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Characterizing patients with chronic heart failure in community care after hospitalization : a potential role for ivabradine
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Elder, Douglas H., Mohan, Mohapradeep, Cochrane, Lynda, Charles, Helena and Lang, Chim C. (2015) Characterizing patients with chronic heart failure in community care after hospitalization : a potential role for ivabradine. Cardiovascular Therapeutics, 33 (3). pp. 104-108. doi:10.1111/1755-5922.12117 ISSN 1755-5922.
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Official URL: https://doi.org/10.1111/1755-5922.12117
Abstract
Aims
To identify the prevalence and characteristics of recently hospitalized chronic heart failure (CHF) patients in community care who meet the indication for ivabradine.
Methods
A retrospective clinical audit of CHF patients recently hospitalized with acute decompensated heart failure (ADHF) and subsequently referred to the Tayside Heart Failure Nurse Liaison Service (THFNLS), a Scottish nurse‐led community heart failure liaison service. Inclusion criteria were previous hospitalization with ADHF, subsequent referral to the THFNLS, data for ≥2 nurse visits, and a recorded pulse. The main outcome measure was the proportion of patients who meet the indicated criteria for ivabradine.
Results
In the UK, ivabradine is indicated for CHF with systolic dysfunction in patients in sinus rhythm, with a heart rate ≥75 bpm, and NYHA class II–class IV. After up‐titration of a beta‐blocker, 19.0% of patients in the full dataset (158 of 830) met the indication for ivabradine at the last visit. Of these “ivabradine‐suitable” patients, 101 of 158 (63.9%) received bisoprolol “at any time” during the study period; 20 of 158 (12.7%) achieved the target dose (10 mg daily); 52 of 158 (32.9%) received 5 mg or 7.5 mg daily; and 93 of 158 (58.9%) received <5 mg daily.
Conclusions
In this group of Scottish patients previously hospitalized with ADHF and under the care of a protocol‐driven clinic, 19% met the indication for ivabradine and may benefit from the increased control of CHF that ivabradine can provide. Among these “ivabradine‐suitable” patients, <15% achieved the target dose of beta‐blockers, illustrating the substantial clinical need for a well‐tolerated and effective therapy such as ivabradine.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Cardiovascular Therapeutics | ||||
Publisher: | Wiley-Blackwell Publishing, Inc | ||||
ISSN: | 1755-5922 | ||||
Official Date: | June 2015 | ||||
Dates: |
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Volume: | 33 | ||||
Number: | 3 | ||||
Page Range: | pp. 104-108 | ||||
DOI: | 10.1111/1755-5922.12117 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access | ||||
Description: | Free Access |
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