Ryan Haumschild, PharmD, MS, MBA: Do you want patients to start different treatments based on whether they have a reduced or preserved ejection fraction? What are the main differences when it comes to clustering?
Rohit Uppal, MD, MBA, SFH: Doctor [John E.] Anderson entertained this question nicely. The difference in terms of population health is insignificant. Looking at these two groups, our goals for them are very similar. Negative morbidity outcomes were found to be similar in both groups. So what can you do to reduce symptoms and improve quality of life? As a hospitalist, can you reduce the risk of readmission? , there is no clear evidence that our interventions reduce mortality. But certainly the goal of reducing morbidity is important. A lower ejection fraction makes the strategy clearer. How do you provide evidence-based, goal-directed care to your patients? Nothing to add about sequencing.
Because we see patients with preserved ejection fraction and many comorbidities, we focus more on managing heart failure symptoms and improving quality of life over time, a common condition seen with CHF. I’m here. [congestive heart failure]: High blood pressure, atrial fibrillation [atrial fibrillation], coronary artery disease, and diabetes.We manage these comorbidities as we do in non-CHF populations, unless a second or third treatment potentially overlaps with heart failure treatment. Dr. Anderson mentioned SGLT2 [inhibitors] Mineralocorticoid receptor antagonists in diabetics or hypertension are good examples.
Ryan Haumschild, PharmD, MS, MBA: Thanks for that overview. Dr. Anderson gave his opinion on the initial treatment and did a great job. It helps guide many decisions. As long as they get these results and manage their comorbidities, they have the best chance of slowing the progression of heart failure.
Edited transcript for clarity.