Chronic heart failure: a review of pharmacotherapy management
DOI:
https://doi.org/10.33448/rsd-v11i11.33978Keywords:
Congestive hearth failure; Heart failure with reduced ejection fraction; Pharmacotherapy; Neprilysin; Angiotensin receptor antagonists; Inhibitor sodium-glucose transporter 2.Abstract
To evaluate, describe and compare the pharmacological treatments available for heart failure (HF). This is a literature review about the pharmacological treatment of HF based on articles selected from the PubMed database, as well as relevant guidelines, using pertinent keywords and application of inclusion and exclusion criteria. Chronic heart failure is a common condition that, if untreated, harms quality of life and is associated with a high risk of mortality, morbidity, and recurrent hospitalization. However, the prognosis of patients with this condition has been improved with knowledge of the pathophysiology of HF and, therefore, assertive application of both non-pharmacological and pharmacological treatment recommendations. Pharmacotherapy is based on neurohormoral inhibition of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system to improve the health status and survival of these patients. Currently, the recommendation for the treatment of HF with reduced ejection fraction (HFrEF) includes 4 drug classes: an angiotensin/neprilysin receptor inhibitor (ANRi), beta-blockers, mineralocorticoid receptor antagonists (MRA) and SGLT2 inhibitors (SGLT2ii). Mortality-reducing pharmacotherapy in HF currently includes ANRi, beta-blockers, MRA and SGLT2. Therefore, the challenge is to transform the results achieved in clinical studies into reality for the majority of patients with HF. This path must be promoted through multidisciplinary care with improved access to recommended drugs, close monitoring of patients, healthy habits, control of comorbidities and therapeutic adherence.
References
Adams, K. F., Jr, Butler, J., Patterson, J. H., Gattis Stough, W., Bauman, J. L., van Veldhuisen, D. J., Schwartz, T. A., Sabbah, H., Mackowiak, J. I., Ventura, H. O., & Ghali, J. K. (2016). Dose response characterization of the association of serum digoxin concentration with mortality outcomes in the Digitalis Investigation Group trial. European journal of heart failure, 18(8), 1072–1081. https://doi.org/10.1002/ejhf.584
Albuquerque, D. C., Neto, J. D., Bacal, F., Rohde, L. E., Bernardez-Pereira, S., Berwanger, O., Almeida, D. R., & Investigadores Estudo BREATHE (2015). I Brazilian Registry of Heart Failure - Clinical Aspects, Care Quality and Hospitalization Outcomes. Arquivos brasileiros de cardiologia, 104(6), 433–442. https://doi.org/10.5935/abc.20150031
Amado, J., Gago, P., Santos, W., Mimoso, J., Jesus, I. (2016). Choque cardiogênico- fármacos inotrópicos e vasopressores. Rev. Port. Cardiol., 35 (12). .https://doi.org/10.1016/j.repc.2016.08.004
Araújo A. A., Nóbrega, M. M. L., & Garcia T. R (2013). .Diagnósticos e intervenções de enfermagem para pacientes portadores de insuficiência cardíaca congestiva utilizando a CIPE® Rev.Esc.Enferm.USP, 47(2), 385-9 https://doi.org/10.1590/S0080623420 130002000 16.
Barreto, A. C. P., & Ramires, J. A. F. (1998). Insuficiência cardíaca. Arq. Bras. Cardilol, 71 (4).
Batlouni, M., & Albuquerque, D. C. (2000). Beta-adrenergic blocking agents in heart failure. Arq. Bras Cardiol. .75 (4), 350-360. https://doi.org/10.1590/S0066-782X2000001000009.
Berliner, D., Hänselmann, A., & Bauersachs, J. (2020). The Treatment of Heart Failure with Reduced Ejection Fraction. Deutsches Arzteblatt international, 117(21), 376–386. https://doi.org/10.3238/arztebl.2020.0376
Brasil, Ministério da Saúde (2022). Banco de dados do Sistema Único de Saúde-DATASUS. http://www.datasus.gov.br
Braunwald E. (2013). Heart failure. JACC. Heart failure, 1(1), 1–20. https://doi.org/10.1016/j.jchf.2012.10.002
Goodman, L. S., Brunton, L. L., Chabner, B., & Knollmann, B. C. (2011). Goodman & Gilman's pharmacological basis of therapeutics: McGraw-Hill.
