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Symptomatic despite Multiple Drug Therapy: Where do you Turn Next?

ANMCO Research Centre, Florence, Italy, maggioni{at}anmco.it

Clinicians may be reluctant to implement evidence-based guideline recommendations because they believe that patients with chronic heart failure (CHF) who are enrolled into clinical trials are not truly representative of those seen in routine practice. Moreover, there may also be perceived safety issues associated with polypharmacy in patients with CHF. Clinicians should strive to implement guideline recommendations for the management of CHF to ensure optimal patient outcome in routine clinical practice.

This case report demonstrates that symptom control may require a large number of pharmacological treatments, to be administered in accordance with guidelines.

Key Words: Chronic heart failure • Polypharmacy • Angiotensin Receptor blocker

References

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• Cohn JN, Tognoni G., Valsartan Heart Failure Trial Investigators. A randomised trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001;345:1667-75.[Abstract/Free Full Text]
• Swedberg K., Cleland J., Dargie H. et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005). The Taskforce for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005;26:1115-40.[Free Full Text]
• Maggioni AP, Latini R., Carson PE et al. Valsartan reduces the incidence of atrial fibrillation in patients with heart failure: Results from the Valsartan Heart Failure Trial (Val-HeFT). Am Heart J 2005;149:548-57.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
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Journal of Renin-Angiotensin-Aldosterone System, Vol. 6, No. 2 suppl, S13-S14 (2005)
DOI: 10.1177/14703203050060020501


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Pietro Maggioni, A. Search for Related Content PubMed Articles by Pietro Maggioni, A. Social Bookmarking                         What's this?