Currently Viewing:
European Society of Cardiology (ESC) 2017
Dr Christi Deaton on the Most Important Steps for Cardiovascular Prevention
November 12, 2017
Dr John Rumsfeld: We're Just at the Beginning of the Digital Health Transformation
November 09, 2017
Dr Jeanette Stingone on Environmental Factors That Impact Public Health
November 07, 2017
Christi Deaton: Challenges of Motivating Patients to Participate in CVD Prevention Strategies
November 04, 2017
Dr John Rumsfeld on the Digital Transformation of Cardiovascular Medicine
October 24, 2017
Dr Deepak Bhatt on the Impact of the COMPASS Trial on Standard of Care
October 19, 2017
Dr Jeanette Stingone: Air Pollution Is an Issue Everywhere in the US
October 12, 2017
Dr John Rumsfeld Outlines ACC's Main Goals for the Future of Cardiology
October 07, 2017
Dr Simon Gibbs Discusses the Future of Pulmonary Hypertension Treatments
October 03, 2017
Dr Steven Nissen Argues for Aggressively Lowering LDL Cholesterol
October 01, 2017
Dr John Eikelboom on the COMPASS Trial Findings
September 28, 2017
Dr John Eikelboom on the Surprising Results of the COMPASS Trial
September 15, 2017
Dr Simon Gibbs Outlines Monotherapy vs Combination Therapy in Pulmonary Hypertension
September 14, 2017
Dr Christi Deaton: Ask Cardiac Patients About Their Diet and Exercise
September 12, 2017
Dr Steven Nissen on Which Patients Should Be Treated With PCSK9 Inhibitors
September 11, 2017
Dr Jeanette Stingone on Lasting Cardiovascular Effects of Prenatal Exposure to Air Pollution
September 07, 2017
Dr Christi Deaton on Promoting Better Self-Management for Patients With CVD
August 29, 2017
Dr John Eikelboom: COMPASS' Rivaroxaban Plus Aspirin Will Become Standard for CAD, PAD
August 29, 2017
Currently Reading
Comorbidities in Patients With Heart Failure: Treating the Whole Patient
August 29, 2017

Comorbidities in Patients With Heart Failure: Treating the Whole Patient

Laura Joszt
Patients with heart failure tend to have other health issues, requiring cardiologists to understand how to care for heart failure while keeping in mind treatment for these other comorbidities, said panelists at the European Society of Cardiology Congress 2017, held August 26-30 in Barcelona, Spain.
Ewa A. Jankowska, MD, PhD, FESC, FHFA, of Wrocław Medical University, outlined the complication of addressing iron deficiency in patients with heart failure. Iron deficiency is prevalent in chronic heart failure and it leads to anemia, which is a predictor of a poor outcome for these patients. However, iron deficiency on its own actually has a greater impact.
 
“When we judge independently, the impact of anemia itself and iron deficiency on symptoms on survival … you may be surprised that the impact of iron deficiency itself, without anemia, is much more important than anemia itself,” she explained.
 
Iron is needed for proper energy metabolism and is present in all tissues and cells. Patients with iron deficiency have lower peak oxygen consumption levels, which reduces their exercise capacity. A study of failing hearts has found that they do not have enough iron.
 
Physicians can detect iron deficiency by testing for ferritin, which indicates how much iron is in a body. Ferritin is involved with iron metabolism and is related to the storage of intracellular iron.
 
One treatment is intravenous iron, which was studied in the FAIR-HF trial that included patients with iron deficiency who had been anemic as well as those who had not been anemic. The trial found clinical improvement in all patients.
 
There are 4 currently ongoing morbidity and mortality trials—AFFIRM-AHF, FAIR-HF-2, HEAD-FID, IRONMAN—using intravenous iron in patients with heart failure.
 
Finally, Mark Pfeffer, MD, PhD, of Harvard Medical School and Brigham & Women’s Hospital, discussed kidney dysfunction in patients with heart failure. He explained that a young person on dialysis has the mortality rate of an 80-year-old who is not on dialysis. In general, someone with kidney disease, who has not progressed as far as dialysis, has a cardiovascular risk of death that is equivalent to that of a 60- to 70-year-old person.
 
“If you have chronic kidney disease … no one Is surprised that you’re more likely to develop heart failure, have coronary heart disease, and have stroke,” Pfeffer said.
 
The problem is that there are factors that make medications not work as they’re supposed to. For instance, as kidneys fail, they no longer remove potassium or creatinine. Rising levels of both of these prevents physicians from giving more of a therapy or increasing doses for patients with heart failure.
 
There are therapies on the horizon that would combat the high levels of potassium, but it is still unclear at this point if they would allow physicians to prescribe more of a medication.
 
Pfeffer concluded by reminding the audience that the diseases all go together and impact treatment—cardiologists aren’t just treating a patient’s heart failure, they are also treating the patient’s other diseases.
 
“We should understand that it’s 1 patient, and look at the whole patient,” he said.


 
Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!