Burnett, H., Earley, A., Voors, A. A., Senni, M., McMurray, J. J., Deschaseaux, C., & Cope, S. (2017). Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction: A Network Meta-Analysis. Circulation. Heart failure, 10(1), e003529. https://doi.org/10.1161/CIRCHEARTFAILURE.116.003529
Cai, D. (2001). Puesta al día en el tratamiento de la insuficiencia cardíaca congestiva crónica. Revista Costarricense de Cardiología, 3(2), 22-30.
Campelo, R. C., Silva, W. C., & Batista, N. J. C. (2018) A Atuação do Enfermeiro nas Orientações para a Prevenção de Fatores Agravantes na Insuficiência Cardíaca Congestiva: Revisão Integrativa. Braz. J. Surg. Clin. Res,24 (2), 176-180.
Feitosa, G. S., & Carvalho, E. N. (2000). Sistema renina-angiotensina e insuficiência cardíaca: o uso dos antagonistas do receptor da angiotensina II. Rev Bras Hipertens 3, 250-54.
Ferrante, D. (2011) Programas de manejo en la insuficiencia cardiaca: un paso más allá de la farmacología.. Rev. Esp. Cardiol. 64 (4). https://doi.org/10.1016/j.recesp.2010.12.005.
Ferreira, M. C. S., & Gallani, M. C. B. J. (2005). Insuficiência Cardíaca: antiga síndrome, novos conceitos e a atuação do enfermeiro. Rev. Bras. enferm., 58 (1) . https://doi.org/10.1590/S0034-71672005000100013
Filho, H. V. (2007). HAS- Antagonista de Angiotensina II: Droga de 1 ou 2 escolha ?. Revista da Sociedade de Cardiologia do Rio Grande do Sul,11.
Francis, G. S., Bartos, J. A., & Adatya, S. (2014). Inotropes. Journal of the American College of Cardiology, 63(20), 2069–2078. https://doi.org/10.1016/j.jacc.2014.01.016
Heidenreich., et al. (2022) AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol,79 (17), e263–e421.
Kamel, C. S., Filho, A. G. S., Barreto, L. F., & Benchimol, M. (2001). Insuficiência Cardíaca Congestiva. Correlação entre a Classe Funcional e as Funções Sistólica e Diastólica Avaliadas pela Ecocardiografia com Doppler. Arq Bras Cardiol, 76 (2), 127-31.
Książczyk, M., & Lelonek, M. (2020). Angiotensin receptor/neprilysin inhibitor-a breakthrough in chronic heart failure therapy: summary of subanalysis on PARADIGM-HF trial findings. Heart failure reviews, 25(3), 393–402. https://doi.org/10.1007/s10741-019-09879-x
Kuster, G. M., & Pfister, O. (2019). Chronic heart failure: advances in pharmacological treatment and future perspectives. Swiss medical weekly, 149, w20036. https://doi.org/10.4414/smw.2019.20036
Koruth, J. S., Lala, A., Pinney, S., Reddy, V. Y., & Dukkipati, S. R. (2017). The Clinical Use of Ivabradine. Journal of the American College of Cardiology, 70(14), 1777–1784. https://doi.org/10.1016/j.jacc.2017.08.038
Mizzaci C, Rieira R., & Martimbianco A. L. C. (2017). Tratamento farmacológico para insuficiência cardíaca sistólica crônica e as evidências disponíveis: uma revisão narrativa da literatura. Diagn. Tratamento, 22(1), 8-20.
