OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020
Background Heart failure (HF) is an increasing health problem globally. Profound sex-related differences have been observed regarding the cause, treatment, and prognosis of HF.Aim To assess baseline predictors for achieving optimal medical treatment (OMT) and the prognostic importance of OMT for mal...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Blood Pressure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/08037051.2025.2481229 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849766492153839616 |
|---|---|
| author | Alaa Sharfo Astrid Lahn Sørensen Emil Eik Nielsen Ilan Esra Raymond Anne Merete Boas Soja Michael Hecht Olsen |
| author_facet | Alaa Sharfo Astrid Lahn Sørensen Emil Eik Nielsen Ilan Esra Raymond Anne Merete Boas Soja Michael Hecht Olsen |
| author_sort | Alaa Sharfo |
| collection | DOAJ |
| description | Background Heart failure (HF) is an increasing health problem globally. Profound sex-related differences have been observed regarding the cause, treatment, and prognosis of HF.Aim To assess baseline predictors for achieving optimal medical treatment (OMT) and the prognostic importance of OMT for male and female patients who have attended a HF clinical program (HFCP).Methods OPTIHEART was a retrospective study that included 870 consecutive patients with left ventricular ejection fraction (LVEF)≤40% discharged from HFCP in 2018, 2019 or 2020 and followed in registers for a mean of 1083(SD 11.3) days. OMT was defined as receiving an angiotensin-converting-enzyme-inhibitor (ACEi), angiotensin-receptor blocker (ARB) or angiotensin-II-receptor blocker and nephrylisin-inhibitor (ARNI) AND a betablocker (BB) both in doses ≥ 50% of target doses.Results Achieving OMT was associated with male sex (OR: 2.05 95%CI 1.44-2.97; p < 0.0001) independently of younger age, higher diastolic blood pressure (DBP), and lower creatinine. A lower rate of 5-point MACE was associated with achieved OMT (HR: 0.67 95%CI 0.50-0.90; p = 0.007) independently of female sex (HR: 0.64 95%CI 0.48-0.84; p = 0.002), younger age, never smoking and NYHA ≤ 2. The beneficial effect of OMT was insignificantly more pronounced in patients with male sex, older age, higher creatinine, lower DBP, and body mass index ≤25kg/m2.Conclusion OMT was more frequently achieved in patients with male sex independently of age, DBP, and creatinine. Achieving OMT was associated with less 5-point MACE independently of female sex, younger age, never smoking and NYHA ≤ 2. |
| format | Article |
| id | doaj-art-d8db0208d9114841b47dfa0f9e561559 |
| institution | DOAJ |
| issn | 0803-7051 1651-1999 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Blood Pressure |
| spelling | doaj-art-d8db0208d9114841b47dfa0f9e5615592025-08-20T03:04:34ZengTaylor & Francis GroupBlood Pressure0803-70511651-19992025-12-0134110.1080/08037051.2025.2481229OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020Alaa Sharfo0Astrid Lahn Sørensen1Emil Eik Nielsen2Ilan Esra Raymond3Anne Merete Boas Soja4Michael Hecht Olsen5Department of Internal Medicine 1, Holbaek Hospital, Holbaek, DenmarkDepartment of Internal Medicine 1, Holbaek Hospital, Holbaek, DenmarkDepartment of Internal Medicine 1, Holbaek Hospital, Holbaek, DenmarkDepartment of Cardiology, Copenhagen University Hospital, Amager and Hvidovre Hospital, Hvidovre, DenmarkDepartment of Internal Medicine 1, Holbaek Hospital, Holbaek, DenmarkDepartment of Internal Medicine 1, Holbaek Hospital, Holbaek, DenmarkBackground Heart failure (HF) is an increasing health problem globally. Profound sex-related differences have been observed regarding the cause, treatment, and prognosis of HF.Aim To assess baseline predictors for achieving optimal medical treatment (OMT) and the prognostic importance of OMT for male and female patients who have attended a HF clinical program (HFCP).Methods OPTIHEART was a retrospective study that included 870 consecutive patients with left ventricular ejection fraction (LVEF)≤40% discharged from HFCP in 2018, 2019 or 2020 and followed in registers for a mean of 1083(SD 11.3) days. OMT was defined as receiving an angiotensin-converting-enzyme-inhibitor (ACEi), angiotensin-receptor blocker (ARB) or angiotensin-II-receptor blocker and nephrylisin-inhibitor (ARNI) AND a betablocker (BB) both in doses ≥ 50% of target doses.Results Achieving OMT was associated with male sex (OR: 2.05 95%CI 1.44-2.97; p < 0.0001) independently of younger age, higher diastolic blood pressure (DBP), and lower creatinine. A lower rate of 5-point MACE was associated with achieved OMT (HR: 0.67 95%CI 0.50-0.90; p = 0.007) independently of female sex (HR: 0.64 95%CI 0.48-0.84; p = 0.002), younger age, never smoking and NYHA ≤ 2. The beneficial effect of OMT was insignificantly more pronounced in patients with male sex, older age, higher creatinine, lower DBP, and body mass index ≤25kg/m2.Conclusion OMT was more frequently achieved in patients with male sex independently of age, DBP, and creatinine. Achieving OMT was associated with less 5-point MACE independently of female sex, younger age, never smoking and NYHA ≤ 2.https://www.tandfonline.com/doi/10.1080/08037051.2025.2481229Heart failuresex-related differencesoptimal medical treatmentprognosisrehabilitation |
| spellingShingle | Alaa Sharfo Astrid Lahn Sørensen Emil Eik Nielsen Ilan Esra Raymond Anne Merete Boas Soja Michael Hecht Olsen OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 Blood Pressure Heart failure sex-related differences optimal medical treatment prognosis rehabilitation |
| title | OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 |
| title_full | OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 |
| title_fullStr | OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 |
| title_full_unstemmed | OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 |
| title_short | OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 |
| title_sort | optiheart determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020 |
| topic | Heart failure sex-related differences optimal medical treatment prognosis rehabilitation |
| url | https://www.tandfonline.com/doi/10.1080/08037051.2025.2481229 |
| work_keys_str_mv | AT alaasharfo optiheartdeterminantsandprognosticimportanceofoptimalmedicaltreatmentinpatientswithheartfailurewithreducedejectionfractiondischargedfromaheartfailureclinicfrom2018to2020 AT astridlahnsørensen optiheartdeterminantsandprognosticimportanceofoptimalmedicaltreatmentinpatientswithheartfailurewithreducedejectionfractiondischargedfromaheartfailureclinicfrom2018to2020 AT emileiknielsen optiheartdeterminantsandprognosticimportanceofoptimalmedicaltreatmentinpatientswithheartfailurewithreducedejectionfractiondischargedfromaheartfailureclinicfrom2018to2020 AT ilanesraraymond optiheartdeterminantsandprognosticimportanceofoptimalmedicaltreatmentinpatientswithheartfailurewithreducedejectionfractiondischargedfromaheartfailureclinicfrom2018to2020 AT annemereteboassoja optiheartdeterminantsandprognosticimportanceofoptimalmedicaltreatmentinpatientswithheartfailurewithreducedejectionfractiondischargedfromaheartfailureclinicfrom2018to2020 AT michaelhechtolsen optiheartdeterminantsandprognosticimportanceofoptimalmedicaltreatmentinpatientswithheartfailurewithreducedejectionfractiondischargedfromaheartfailureclinicfrom2018to2020 |