Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2010-4-12
pubmed:abstractText
Guidelines have been established for the treatment of patients with heart failure (HF) and left ventricular dysfunction, but renal dysfunction might limit adherence to these guidelines. Few data have characterized the use of guideline-recommended therapy for patients with HF, left ventricular dysfunction, and renal dysfunction who are treated in outpatient settings. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) was a prospective study of patients receiving treatment as outpatients in cardiology practices in the United States. The rates of adherence to 7 guideline-recommended therapies were evaluated for patients with a left ventricular ejection fraction of < or = 35%. The estimated glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula for 13,164 patients who were categorized as having stage 1 through stage 4/5 chronic kidney disease (CKD). More than 1/2 (52.2%) of the patients had stage 3 or 4/5 CKD. Older patients and women were at increased risk of higher stage CKD, and the rates of co-morbid health conditions were significantly greater among patients with more severe CKD. The patients with more severe CKD were significantly less likely to receive all interventions except cardiac resynchronization therapy. However, multivariate analysis controlling for patient characteristics revealed that the severity of CKD was an independent predictor of adherence to angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy but not to any of the 6 other guideline-recommended measures. In conclusion, these results confirm that CKD is common in patients with HF and left ventricular dysfunction but is not independently associated with adherence to guideline-recommended therapy in outpatient cardiology practices, with the exception of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
1879-1913
pubmed:author
pubmed:copyrightInfo
Copyright 2010. Published by Elsevier Inc.
pubmed:issnType
Electronic
pubmed:day
15
pubmed:volume
105
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1140-6
pubmed:meshHeading
pubmed-meshheading:20381667-Aged, pubmed-meshheading:20381667-Cardiovascular Agents, pubmed-meshheading:20381667-Creatinine, pubmed-meshheading:20381667-Echocardiography, pubmed-meshheading:20381667-Female, pubmed-meshheading:20381667-Follow-Up Studies, pubmed-meshheading:20381667-Glomerular Filtration Rate, pubmed-meshheading:20381667-Guideline Adherence, pubmed-meshheading:20381667-Heart Failure, pubmed-meshheading:20381667-Humans, pubmed-meshheading:20381667-Kidney Failure, Chronic, pubmed-meshheading:20381667-Magnetic Resonance Imaging, pubmed-meshheading:20381667-Male, pubmed-meshheading:20381667-Middle Aged, pubmed-meshheading:20381667-Outpatients, pubmed-meshheading:20381667-Practice Guidelines as Topic, pubmed-meshheading:20381667-Prognosis, pubmed-meshheading:20381667-Prospective Studies, pubmed-meshheading:20381667-Renal Insufficiency, pubmed-meshheading:20381667-Stroke Volume, pubmed-meshheading:20381667-Ventricular Dysfunction, Left, pubmed-meshheading:20381667-Ventricular Function, Left
pubmed:year
2010
pubmed:articleTitle
Influence of renal function on the use of guideline-recommended therapies for patients with heart failure.
pubmed:affiliation
Scripps Clinic, La Jolla, CA, USA. Heywood.Tom@scrippshealth.org
pubmed:publicationType
Journal Article, Comparative Study