Mineralocorticoid receptor antagonist pattern of use in heart failure with reduced ejection fraction: findings from BIOSTAT‐CHF

Abstract

In this prospective observational study across Europe, MRAs were largely under-prescribed and frequently discontinued. Owing to these dynamic changes, outcome inferences are inconclusive.

The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology

“…Furthermore, MRA therapy might be useful in offsetting the hypokalaemic effect of potassium‐wasting loop and thiazide diuretics . Importantly, data indicate marked under‐utilization of MRAs as a disease‐modifying drug class in HFrEF . It is the opinion of the expert panel that early initiation of a MRA, in a regular dose (25 mg), might be useful in reducing treatment‐induced hypokalaemia and may lead to higher chance of HFrEF patients being discharged on an optimized disease‐modifying therapy regimen.…”

“…106 -108 Importantly, data indicate marked under-utilization of MRAs as a disease-modifying drug class in HFrEF. 109 It is the opinion of the expert panel that early initiation of a MRA, in a regular dose (25 mg), might be useful in reducing treatment-induced hypokalaemia and may lead to higher chance of HFrEF patients being discharged on an optimized disease-modifying therapy regimen. However, the use of MRA in the acute settings needs to be individualized with temporarily discontinuation in case of the development of hyperkalaemia.…”

Plasma proteomic approach in patients with heart failure: insights into pathogenesis of disease progression and potential novel treatment targets

“…Overall, 100 patients with HF in this study were selected from the EU FP7 funded BIOSTAT‐CHF (A systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) project. This was a multicentre clinical study in Europe that aimed to identify poor outcomes in HF patients with standard treatment using a systems biology approach (including demographics, biomarkers, genetics, and proteomics) . This project was conducted according to the Declaration of Helsinki that was approved by national and local ethics committees.…”

“…This was a multicentre clinical study in Europe 14 that aimed to identify poor outcomes in HF patients with standard treatment using a systems biology approach (including demographics, biomarkers, genetics, and proteomics). [15][16][17][18][19][20][21][22][23][24][25][26][27] This project was conducted according to the Declaration of Helsinki that was approved by national and local ethics committees. All patients in this study had written informed consent.…”

The year in cardiology 2017: heart failure

“…7 Chronic kidney disease and hyperkalaemia are common in HF 8 and reasons for MRA under-use appear to be perceived risk of or actual hyperkalaemia and worsening renal function. 9 More novel drugs such as ivabradine and sacubitril/valsartan may be deferred due to clinician inertia, even though they have demonstrated benefit regardless of HF duration 10 and very early after initiation.…”