Authors say better use of guideline-directed medical therapy may cut reshospitalizations, costs
By Lori Solomon HealthDay Reporter
FRIDAY, June 30, 2023 (HealthDay News) — Globally, one in four heart failure patients die within the first year of their first heart failure-related hospitalization, according to a study published online June 21 in JACC: Heart Failure.
Biykem Bozkurt, M.D., Ph.D., from Baylor College of Medicine in Houston, and colleagues described rehospitalizations, hospitalization costs, use of guideline-directed medical therapy, and mortality after hospitalization for heart failure. Analysis included electronic health record or claims data for 263,525 adult patients in Japan, Sweden, the United Kingdom, and the United States with a first heart failure discharge between 2018 and 2022.
The researchers found that 28 percent of patients died within the first year posthospitalization heart failure (event rate: 28.4). Heart failure (event rate: 13.6) and chronic kidney disease (CKD; event rate: 4.5) drove rehospitalizations. Similarly, heart failure and CKD drove health care costs. There was little change seen between 2020 and 2022 for use of renin-angiotensin system inhibitors, sacubitril/valsartan, beta-blockers, and mineralocorticoid receptor antagonists. However, uptake of sodium-glucose cotransporter-2 inhibitors increased two- to sevenfold.
“Incident posthospitalization heart failure rehospitalization risks and costs were high, and guideline-directed medical therapy use changed little in the year following discharge, highlighting the need to consider earlier and greater implementation of guideline-directed medical therapy to manage risks and reduce costs,” the authors write.
Several authors disclosed ties to the pharmaceutical industry. Medical writing support was provided by AstraZeneca, which also funds EVOLUTION HF, the longitudinal cohort study from where the data was pulled.
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