Treatment with beta-blockers in nurse-led heart failure clinics: titration efficacy and predictors of failure.
Eur J Heart Fail
; 9(9): 910-6, 2007 Sep.
Article
em En
| MEDLINE
| ID: mdl-17572146
ABSTRACT
BACKGROUND:
Beta-blockers (BBs) are a cornerstone in the treatment of chronic heart failure (HF), but several surveys have documented that many patients are not offered treatment or are not titrated to target doses. In part to address this problem, specialized, nurse-led HF clinics have been initiated in many countries. However, little information is available to describe if such programs are successful in initiating and up-titrating BBs in daily clinical practice.AIMS:
To assess the proportion of patients with HF due to left ventricular systolic dysfunction on BB treatment three months after referral to a nurse-led HF clinic, and to identify baseline predictors of treatment failure.METHODS:
Consecutive records from 14 Danish nurse-led HF clinics were used.RESULTS:
1533 patients met inclusion criteria. Mean age was 68.7 years and 72% were men. Three months after the initial HF clinic visit 63% of the patients were being treated with a BB. Mean dose (relative to target dose) was 63 (+/-35)% in patients receiving a BB and target dose was reached by 21%. Patients who were not on BBs were more often female, elderly and in NYHA class III-IV. In a multivariable model only lower age predicted BB use at three months (P<0.05). Younger age (P<0.001) and higher systolic blood pressure (P<0.001) were associated with higher doses of BB.CONCLUSION:
BB up-titration continues to be a challenge even in specialized clinics dedicated to this task. Elderly patients appear to be less likely to receive treatment.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Disfunção Ventricular Esquerda
/
Antagonistas Adrenérgicos beta
/
Insuficiência Cardíaca
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Heart Fail
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Dinamarca