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Treatment of patients with heart failure with reduced ejection fraction (HFrEF) in Germany: differences between cardiologists and primary care physicans

Session Poster Session 2

Speaker Uwe Zeymer

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : U Zeymer (Ludwigshafen Am Rhein,DE), R Groves (Nuremberg,DE), T Merkel (Nuremberg,DE)

Authors:
U Zeymer1 , R Groves2 , T Merkel2 , 1Institut für Herzinfarktforschung - Ludwigshafen Am Rhein - Germany , 2Novartis Pharma - Nuremberg - Germany ,

Citation:

Background 
Simultaneosly  two prospective non-interventional patient registries were conducted to assess the treatment of chronic heart failure with reduced ejection fraction (HFrEF) therapy: AURORA assessed HF therapy as provided by primary care physicians in Germany, whereas ARIADNE assessed HF therapy as provided by private practice based cardiologists / internal medicine specialists across Europe. 
Purpose 
Here, two real-world cohorts of HFrEF patients treated by primary care physicans vs. specialists are compared. 
Methods 
Consecutive patients with symptomatic chronic HF (NYHA II–IV) and reduced LVEF were eligible  for both studies. Baseline demographics, medical history and heart failure medication data are presented here according to HFrEF Treatment (Sacubitril/Valsartan) SacVal or "conventional" standard of care HF therapy (SoC) as per index visit. AURORA  enrolled 1260 HFrEF patients treated by 220 primary care physicians (PCP) throughout Germany. ARIADNE data represents a subgroup of 4768 patients enrolled in Germany by 340 specialists.
Results 
The baseline characteristics and HF treatments are given in the table. 
Conclusion 
 In Germany characteristics and treatment of patients with chronic HFrEF differ between primary care physicans and specialists, with a higher rate of guideline recommended therapy by specialists. For both PCP- and specialist-treated patients, a higher HF symptom burden (NYHA class/LVEF) at baseline resulted in a more common selection of Sac/Val therapy above conventional HF therapy.

AURORA

ARIADNE

Sac/Val

SoC

Sac/Val

SoC

N

761

499

2409

2359

Age (yrs)

72.4

73.3

67.8

69.5

Diabetes

47.0

42.7

35.5

35.2

Coronary artery disease

63.6

61.5

59.1

63.1

LV-EF

38.3

34.9

32.7

36.3

NYHA class > II

67.4

47.7

60.2

33.4

HF-medication

Beta Blocker

71.6

60.1

85.2

86.2

MRA

33.0

24.8

57.1

51.7

Loop diuretics

61.1

53.7

63.1

57.6

ACEi

17.7

34.5

4.2

56.7

ARB

10.8

19.6

3.6

31.2

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