Multimorbidity in Heart Failure: Leveraging Cluster Analysis to Guide Tailored Treatment Strategies.
Mariëlle C van de VeerdonkGianluigi SavareseM Louis HandokoJoline W J BeulensFolkert AsselbergsAlicia UijlPublished in: Current heart failure reports (2023)
Treatment response differed among clusters; ACE inhibitors were beneficial in all HFrEF phenotypes, while only some studies show similar beneficial prognostic effects in HFpEF patients. Beta-blockers had favourable effects in all HFrEF patients but not in HFpEF phenotypes and tended to worsen prognosis in older, cardiorenal patients. Mineralocorticoid receptor antagonists had more favourable prognostic effects in young, obese males and metabolic HFpEF patients. While a phenotype-guided approach is a promising solution for individualised treatment strategies, there are several aspects that still require improvements before such an approach could be implemented in clinical practice. Stronger evidence from clinical trials and real-world data may assist in establishing a phenotype-guided treatment approach for patient with HF in the future.
Keyphrases
- end stage renal disease
- heart failure
- ejection fraction
- newly diagnosed
- clinical trial
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- patient reported outcomes
- left ventricular
- machine learning
- bariatric surgery
- electronic health record
- big data
- angiotensin converting enzyme
- phase iii
- cardiac resynchronization therapy