Esto se considera preferible a iniciar menos medicamentos a una dosis máxima. El primer objetivo es garantizar que las 4 clases de medicación recomendadas se inicien cuanto antes para establecer una terapia eficaz, incluso a dosis bajas. El objetivo de esta revisión es proponer un algoritmo pragmático para optimizar el tratamiento, diseñado para que sea lo más fácil posible de aplicar en la práctica diaria. En consecuencia, muchos pacientes con IC-FEr no pasan a un régimen de tratamiento optimizado. Sin embargo, no especifican cómo deben introducirse y ajustarse estos tratamientos. Application of this algorithm should allow an optimal treatment protocol to be achieved within 2-months in most patients, which should the treatment goal in HFrEF.Įl tratamiento de los pacientes con insuficiencia cardiaca con fracción de eyección reducida (IC-FEr) con una combinación de 4 clases de fármacos se recomienda en las principales guías de práctica clínica internacionales. Specific proposals are made for older patients (> 75 years) who are frail, and for those with cardiac rhythm disorders. The second goal is to ensure that the intervals between the introduction of different medications and between different titration steps are as short as possible to ensure patient safety. This is considered preferable to starting fewer medications at a maximum dose. The first goal is to ensure that all 4 recommended medication classes are initiated as early as possible to establish effective therapy, even at a low dose. This review proposes a pragmatic algorithm for treatment optimization designed to be easily applied in routine practice. Consequently, many patients with HFrEF do not receive an optimized treatment regimen. Major international practice guidelines recommend the use of a combination of 4 medication classes in the treatment of patients with heart failure with reduced ejection fraction (HFrEF) but do not specify how these treatments should be introduced and up-titrated.
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