SPC365

The representativeness of VICTORIA and GALACTIC-HF trials in a contemporary cohort of patients with heart failure with reduced ejection fraction

Session: Posters - D. Heart Failure
Speaker: Andreia Campinas

Congress: CPC 2021
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.7 Chronic Heart Failure - Other
Session Type: Posters
FP Number: ---
Authors: Andreia Campinas; Sérgio Campos; Ricardo Costa; André Dias De Frias; Anaisa Pereira; Maria Trêpa; Catarina Peixoto Gomes; Mário Silva Santos; Severo Torres

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><u><span style="font-family:&quot;Times New Roman&quot;,serif">Introduction</span></u><span style="font-family:&quot;Times New Roman&quot;,serif">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#212121">New therapies for heart failure with reduced ejection fraction (HFrEF) have been recently developed. It is still unclear the proportion of patients of clinical practice that will benefit from them. W</span></span></span><span style="font-family:&quot;Times New Roman&quot;,serif">e aimed to examine the representativeness of the VICTORIA and GALACTIC-HF trials among a contemporary cohort of HFrEF patients followed at an HF outpatient clinic.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><u><span style="font-family:&quot;Times New Roman&quot;,serif">Methods</span></u><span style="font-family:&quot;Times New Roman&quot;,serif">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif">We performed a retrospective, cross-sectional, single-center study of 100 consecutive HFrEF patients from our HF outpatient clinic (January-June 2020). VICTORIA eligibility criteria were an LVEF &lt;45%; NT-proBNP &gt;=1000 pg/mL if sinus rhythm (SR) or &gt;=1600 pg/mL if atrial fibrillation (Afib); and prior hospitalization in the last 6 months or IV diuretic therapy in the last 3 months. GALACTIC-HF eligibility criteria were an LVEF &lt;35%, hospitalization or emergency room visit in the last 12 months; NT-proBNP &gt; 400 ng/mL if SR or &gt;=1200 pg/mL if Afib or atrial flutter.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><u><span style="font-family:&quot;Times New Roman&quot;,serif">Results</span></u><span style="font-family:&quot;Times New Roman&quot;,serif">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif">The mean age of our patients was 62&plusmn;12 years and only 24% were female. The etiology of HF was ischemic in 42% of the patients, 86% of patients were in NYHA II class and 5% in NYHA III-IV. The mean LVEF was 34&plusmn;5% and the median NT-proBNP was 482 pg/mL [172-1120]. Regarding treatment, 92% of patients were on betablockers (BB), 67% on ACEI/ARBs, 25% on ARNI, 81% on MRA and 30% on iSGLT2. The use of implantable cardioverter-defibrillators was 38% </span><span style="background-color:white"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">an</span></span></span><span style="font-family:&quot;Times New Roman&quot;,serif">d 20% of patients were resynchronized. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif">The proportion of patients meeting VICTORIA and GALACTIC-HF eligibility criteria was 11% and 21%, respectively. But excluding the criteria of recent hospitalization the representativeness of the VICTORIA trial increased to 28% and the GALACTIC-HF to 44%. The patients that met VICTORIA eligibility criteria were older (60&plusmn;11 y vs 10&plusmn;12 y; p=0.006), had worse functional class (NYHA III-IV: 18% vs 3%; p=0.03), were less likely to be treated with an MRA (55% vs 85%; p=0.013) and an iSGLT2 (0% vs 34%; p=0.02). Those that met GALACTIC-HF eligibility criteria had a lower LVEF (31&plusmn;3% vs 35&plusmn;6%; p=0.01), were less likely to be treated with an iSGLT2 (35% vs 10%; p=0.02) and more likely to be treated with a loop diuretic (86% vs 65%; p=0.06). </span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><u><span style="font-family:&quot;Times New Roman&quot;,serif">Conclusions:</span></u></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif">In a contemporary optimally treated HFrEF cohort only a small proportion of patients met the eligibility criteria used in VICTORIA and GALACTIC-HF trials, which identified older patients with more advanced disease. </span></span></span></p>