Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort
Aims: Implementation of guideline-recommended pharmacological treatment in heart failure (HF) patients remains challenging. In 2021, the European Heart Failure Association (HFA) published a consensus document in which patient profiles were created based on readily available patient characteristics a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1081579/full |
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| author | Sumant P. Radhoe Pascal R. D. Clephas Gerard C. M. Linssen Remko M. Oortman Frank J. Smeele Annemarie A. Van Drimmelen Henk-Jan Schaafsma Paul H. Westendorp Hans-Peter Brunner-La Rocca Jasper J. Brugts |
| author_facet | Sumant P. Radhoe Pascal R. D. Clephas Gerard C. M. Linssen Remko M. Oortman Frank J. Smeele Annemarie A. Van Drimmelen Henk-Jan Schaafsma Paul H. Westendorp Hans-Peter Brunner-La Rocca Jasper J. Brugts |
| author_sort | Sumant P. Radhoe |
| collection | DOAJ |
| description | Aims: Implementation of guideline-recommended pharmacological treatment in heart failure (HF) patients remains challenging. In 2021, the European Heart Failure Association (HFA) published a consensus document in which patient profiles were created based on readily available patient characteristics and suggested that treatment adjusted to patient profile may result in better individualized treatment and improved guideline adherence. This study aimed to assess the distribution of these patient profiles and their treatment in a large real-world chronic HF cohort.Methods and results: The HFA combined categories of heart rate, blood pressure, presence of atrial fibrillation, chronic kidney disease, and hyperkalemia into eleven phenotypic patient profiles. A total of 4,455 patients with chronic HF and a left ventricular ejection fraction ≤40% with complete information on all characteristics were distributed over these profiles. In total, 1,640 patients (36.8%) could be classified into one of the HFA profiles. Three of these each comprised >5% of the population and consisted of patients with a heart rate >60 beats per minute with normal blood pressure (>90/60 mmHg) and no hyperkalemia.Conclusion: Nearly forty percent of a real-world chronic HF population could be distributed over the eleven patient profiles as suggested by the HFA. Phenotype-specific treatment recommendations are clinically relevant and important to further improve guideline implementation. |
| first_indexed | 2024-04-10T05:14:05Z |
| format | Article |
| id | doaj.art-b78ec14a8d904dac9e009b5d0ddec211 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-10T05:14:05Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-b78ec14a8d904dac9e009b5d0ddec2112023-03-09T05:35:13ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-03-011410.3389/fphar.2023.10815791081579Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohortSumant P. Radhoe0Pascal R. D. Clephas1Gerard C. M. Linssen2Remko M. Oortman3Frank J. Smeele4Annemarie A. Van Drimmelen5Henk-Jan Schaafsma6Paul H. Westendorp7Hans-Peter Brunner-La Rocca8Jasper J. Brugts9Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Cardiology, Hospital Group Twente, Hengelo, NetherlandsDepartment of Cardiology, Bravis Hospital, Bergen op Zoom, NetherlandsDepartment of Cardiology, Slingeland Hospital, Doetinchem, NetherlandsDepartment of Cardiology, Amphia Hospital, Breda, NetherlandsDepartment of Cardiology, Hospital Gelderse Vallei, Ede, NetherlandsDepartment of Cardiology, Rivas Beatrix Hospital, Gorinchem, NetherlandsDepartment of Cardiology, Maastricht University Medical Center, Maastricht, NetherlandsDepartment of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsAims: Implementation of guideline-recommended pharmacological treatment in heart failure (HF) patients remains challenging. In 2021, the European Heart Failure Association (HFA) published a consensus document in which patient profiles were created based on readily available patient characteristics and suggested that treatment adjusted to patient profile may result in better individualized treatment and improved guideline adherence. This study aimed to assess the distribution of these patient profiles and their treatment in a large real-world chronic HF cohort.Methods and results: The HFA combined categories of heart rate, blood pressure, presence of atrial fibrillation, chronic kidney disease, and hyperkalemia into eleven phenotypic patient profiles. A total of 4,455 patients with chronic HF and a left ventricular ejection fraction ≤40% with complete information on all characteristics were distributed over these profiles. In total, 1,640 patients (36.8%) could be classified into one of the HFA profiles. Three of these each comprised >5% of the population and consisted of patients with a heart rate >60 beats per minute with normal blood pressure (>90/60 mmHg) and no hyperkalemia.Conclusion: Nearly forty percent of a real-world chronic HF population could be distributed over the eleven patient profiles as suggested by the HFA. Phenotype-specific treatment recommendations are clinically relevant and important to further improve guideline implementation.https://www.frontiersin.org/articles/10.3389/fphar.2023.1081579/fullheart failureguideline-directed medical therapyclinical profilesguideline implementationpharmacotherapyphenotype |
| spellingShingle | Sumant P. Radhoe Pascal R. D. Clephas Gerard C. M. Linssen Remko M. Oortman Frank J. Smeele Annemarie A. Van Drimmelen Henk-Jan Schaafsma Paul H. Westendorp Hans-Peter Brunner-La Rocca Jasper J. Brugts Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort Frontiers in Pharmacology heart failure guideline-directed medical therapy clinical profiles guideline implementation pharmacotherapy phenotype |
| title | Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort |
| title_full | Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort |
| title_fullStr | Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort |
| title_full_unstemmed | Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort |
| title_short | Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort |
| title_sort | phenotypic patient profiling for improved implementation of guideline directed medical therapy an exploratory analysis in a large real world chronic heart failure cohort |
| topic | heart failure guideline-directed medical therapy clinical profiles guideline implementation pharmacotherapy phenotype |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1081579/full |
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