The Prevalence and Characteristic of Patients Achieve Target Doses of Medications Used to Treat Heart Failure with Reduced Ejection Fraction at Heart Failure Clinic

Abstract

OBJECTIVES: To determine the prevalence and characteristics of patients who achieved target doses of angiotensin converting enzyme inhibitors (ACEIs)/ angiotensin II receptor blockers (ARBs), beta-blocker, and mineralocorticoid receptor antagonists (MRAs).

MATERIALS AND METHODS: A retrospective chart review study of heart failure with reduced ejection fraction (HFrEF) patients who received ACEIs/ARBs, beta-blockers, or MRAs and follow-up more than four times at the heart failure outpatient clinic, Chonburi hospital from February 1st, 2017 to February 29th, 2020. Patient data were retrieved from electronic medical records. Two authors collected data into record form (CRF) independently. Achieving target doses was defined by recommended doses according to the ACC/AHA/HFSA Guideline, 2017. The comparison of continuous data was conducted with the Mann-Whitney U test. Pearson Chi-Square and Fisher’s exact test were used for the comparison of categorical data.

RESULTS: Patients who achieved target doses of ACEIs/ARBs, beta-blockers and MRAs was 73.3%, 55.3%, and 7.1% respectively. Patients’ characteristics of achieved target doses of ACEIs/ARBs were higher baseline left ventricular ejection fractions (p = 0.026). Younger age (p = 0.016), body mass index (BMI) ≥ 23 kg/m2 (p = 0.037; OR 5.3) and serum creatinine ≤ 2 mg/dL (p = 0.004) were the characteristics of patients who achieved target doses of beta-blockers.

CONCLUSION: Most patients in heart failure clinic achieved target doses of ACEIs/ARBs followed by beta-blockers but only a few patients for MRAs. Patient and medical characteristics were different in target doses achievable.