2023-10-22 02:57:39
Close and early post-discharge follow-up is essential to reduce the risk of rehospitalization. 80% of cardiovascular diseases are preventable. Heart failure is one of the main cardiovascular diseases.
New drugs to treat heart failure (HF) and others already known but with new indications are some of the notable advances for the management of this disease at the international meeting organized by the Heart Failure and Heart Transplant Unit of the University Hospital Complex of A Coruña (Chuac).
Among the new developments, tafamidis stands out, now available in Spain, for transthyretinal amyloidosis. “It reduces the deposition of transthyretin in the heart, delays the progression of the disease, improves survival and quality of life,” explains Marisa Crespo, one of the directors of the Chuac Unit.
Another novel drug is vericiguat, which has a different mechanism of action: “It increases cGMP and can be indicated in patients with heart failure who, despite having correct treatment, are in a situation of progression of HF, especially those who “They have suffered hospitalization.”
The SGLT2 inhibitors, dapagliflozin and empagliflozin, were used in the past as antidiabetics, but are now known to have cardiovascular as well as renal benefit.
Currently, they are indicated in patients with HF, both in reduced, slightly reduced and preserved ejection fraction. Together with the glucosuric effect, they improve survival and quality of life, are well tolerated and easy to take. The dose is a single dose, 10mg/day.
Precisely, in the update of the heart failure guidelines of the European Society of Cardiology, dapagliflozin or empagliflozin have a grade I level of evidence A indication to reduce the combination of death or hospitalizations due to HF.
Pre-discharge and post-discharge follow-up
One of the aspects that the experts gathered in A Coruña have emphasized has to do with pre-discharge recommendations and post-discharge follow-up in order to reduce the risk of rehospitalization or death from this disease.
The results of the clinical trial have been reviewed Strong-HFin which an intensive strategy of rapid initiation and updating of treatment based on evidence, that is, on clinical practice guidelines, is recommended before discharge and during follow-up visits: “These visits have to be frequent and careful in the first six weeks after hospitalization for HF,” means the Chuac specialist.
Other useful measures to prevent these patients from having to be admitted to the hospital are the incorporation of remote monitoring using implantable devices, such as the wireless lung pressure sensor (cardioMEMS device) and the use of parameters that an ICD can collect. or resynchronizer.
“In this way, developing a score risk and, based on it, prioritize care for high-risk patients, treating them and avoiding hospitalizations. It is the strategy Triage-HF “which we are already implementing in several centers in Spain and Europe.”
Asked about the applications that artificial intelligence can have in the management of heart failure, Marisa Crespo comments that there are many, especially the processing of large amounts of data at greater speed: “It can eliminate time-consuming tasks for the doctor and thus be able to be more available to the patient in tasks in which the doctor cannot be replaced.” Maria R. Lagoa
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