Chf medications
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Summary
10 papers analyzed
These studies suggest that various medications and interventions, including EPO with IV iron, perhexiline, Xinmailong Injection, and guanxinshutong capsules, as well as strategies to improve medication adherence and interdisciplinary reviews, can improve cardiac function, patient outcomes, and reduce hospitalizations in chronic heart failure patients.
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Medications for Chronic Heart Failure (CHF)
Correction of Anemia in CHF Patients
Erythropoietin and Intravenous Iron
Anemia is a common comorbidity in patients with severe congestive heart failure (CHF). A study investigated the effects of correcting anemia using subcutaneous erythropoietin (EPO) and intravenous (IV) iron in patients with moderate to severe CHF. The results showed significant improvements in cardiac function, patient functionality, and reduced hospitalization rates. Specifically, patients receiving EPO and IV iron experienced a 42.1% improvement in New York Heart Association (NYHA) class, a 5.5% increase in left ventricular ejection fraction (LVEF), and a substantial reduction in the need for diuretics and hospital days.
Enhancing Medication Adherence in CHF
Systematic Review of Adherence Interventions
Medication adherence is crucial for the effective management of CHF. A systematic review highlighted that nonadherence to medications such as angiotensin-converting enzyme inhibitors, β-blockers, and spironolactone is a significant barrier to treatment efficacy. Strategies to enhance adherence, such as patient education and regular follow-ups, have shown potential in improving survival rates and reducing hospitalizations.
Interdisciplinary Physician-Pharmacist Reviews
An interdisciplinary approach involving both physicians and pharmacists can optimize drug treatment for CHF patients. A subanalysis of the PHARM-CHF trial demonstrated that medication reviews led to significant changes in medication plans, improving adherence and potentially reducing drug-related problems. This approach harmonized and optimized the drug treatment, affecting one-third of the medications reviewed.
Novel Treatments for CHF
Perhexiline
Perhexiline, an antianginal drug, has shown promise as a novel treatment for CHF by enhancing metabolic efficiency. A randomized controlled trial found that perhexiline significantly improved peak exercise oxygen consumption, LVEF, and quality of life in CHF patients. The treatment also improved myocardial function and skeletal muscle energetics without adverse effects, suggesting it could be a valuable addition to CHF therapy.
Xinmailong Injection
Xinmailong Injection (XMLI), derived from Periplaneta americana, has been used in China for CHF treatment. A meta-analysis of 26 randomized controlled trials indicated that XMLI, when combined with conventional therapy, significantly improved LVEF, 6-minute walking distance, and reduced levels of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP). The combination therapy also showed a better overall effective rate compared to conventional treatment alone.
Traditional and Complementary Treatments
Guanxinshutong Capsules
Guanxinshutong (GXST) capsules, commonly used for coronary heart disease, have shown potential benefits for CHF patients. A multicenter, randomized, double-blind, placebo-controlled trial is underway to evaluate the efficacy and safety of GXST in CHF patients with reduced LVEF. Preliminary findings suggest that GXST may improve exercise capacity and reduce plasma levels of NT-proBNP, contributing to better management of CHF.
Conclusion
The management of chronic heart failure involves a multifaceted approach, including the correction of anemia, enhancing medication adherence, and exploring novel and complementary treatments. Erythropoietin and IV iron, interdisciplinary medication reviews, perhexiline, Xinmailong Injection, and Guanxinshutong capsules have all shown potential in improving outcomes for CHF patients. Continued research and high-quality clinical trials are essential to confirm these findings and optimize treatment strategies.
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