Beta-blockers utilization in heart failure patients: Sub-analysis of a nation-wide population-based study in the Czech Republic

Táborský, Miloš; Aiglová, Renata; Lazarová, Marie; Pavlů, Luděk; Daněk, Josef; Přeček, Jan; Schee, Alexander; Gloger, Vít; Vícha, Marek; Škála, Tomáš

doi:10.5507/bp.2020.057

Cited by 3 publications

(1 citation statement)

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“…To představuje 41 %. 5 Celosvětově trpí chronickým srdečním selháním 64 milionů lidí. 6 Chronické srdeční selhání je hlavní příčinou hospitalizace u nemocných starších 65 let.…”

Section: Epidemiologieunclassified

(Type 2 diabetes and heart failure - how to optimize cooperation of cardiologist and diabetologist)

Kubíčková¹,

Bis²

2021

Cor Vasa

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Srdeční selhání a diabetes mellitus 2. typu se často vyskytují společně a jsou spojeny s nepříznivou prognózou a vysokou mortalitou. Kardiovaskulární studie s inhibitory sodíko-glukózového kotransportéru 2 (SGLT2) provedené v posledních letech u diabetiků 2. typu prokázaly příznivý vliv na redukci hospitalizací pro srdeční selhání. Tento příznivý efekt prokázaný u všech glifl ozinů (empaglifl ozinu, dapaglifl ozinu, canaglifl ozinu) se stal předmětem dalšího výzkumu, a tak i nadějí pro léčbu srdečního selhání. Studie DA-PA-HF s dapaglifl ozinem zaměřená na pacienty s chronickým srdečním selháním a sníženou ejekční frakcí (HFrEF) potvrdila pokles hospitalizací pro srdeční selhání a pokles mortality z kardiovaskulárních příčin i celkové mortality u nemocných léčených dapaglifl ozinem bez ohledu na přítomnost diabetu. Dapaglifl ozin je tak nejen antidiabetikem, ale stává se i lékem vhodným pro léčbu chronického srdečního selhání se sníženou ejekční frakcí.

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Section: Epidemiologieunclassified

(Type 2 diabetes and heart failure - how to optimize cooperation of cardiologist and diabetologist)

Kubíčková¹,

Bis²

2021

Cor Vasa

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Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2‐year adverse outcomes. Data from the FARNHL registry

Labr,

Spinar,

Parenica

et al. 2024

Journal of Diabetes

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Background/AimThe study aims to describe the role of diabetes in patients with heart failure.MethodsIn all, 1052 chronic heart failure patients were included in the FARmacology and NeuroHumoral Activation (FAR NHL) multicenter prospective registry. They had ejection fraction below 50% and were on stable medication for at least 1 month.ResultsMore than one‐third (38.9%) of the patients had diabetes mellitus (DM). Diabetic patients (N = 409) were older (median 67 vs. 64, p < 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m2, p < 0.001), much more frequently had ischemic heart disease (71 vs. 47%, p < 0.001), hypertension (80 vs. 67%, p < 0.001), dyslipidemia (89 vs. 69%, p < 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m2, p < 0.001), and higher N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) (median 681 vs. 463 pg/mL, p = 0.003). All‐cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2‐year follow‐up. In the 2‐year follow‐up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (p = 0.089). DM is a statistically significant predictor of NT‐proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT‐proBNP level was high, the presence of DM did not influence the prognosis.ConclusionThe combination of diabetes and NT‐proBNP levels may better stratify the prognosis of patients with chronic heart failure.image

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Comparison of Patients with Reduced and Mildly Reduced Left Ventricular Ejection Fraction: Intermediate Data from the FAR NHL Registry

et al. 2022

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Introduction: We present the results of a study by the Pharmacology and NeuroHumoral Activation Registry (FAR NHL), which collects data on patients with chronic heart failure. The register contains 1088 patients from three workplaces in the Czech Republic which specialize in the care of patients with heart failure. Objectives: The aim was to obtain a comparison of pharmacotherapy and the incidence of comorbidities in patients with reduced ejection fraction (HFrEF) versus patients with mid-range (or newly mildly reduced) ejection fraction (HFmrEF). Methods: Patients with a baseline left ventricular ejection fraction below 50% were included and divided into HFrEF with EF below 40% and HFmrEF with EF 40–49%, according to the 2016 ESC Guidelines. In addition to the clinical condition, we also monitored laboratory parameters, comorbidities and pharmacotherapy in the patients. Results: Patients with HFrEF versus HFmrEF are more likely to be male (p < 0.008), younger (p < 0.001), have lower systolic blood pressure and are less likely to have ischemic etiology of heart failure (p < 0.001). There were no differences between the groups in the proportion of comorbidities: hypertension, diabetes mellitus, dyslipidemia, ischemic lower limb disease or chronic obstructive pulmonary disease. There were no differences in the proportion of smokers and non-smokers between the groups. Patients with HFrEF have a higher class of New York Heart Association (NYHA), a level of N-terminal fraction of natriuretic peptide B (NT-proBNP), and a higher level of urea and uric acid. They are more often treated with loop diuretics or mineral corticosteroid receptor (MRA) blockers and less often with thiazides (p < 0.001), and also have a worse two-year prognosis. Conclusion: Compared to patients with HFmrEF, patients with HFrEF have more severe heart failure, more pronounced neurohumoral activation and a worse prognosis. They do not differ in the presence of comorbidities.

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Beta-blockers utilization in heart failure patients: Sub-analysis of a nation-wide population-based study in the Czech Republic

Cited by 3 publications

References 15 publications

(Type 2 diabetes and heart failure - how to optimize cooperation of cardiologist and diabetologist)

(Type 2 diabetes and heart failure - how to optimize cooperation of cardiologist and diabetologist)

Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2‐year adverse outcomes. Data from the FARNHL registry

Comparison of Patients with Reduced and Mildly Reduced Left Ventricular Ejection Fraction: Intermediate Data from the FAR NHL Registry

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