Magnani, G., Giugliano, R. P., Ruff, C. T., Murphy, S. A., Nordio, F., Metra, M., Moccetti, T., Mitrovic, V., Shi, M., Mercuri, M., Antman, E. M., & Braunwald, E. (2016). Efficacy and safety of edoxaban compared with warfarin in patients with atrial fibrillation and heart failure: insights from ENGAGE AF-TIMI 48. European journal of heart failure, 18(9), 1153–1161. https://doi.org/10.1002/ejhf.595
Marcondes-Braga, F. G., Moura, L., Issa, V. S., Vieira, J. L., Rohde, L. E., Simões, M. V., Fernandes-Silva, M. M., Rassi, S., Alves, S., Albuquerque, D. C., Almeida, D. R., Bocchi, E. A., Ramires, F., Bacal, F., Rossi Neto, J. M., Danzmann, L. C., Montera, M. W., Oliveira Junior, M. T., Clausell, N., Silvestre, O. M., & Mesquita, E. T. (2021). Emerging Topics Update of the Brazilian Heart Failure Guideline - 2021. Atualização de Tópicos Emergentes da Diretriz Brasileira de Insuficiência Cardíaca – 2021. Arquivos brasileiros de cardiologia, 116(6), 1174–1212. https://doi.org/10.36660/abc.20210367
Oigman, W., & Fritsch, M. T. (1998) Antagonistas de canais de cálcio. HiperAtivo, 5 (2).
Redfield, M. M., Anstrom, K. J., Levine, J. A., Koepp, G. A., Borlaug, B. A., Chen, H. H., et al. (2015). Mononitrate in Heart Failure with Preserved Ejection Fraction. N Engl J Med. 373(24):2314–24. http://dx.doi.org/10.1056/NEJMoa1510774.
Rohde, L., Montera, M. W., Bocchi, E. A., Clausell, N. O., Albuquerque, D. C., Rassi, S., Colafranceschi, A. S., Freitas, A. F., Junior, Ferraz, A. S., Biolo, A., Barretto, A., Ribeiro, A., Polanczyk, C. A., Gualandro, D. M., Almeida, D. R., Silva, E., Figueiredo, E. L., Mesquita, E. T., Marcondes-Braga, F. G., & Martins, W. A. (2018). Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arquivos brasileiros de cardiologia, 111(3), 436–539. https://doi.org/10.5935/abc.20180190
Silva. P. (2010). Farmacologia. Guanabara Koogan Editorial.
Siqueira, A. S. E., Siqueira-Filho, A. G., & Land, M. G. P. (2017). Análise do Impacto Econômico das Doenças Cardiovasculares nos Últimos Cinco Anos no Brasil. Arq. Bras. Cardiol., 109(1), 39-46.
Schwinger R. (2021). Pathophysiology of heart failure. Cardiovascular diagnosis and therapy, 11(1), 263–276. https://doi.org/10.21037/cdt-20-302
Tavares, J. G. P., et al. (2017). A simple and efficient methodology for the study of cardioprotective drugs in animal model of cardiac ischemia-reperfusion. J Mol Imag Dynamic, 7(2), 10.4172/2155-9937.1000133.
Tomasoni, D., Adamo, M., Lombardi, C. M., & Metra, M. (2019). Highlights in heart failure. ESC heart failure, 6(6), 1105–1127. https://doi.org/10.1002/ehf2.12555
Truby, L. K., & Rogers, J. G. (2020) Advanced Heart Failure: Epidemiology, Diagnosis, and Therapeutic Approaches, JACC: Heart Failure, 8( 7), 523-536. https://doi.org/10.1016/j.jchf.2020.01.014.
Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Jr, Drazner, M. H., Fonarow, G. C., Geraci, S. A., Horwich, T., Januzzi, J. L., Johnson, M. R., Kasper, E. K., Levy, W. C., Masoudi, F. A., McBride, P. E., McMurray, J. J., Mitchell, J. E., Peterson, P. N., Riegel, B., Sam, F., & American Heart Association Task Force on Practice Guidelines (2013). 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 62(16), e147–e239. https://doi.org/10.1016/j.jacc.2013.05.019
Wu, C., Boiron, R., Kechemir, H., Gandhi, S., Lin, S., Wieloch, M., & Juhaeri, J. (2021). Evaluating the Risk of Digitalis Intoxication Associated With Concomitant Use of Dronedarone and Digoxin Using Real-World Data. Clinical therapeutics, 43(5), 852–858.e2. https://doi.org/10.1016/j.clinthera.2021.03.014
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Letícia de Oliveira Pinto; Calos Eduardo Braga Filho; Matheus Ritto ; Flávia de Sousa Gehrke; Juliane Vismari de Oliveira; Marcelo Pires de Oliveira; Rafael Guzella de Carvalho; Fernando Sabia Tallo; Murched Omar Taha; Francisco Sandro Menezes Rodrigues
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
