The huge burden of heart failure disease
- One major origin of post-discharge events is the residual patient congestion that is not optimally alleviated at discharge.1
- In fact, many patients leave the hospital before their diuretic therapy is optimized.
- Another important fact is that patients are discharged before lifesaving renin-angiotensin antagonists and mineralocorticoid receptor antagonists could be optimized to reach the highest tolerable doses.2
Then why are these life-saving medications often under-utilized and under-dosed?
So, what is the expressed need here?
But this is only part of the solution … We also need to be monitoring serum potassium and renal function so that physicians can optimize not just the dose of a diuretic, but also optimize doses of ACE-I, ARB or MRA. With such a complete view of the status of their HF patient overtime, physicians would feel safe and confident so as to optimize medication precisely to each patient status.
- Coiro S et al, Prognostic value of residual pulmonary congestion at discharge assessed by lung ultrasound imaging in heart failure. Eur J Heart Fail 2015;17:1172–1181.
- 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, European Heart Journal (2016) 37, 2129–2200
- Epstein M et al, Evaluation of the gap between guidelines and the utilization of RAAS Inhibitors; Am J of Managed Care, 2015, 21, S212-S220
- Abraham W et al, Wireless pulmonary artery hemodynamic monitoring in chronic heart failure: a randomized controlled trial; Lancet 2011; 377: 658–66
What if we could ...
If there was a way to reliably, simply, and cost-effectively monitor serum potassium, renal function, and the degree of congestion in our heart failure patients at home, could we then optimize the use of these life-saving medicines? With a more comprehensive approach like this, we may be able to reduce not just hospital readmissions, but we may also be able to improve the quality of life and survival of HF patients.