Juan Salazar, Instituto de Investigaciones de Enfermedades Cardiovasculares, La Universidad del Zulia (IECLUZ), Maracaibo, Venezuela
Mayela Bracho, Instituto de Investigaciones de Enfermedades Cardiovasculares, La Universidad del Zulia (IECLUZ), Maracaibo, Venezuela
Carlos Esis, Instituto de Investigaciones de Enfermedades Cardiovasculares, La Universidad del Zulia (IECLUZ), Maracaibo, Venezuela
Soledad Briceño, Instituto de Investigaciones de Enfermedades Cardiovasculares, La Universidad del Zulia (IECLUZ), Maracaibo, Venezuela
Douglas Inciarte, Instituto de Investigaciones de Enfermedades Cardiovasculares, La Universidad del Zulia (IECLUZ), Maracaibo, Venezuela
Eglé Silva, Instituto de Investigaciones de Enfermedades Cardiovasculares, La Universidad del Zulia (IECLUZ), Maracaibo, Venezuela
Background: The initiation strategies and sequence of drug therapy for heart failure with reduced ejection fraction (HFrEF) are still debatable in modern cardiology. Objective: To evaluate the opinion and points of view of Venezuelan cardiologists in relation to the initiation and pharmacological sequence for patients with HFrEF. Method: A virtual survey designed by heart failure specialists and adapted to regional characteristics was used, this was sent out to the community of Venezuelan cardiologists by e-mail and social media for three months. Results: The responses of 94 cardiologists with an overall age: 51.7 ± 12 years (men: 58.5%; n=55) were evaluated. 72.3% (n = 68) considered that the use of low doses of each pharmacological class is the best therapeutic strategy and 79.8% (n = 75) that it is possible to introduce all pharmacological classes during hospitalization and make the prescription at discharge. The selected drugs in a sequential approach were: first, renin-angiotensin system inhibitors (64.9%), second beta-blockers (55.3%), third sodium-glucose cotransporter type 2 inhibitors (42.6%) and fourth mineralocorticoid antagonists (48.9%). Conclusions: Most of the surveyed cardiologists consider that the simultaneous use of the various pharmacological classes at low doses is the best strategy to follow and that it is possible to start it in the intrahospital course. The historical sequential scheme is still common in clinical practice, renin-angiotensin system inhibitors being the preferred drugs for initiation.
Keywords: Heart failure. Pharmacotherapy. Treatment. Venezuela.