Comparison of Medication Practices in Patients With Heart Failure and Preserved Versus Those With Reduced Ejection Fraction (from the Cardiovascular Research Network [CVRN])
Department of Medicine, Division of Geriatric Medicine; Department of Quantitative Health Sciences; Meyers Primary Care Institute; Department of Medicine, Division of Cardiovascular Medicine
Cardiotonic Agents; Heart Failure; Population Surveillance; Stroke Volume; Ventricular Function, Left
Cardiology | Cardiovascular Diseases | Health Services Administration | Health Services Research
Limited data exist describing the differences in the medical treatment of patients with heart failure with preserved ejection fraction (HF-PEF) from those with heart failure with reduced ejection fraction (HF-REF) in more generalizable population-based cohorts. We studied patients with incident HF diagnosed from 2005 to 2008 from 4 sites participating in the Cardiovascular Research Network. These patients, their medication profile, and left ventricular systolic function status were identified from the hospital discharge and ambulatory visit diagnoses, pharmacy dispensing information, and imaging reports found in the health plan electronic databases and through chart review. The study population consisted of 6,210 patients with newly diagnosed HF-PEF and 3,914 patients with newly diagnosed HF-REF. The mean age of our study population was 73 years, 48% were women, and 74% were white. The patients with HF-REF were less likely to have been treated with various cardiac and HF-related medications before their index HF event; however, they were significantly more likely to have been treated with new cardiac medications and HF therapies after the diagnosis of HF than were the patients with HF-PEF. After controlling for several potentially confounding factors, the patients with HF-PEF were significantly less likely to have been treated with multiple cardiac drug regimens (adjusted odds ratio 0.69, 95% confidence interval 0.59 to 0.81) and multiple HF-related therapies (adjusted odds ratio 0.40, 95% confidence interval 0.38 to 0.42) than were patients with HF-REF. In conclusion, the present results from a large, population-based sample suggest considerable variation in the previous and new use of different cardiac medication classes of drugs in patients with HF-PEF versus HF-REF.
DOI of Published Version
Am J Cardiol. 2013 May 1;111(9):1324-9. doi: 10.1016/j.amjcard.2013.01.276. Link to article on publisher's site
The American journal of cardiology
Goldberg, Robert J.; Gurwitz, Jerry H.; Saczynski, Jane S.; Hsu, Grace; McManus, David D.; Magid, David J.; Smith, David H.; and Go, Alan S., "Comparison of Medication Practices in Patients With Heart Failure and Preserved Versus Those With Reduced Ejection Fraction (from the Cardiovascular Research Network [CVRN])" (2013). Quantitative Health Sciences Publications and Presentations. 1089.