New prediction tool could help increase uptake of heart failure medicines

A groundbreaking calculator developed from over 38,000 heart failure patients could soon make it easier for doctors to prescribe the most effective treatments, potentially increasing the uptake of heart failure medications. The tool, presented at the European Society of Cardiology Congress and published in Nature Medicine, uses individual patient data to predict the effects of various treatment combinations on blood pressure, kidney function, and potassium levels.

Adoption of effective heart failure therapies has been disappointingly low, with only 2% of eligible patients receiving the recommended combination of five major drug classes. Fear of adverse effects often deters clinicians from initiating treatment, but the new calculator addresses this issue by providing personalized estimates of treatment impacts based on patient characteristics like age, sex, BMI, blood pressure, kidney function, potassium levels, and prior hospitalizations.

The calculator was validated against data from 1,016 participants in four additional trials, showing that its estimates align with observed outcomes. In trials where recommended combination therapies were used, patients experienced modest reductions in blood pressure and small to moderate increases in serum potassium, alongside early declines in kidney function.

However, these modest changes were accompanied by significant reductions in the risk of worsening heart failure events, ranging from 31% to 61% compared to standard care.

This tool has the potential to significantly improve clinical decision-making, helping clinicians feel more confident about prescribing multiple therapies simultaneously. By providing a personalized estimate of what to expect when initiating combination therapy, the tool can reduce uncertainty and encourage more patients to receive treatments that have been shown to improve long-term outcomes. The calculator is currently available at https://hfmodel.org/.