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Frailty quick test, effective for risk stratification of inadequate treatment of heart failure

Session Poster Session 3

Speaker Juan Diego Sanchez Vega

Event : Heart Failure 2019

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

Authors : JD Sanchez Vega (Madrid,ES), GL Alonso Salinas (Madrid,ES), S Del Prado Diaz (Madrid,ES), JM Vieitez Florez (Madrid,ES), E Gonzalez Ferrer (Madrid,ES), JL Zamorano (Madrid,ES)

Authors:
JD Sanchez Vega1 , GL Alonso Salinas1 , S Del Prado Diaz1 , JM Vieitez Florez1 , E Gonzalez Ferrer1 , JL Zamorano1 , 1University Hospital Ramon y Cajal de Madrid, Cardiology - Madrid - Spain ,

Citation:

Backgroung

In the treatment of heart failure, the adequate titration of effective therapies that change the natural evolution of this disease are necessary to improve the clinical status of our patients. Despite this, the extended under dosage of these treatments are acknowledge. It appears necessary to develop the proper tools to alert this risk population, especially in the most advanced stages of heart failure.

The FRAIL scale, which can be administrated in less than 5 minutes in a consult setting, can be a useful to detect frailty, a known risk factor for under dosage.

Material and methods

We designed a transversal study, including 42 consecutive patients from the Advanced Heart Failure consult. Participants complete the FRAIL questionnaire, self administered in the waiting room before their consult. We analyzed the percentage of patients who were under different dosage (high, medium, low) of betablockers (BB), angiotensin converter enzyme inhibitors (ACEI) or angiotensin II receptor antagonists (AIIRA), and aldosterone antagonists. The patients were divided in two groups: frail (= 3 points in the FRAIL scale) and non-frail patients.

Results

The results obtained are included in Table 1. Frail patients received lower treatment with ACEI/AIIRA, BB and aldosterone antagonist, statistically significant in the last two drugs. In Figure 1 we observed how the dosage of BB and ACEI/AIIRA are lower in frail patients. Specific for ACEI, despite the absence of statistically significant differences, the dosage showed a trend for being lower, compared to non-frail patients.

Conclusion

The diagnosis of frailty through a quick and self-administered questionnaire (FRAIL) is useful to detect under dosage in effective medications in patients with heart failure.

Table 1: Titration of drugs

NON FRAIL(n=29)

FRAIL

(n=12)

p

Betablockers

26 (89,7%)

6 (50%)

0,005

ACEI/AIIRA

18 (62,1%)

6 (50%)

0,475

Aldosterone Antagonistas

25 (86,2%)

6 (50%)

0,014

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