Gender differences in drug titration among heart failure patients with reduced ejection fraction in the ETIFIC trial
Copyright © 2021 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved..
INTRODUCTION AND OBJECTIVES: Optimal medical therapy decreases mortality and heart failure (HF) hospitalizations in HF patients with reduced left ventricular ejection fraction. Women have been underrepresented in clinical trials and not specifically evaluated. This study aimed to compare the safety and effectiveness of drug titration in women vs men.
METHODS: This post hoc gender study of the ETIFIC multicenter randomized trial included hospitalized patients with new-onset HF with reduced ejection fraction and New York Heart Association II-III and no contraindications to beta-blockers. A structured 4-month titration process was implemented in HF clinics. The primary endpoint was the mean relative dose (% of target dose) of beta-blockers achieved by women vs men. Secondary endpoints included the mean relative doses of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists, adverse events, and other clinical outcomes at 6 months.
RESULTS: A total of 320 patients were included, 83 (25.93%) women and 237 (74.06%) men (76 vs 213 analyzed). The mean±standard deviation of the relative doses achieved by women vs men were as follows: beta-blockers 62.08%±30.72% vs 64.4%±32.77%, with a difference of-2.32% (95%CI,-10.58-5.94), P = .580; and mineralocorticoid receptor antagonists 79.85%±27.72% vs 67.29%±31.43%, P =.003. No other differences in drug dosage were found. Multivariate analysis showed nonsignificant differences. CV mortality was 1 (1.20%) vs 3 (1.26%), P=1, and HF hospitalizations 0 (0.00%) vs 10 (4.22%), P=.125.
CONCLUSIONS: In a post hoc analysis from the HF-titration ETIFIC trial, we found nonsignificant gender differences in drug dosage, cardiovascular mortality, and HF hospitalizations. Trial registry number: NCT02546856.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:75 |
|---|---|
| Enthalten in: |
Revista espanola de cardiologia (English ed.) - 75(2022), 8 vom: 01. Aug., Seite 636-648 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Oyanguren, Juana [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 26.07.2022 Date Revised 26.07.2022 published: Print-Electronic ClinicalTrials.gov: NCT02546856 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.rec.2021.11.002 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM334399459 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM334399459 | ||
| 003 | DE-627 | ||
| 005 | 20231225223627.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.rec.2021.11.002 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1114.xml |
| 035 | |a (DE-627)NLM334399459 | ||
| 035 | |a (NLM)34903479 | ||
| 035 | |a (PII)S1885-5857(21)00325-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Oyanguren, Juana |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Gender differences in drug titration among heart failure patients with reduced ejection fraction in the ETIFIC trial |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.07.2022 | ||
| 500 | |a Date Revised 26.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT02546856 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a INTRODUCTION AND OBJECTIVES: Optimal medical therapy decreases mortality and heart failure (HF) hospitalizations in HF patients with reduced left ventricular ejection fraction. Women have been underrepresented in clinical trials and not specifically evaluated. This study aimed to compare the safety and effectiveness of drug titration in women vs men | ||
| 520 | |a METHODS: This post hoc gender study of the ETIFIC multicenter randomized trial included hospitalized patients with new-onset HF with reduced ejection fraction and New York Heart Association II-III and no contraindications to beta-blockers. A structured 4-month titration process was implemented in HF clinics. The primary endpoint was the mean relative dose (% of target dose) of beta-blockers achieved by women vs men. Secondary endpoints included the mean relative doses of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists, adverse events, and other clinical outcomes at 6 months | ||
| 520 | |a RESULTS: A total of 320 patients were included, 83 (25.93%) women and 237 (74.06%) men (76 vs 213 analyzed). The mean±standard deviation of the relative doses achieved by women vs men were as follows: beta-blockers 62.08%±30.72% vs 64.4%±32.77%, with a difference of-2.32% (95%CI,-10.58-5.94), P = .580; and mineralocorticoid receptor antagonists 79.85%±27.72% vs 67.29%±31.43%, P =.003. No other differences in drug dosage were found. Multivariate analysis showed nonsignificant differences. CV mortality was 1 (1.20%) vs 3 (1.26%), P=1, and HF hospitalizations 0 (0.00%) vs 10 (4.22%), P=.125 | ||
| 520 | |a CONCLUSIONS: In a post hoc analysis from the HF-titration ETIFIC trial, we found nonsignificant gender differences in drug dosage, cardiovascular mortality, and HF hospitalizations. Trial registry number: NCT02546856 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Diferencias | |
| 650 | 4 | |a Differences | |
| 650 | 4 | |a Drug | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Fármaco | |
| 650 | 4 | |a Gender | |
| 650 | 4 | |a Género | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Insuficiencia cardiaca | |
| 650 | 4 | |a Mujer | |
| 650 | 4 | |a Sex | |
| 650 | 4 | |a Sexo | |
| 650 | 4 | |a Titration | |
| 650 | 4 | |a Titulación | |
| 650 | 4 | |a Women | |
| 650 | 7 | |a Adrenergic beta-Antagonists |2 NLM | |
| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 650 | 7 | |a Mineralocorticoid Receptor Antagonists |2 NLM | |
| 700 | 1 | |a Díaz-Molina, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Lekuona, Iñaki |e verfasserin |4 aut | |
| 700 | 1 | |a González-Costello, José |e verfasserin |4 aut | |
| 700 | 1 | |a López-Fernández, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a García-Pinilla, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Garrido, Lluisa |e verfasserin |4 aut | |
| 700 | 1 | |a López-Moyano, Gracia |e verfasserin |4 aut | |
| 700 | 1 | |a Manito, Nicolás |e verfasserin |4 aut | |
| 700 | 1 | |a Cobo-Marcos, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Nebot-Margalef, Magdalena |e verfasserin |4 aut | |
| 700 | 1 | |a Latorre-García, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Arana-Arri, Eunate |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez-Fernández, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Torcal-Laguna, Jesús |e verfasserin |4 aut | |
| 700 | 0 | |a ETIFIC research team group |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Revista espanola de cardiologia (English ed.) |d 2010 |g 75(2022), 8 vom: 01. Aug., Seite 636-648 |w (DE-627)NLM206580851 |x 1885-5857 |7 nnns |
| 773 | 1 | 8 | |g volume:75 |g year:2022 |g number:8 |g day:01 |g month:08 |g pages:636-648 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.rec.2021.11.002 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 75 |j 2022 |e 8 |b 01 |c 08 |h 636-648 | ||