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Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory

Sumant P Radhoe1, Pascal R D Clephas1, Gerard C M Linssen2

  • 1Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.

Frontiers in Pharmacology
|March 27, 2023
PubMed

Insights

Implementing guideline-recommended heart failure (HF) treatments is difficult. A new study found that nearly 40% of chronic HF patients fit into European Heart Failure Association (HFA) defined profiles, suggesting phenotype-specific care can improve treatment adherence.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Guideline-recommended pharmacological treatment for heart failure (HF) presents implementation challenges.
  • The European Heart Failure Association (HFA) developed patient profiles based on clinical characteristics to guide individualized HF treatment.
  • Optimizing treatment based on patient profiles may enhance guideline adherence and patient outcomes.

Purpose of the Study:

  • To determine the distribution of HFA-defined patient profiles within a large, real-world cohort of chronic heart failure patients.
  • To assess the current treatment patterns associated with these identified patient profiles.

Main Methods:

  • Utilized data from 4,455 chronic HF patients with left ventricular ejection fraction ≤40%.
  • Classified patients into eleven phenotypic profiles based on heart rate, blood pressure, atrial fibrillation, chronic kidney disease, and hyperkalemia.
  • Analyzed the proportion of patients fitting into the HFA profiles and their treatment characteristics.

Main Results:

  • 1,640 patients (36.8%) were successfully classified into one of the eleven HFA patient profiles.
  • Three specific profiles, characterized by heart rate >60 bpm, normal blood pressure, and absence of hyperkalemia, each represented over 5% of the classified population.
  • Identified specific patient phenotypes that are prevalent in real-world chronic HF populations.

Conclusions:

  • A significant proportion (nearly 40%) of the real-world chronic HF population can be categorized using the HFA's eleven phenotypic profiles.
  • These phenotype-specific classifications are clinically relevant for improving guideline implementation in heart failure management.
  • Tailoring treatment to patient profiles holds promise for enhancing individualized care and adherence to best practices in HF.

Keywords:
clinical profilesguideline implementationguideline-directed medical therapyheart failurepersonalized medicinepharmacotherapyphenotype

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