date.accessioned2022-07-20T16:56:08Z
dc.date.available2022-07-20T16:56:08Z
dc.date.issued2021
dc.description© 2021 European Society of Cardiologypt_PT
dc.description.abstractDespite guideline recommendations and available evidence, implementation of treatment in heart failure (HF) is poor. The majority of patients are not prescribed drugs at target doses that have been proven to positively impact morbidity and mortality. Among others, tolerability issues related to low blood pressure, heart rate, impaired renal function or hyperkalaemia are responsible. Chronic kidney disease plays an important role as it affects up to 50% of patients with HF. Also, dynamic changes in estimated glomerular filtration rate may occur during the course of HF, resulting in inappropriate dose reduction or even discontinuation of decongestive or neurohormonal modulating therapy in clinical practice. As patients with HF are rarely naïve to pharmacologic therapies, the challenge is to adequately prioritize or select the most appropriate up-titration schedule according to patient profile. In this consensus document, we identified nine patient profiles that may be relevant for treatment implementation in HF patients with a reduced ejection fraction. These profiles take into account heart rate (<60 bpm or >70 bpm), the presence of atrial fibrillation, symptomatic low blood pressure, estimated glomerular filtration rate (<30 or >30 mL/min/1.73 m2 ) or hyperkalaemia. The pre-discharge patient, frequently still congestive, is also addressed. A personalized approach, adjusting guideline-directed medical therapy to patient profile, may allow to achieve a better and more comprehensive therapy for each individual patient than the more traditional, forced titration of each drug class before initiating treatment with the next.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Heart Fail. 2021 Jun;23(6):872-881pt_PT
dc.identifier.doi10.1002/ejhf.2206pt_PT
dc.identifier.eissn1879-0844
dc.identifier.issn1388-9842
dc.identifier.urihttp://hdl.handle.net/10451/53893
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/journal/18790844pt_PT
dc.subjectAtrial fibrillationpt_PT
dc.subjectBlood pressurept_PT
dc.subjectChronic kidney diseasept_PT
dc.subjectClinical profilespt_PT
dc.subjectGuideline-directed medical therapypt_PT
dc.subjectHeart failurept_PT
dc.subjectHeart ratept_PT
dc.subjectHyperkalaemiapt_PT
dc.subjectPre-discharge patientpt_PT
dc.titlePatient profiling in heart failure for tailoring medical therapy: a consensus document of the Heart Failure Association of the European Society of Cardiologypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage881pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage872pt_PT
oaire.citation.titleEuropean Journal of Heart Failurept_PT
oaire.citation.volume23pt_PT
person.familyNamePinto
person.givenNameFausto J.
person.identifier1308889
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.orcid0000-0002-8034-4529
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id7102740158
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5f44176f-69f5-482c-83cd-ab94425a6ec3
relation.isAuthorOfPublication.latestForDiscovery5f44176f-69f5-482c-83cd-ab94425a6ec3

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