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Disease-Modifying Drug Regimen May Offer Benefit in Heart Failure

Lower risk for cardiovascular death or hospital admission seen in HF with reduced ejection fraction

THURSDAY, May 28, 2020 (HealthDay News) — The treatment effects of early comprehensive disease-modifying pharmacological therapy are considerable for patients with heart failure with reduced ejection fraction (HFrEF), according to a study published online May 21 in The Lancet.

Muthiah Vaduganathan, M.D., from Harvard Medical School in Boston, and colleagues estimated lifetime gains in event-free and overall survival with comprehensive therapy (angiotensin receptor-neprilysin inhibitors, β blockers, mineralocorticoid receptor antagonists, and sodium/glucose cotransporter 2 inhibitors) versus conventional therapy (angiotensin-converting enzyme inhibitor or angiotensin receptor blockers and β blockers) in patients with chronic HFrEF. The treatment effects were estimated by making indirect comparisons of three pivotal trials.

The researchers found that for the primary end point of cardiovascular death or hospital admission for heart failure, the hazard ratio for the imputed aggregate treatment effects of comprehensive disease-modifying therapy versus conventional therapy was 0.38. Hazard ratios were also favorable for cardiovascular death alone, hospital admission for heart failure alone, and all-cause mortality (hazard ratios, 0.50, 0.32, and 0.53, respectively). Compared with conventional therapy, treatment with comprehensive disease-modifying pharmacological therapy was estimated to afford 2.7 to 8.3 additional years free from cardiovascular death or first hospital admission for heart failure for an 80- and 55-year-old, respectively, and 1.4 to 6.3 additional years of survival, respectively.

“The survival benefits estimated with comprehensive disease-modifying pharmacological therapy might be important in shared therapeutic decision making and future health system valuation,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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