DETERMINANTS AND CLINICAL OUTCOMES OF UPTITRATION OF RENIN-ANGIOTENSIN-ALDOSTERONEINHIBITORS AND BETA-BLOCKERS IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION HEART FAILURE CLINIC OF DR. ARNULFO ARIAS MADRID HOSPITAL COMPLEX, FEBRUARY 2017 - NOVEMBER 2018
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Introduction: Multiple trials have shown that renin angiotensin aldosterone system inhibitors (RAASI) (including angiotensin-converting enzyme inhibitors [ACEI] and angiotensin receptor blockers [ARB]) and beta-blockers (BB) reduce the risk of mortality and heart failure (HF) hospitalization in patients with heart failure with reduced ejection fraction (HFREF). However, in clinical practice, the proportion of patients reaching the doses studied in these trials is small.
Methods: through a prospective study, we identified patients with HFREF, admitted to Heart Failure Clinic of Dr. Arnulfo Arias Madrid Hospital Complex between February and August 2017, and were followed until November 2018. High doses were defined as equal to or greater than 50% and low doses as less than 50%, both ISRAA and BB
Results: we identified 54 patients; 35.8% reached high doses of RAASI and 37.7% achieved high doses of BB. HF hospitalization rate in high-dose versus low-dose RAASI group was 0% versus 25% (p: 0.024), and 0% vs. 27.3% in high-dose versus low-dose beta-blocker group (p: 0.010)
Conclusions: use of high doses of RAASI and BB reduces the risk of HF hospitalization in patients with HFREF, compared with low doses.
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