ABC Heart Fail Cardiomyop 2022; 2(1): 41-49

Personalized Treatment of Heart Failure with Reduced Ejection Fraction: Ivabradine, Nitrate/Hydralazine, and Digoxin – A Systematic Review and Meta-Analysis

Ivna Girard Cunha Vieira Lima , Edimar Alcides Bocchi

DOI: 10.36660/abchf.20220008

Introduction

In the last 30 years, treatment of chronic heart failure with reduced ejection fraction (HFrEF) has evolved considerably, and a significant reduction was achieved in mortality over time and hospitalization rates for chronic heart failure (CHF).

Neurohormonal blockade has become key in the treatment of CHF, but with the discovery of new therapies such as sodium-glucose cotransporter-2 inhibitors (SGLT2i), neprilysin inhibitors, resynchronization therapies, and new procedures, the number of treatment options in addition to standard therapy has increased considerably. However, it is known that the start of medications that reduce outcomes in CHF has historically been recommended following the order of publication of efficacy trials. Considering the many treatment options available today, a clinical question arises: is it possible to personalize additional treatments according to the patient’s clinical characteristics? This meta-analysis aims to look for populations of interest where ivabradine, hydralazine and nitrate, and digoxin could have incremental beneficial effects.

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