Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience
Background: The role of medical therapy for heart failure with reduced ejection fraction (HFrEF) in subjects with end-stage renal disease receiving renal transplantation (RT) is understudied. Here, we describe post-RT HFrEF medical management practices at a single urban, academic tertiary care cente...
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Elsevier
2024-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235290672400201X |
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| author | Michael C. Hill Kaitlyn Legg Amer Ardati Vicki Groo |
| author_facet | Michael C. Hill Kaitlyn Legg Amer Ardati Vicki Groo |
| author_sort | Michael C. Hill |
| collection | DOAJ |
| description | Background: The role of medical therapy for heart failure with reduced ejection fraction (HFrEF) in subjects with end-stage renal disease receiving renal transplantation (RT) is understudied. Here, we describe post-RT HFrEF medical management practices at a single urban, academic tertiary care center. Methods: RT recipients between January 1, 2015 and November 30, 2020 with history of ejection fraction (EF) <40 % prior to RT were included. Medications, renal function, blood pressure, cardiology follow-up, and echocardiograms ≥90d post-RT were retrospectively collected for 2 years post-RT. Results and conclusions: 47/750 (6.3 %) of RT recipients had prior HFrEF diagnosis, of whom 26 experienced improvement in EF prior to RT. Pre-RT medical therapy included beta blocker (BB) in 43 (92 %) of subjects and renin-angiotensin-aldosterone inhibitors (RAASi) in 23 (49 %). By 24 months post-RT, BB were used in 34 (76 %) and RAASi were used in 12 (27 %) of subjects. Rates of post-RT cardiology follow-up (51 %) and echocardiogram (38 %) were lower than expected in this cohort. Of 29 subjects potentially eligible for RAASi based on preserved renal function and no hyperkalemia or hypotension episodes during follow-up, only 6 (21 %) received RAASi. Of 6 subjects with post-RT EF <50 %, 4 were eligible but did not receive RAASi. Multidisciplinary collaboration between cardiology and transplant teams may help improve care for this high-risk patient population. |
| format | Article |
| id | doaj-art-99d624fe40784ae1966b268c82b0deb2 |
| institution | OA Journals |
| issn | 2352-9067 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-99d624fe40784ae1966b268c82b0deb22025-08-20T02:07:01ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672024-12-015510153510.1016/j.ijcha.2024.101535Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experienceMichael C. Hill0Kaitlyn Legg1Amer Ardati2Vicki Groo3Division of Cardiology, Department of Medicine, University of Illinois Chicago College of Medicine, Chicago, IL, USADepartment of Pharmacy, University of Maryland Medical Center, USADivision of Cardiology, Department of Medicine, University of Illinois Chicago College of Medicine, Chicago, IL, USADepartment of Pharmacy Practice, University of Illinois Chicago Retzky College of Pharmacy, Chicago, IL, USA; Corresponding author.Background: The role of medical therapy for heart failure with reduced ejection fraction (HFrEF) in subjects with end-stage renal disease receiving renal transplantation (RT) is understudied. Here, we describe post-RT HFrEF medical management practices at a single urban, academic tertiary care center. Methods: RT recipients between January 1, 2015 and November 30, 2020 with history of ejection fraction (EF) <40 % prior to RT were included. Medications, renal function, blood pressure, cardiology follow-up, and echocardiograms ≥90d post-RT were retrospectively collected for 2 years post-RT. Results and conclusions: 47/750 (6.3 %) of RT recipients had prior HFrEF diagnosis, of whom 26 experienced improvement in EF prior to RT. Pre-RT medical therapy included beta blocker (BB) in 43 (92 %) of subjects and renin-angiotensin-aldosterone inhibitors (RAASi) in 23 (49 %). By 24 months post-RT, BB were used in 34 (76 %) and RAASi were used in 12 (27 %) of subjects. Rates of post-RT cardiology follow-up (51 %) and echocardiogram (38 %) were lower than expected in this cohort. Of 29 subjects potentially eligible for RAASi based on preserved renal function and no hyperkalemia or hypotension episodes during follow-up, only 6 (21 %) received RAASi. Of 6 subjects with post-RT EF <50 %, 4 were eligible but did not receive RAASi. Multidisciplinary collaboration between cardiology and transplant teams may help improve care for this high-risk patient population.http://www.sciencedirect.com/science/article/pii/S235290672400201XHeart failureRenal transplantationQuality improvementMedication management |
| spellingShingle | Michael C. Hill Kaitlyn Legg Amer Ardati Vicki Groo Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience International Journal of Cardiology: Heart & Vasculature Heart failure Renal transplantation Quality improvement Medication management |
| title | Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience |
| title_full | Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience |
| title_fullStr | Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience |
| title_full_unstemmed | Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience |
| title_short | Heart failure medication use and follow-up patterns in renal transplant recipients with reduced ejection fraction: A single-center experience |
| title_sort | heart failure medication use and follow up patterns in renal transplant recipients with reduced ejection fraction a single center experience |
| topic | Heart failure Renal transplantation Quality improvement Medication management |
| url | http://www.sciencedirect.com/science/article/pii/S235290672400201X |
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