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Comprehensive heart failure assessment: A challenge to modify the course of heart failure. Author's reply

Published:February 08, 2020DOI:https://doi.org/10.1016/j.ejim.2020.01.020
      We read with great interest the article by JF Martín-Sánchez [
      • Martín-Sánchez F.J.
      Comprehensive heart failure assessment: a challenge to modify the course of heart failure.
      ] commenting on our article "Comorbidities in chronic heart failure: An update from Italian Society of Cardiology (SIC) Working Group on Heart Failure" [
      • Correale M.
      • Paolillo S.
      • Mercurio V.
      • Limongelli G.
      • Barillà F.
      • Ruocco G.
      • Palazzuoli A.
      • Scrutinio D.
      • Lagioia R.
      • Lombardi C.
      • Lupi L.
      • Magrì D.
      • Masarone D.
      • Pacileo G.
      • Scicchitano P.
      • Matteo Ciccone M.
      • Parati G.
      • Tocchetti C.G.
      • Nodari S.
      Comorbidities in chronic heart failure: an update from Italian society of cardiology (SIC) working group on heart failure.
      ]. In his editorial, FJ Martín-Sánchez highlights the need to consider two others specific issues related to comorbidity in heart failure (HF), such as polypharmacy and frailty, to improve outcomes in HF patients with comorbidity. We strongly agree on what is reported about these two issues. In particular, we join the recommendation to minimize the polypharmacy, particularly in case of advanced renal and/or hepatic failure [
      • Correale M.
      • Tarantino N.
      • Petrucci R.
      • Tricarico L.
      • Laonigro I.
      • Di Biase M.
      • Brunetti N.D.
      Liver disease and heart failure: back and forth.
      ,
      • Correale M.
      • Tricarico L.
      • Leopizzi A.
      • Mallardi A.
      • Mazzeo P.
      • Tucci S.
      • Grazioli D.
      • Di Biase M.
      • Brunetti N.D.
      Liver disease and heart failure: an uptodate.
      ] and in case of poor hemodynamic condition and, finally, in the palliative care [
      • Antonione R.
      • Sinagra G.
      • Moroni M.
      • Correale M.
      • Redaelli D.
      • Scrutinio D.
      • Malinverni E.
      • Nodari S.
      • Calabrò R.
      • Penco I.
      • Mercuro G.
      [Palliative care in the cardiac setting: a consensus document of the Italian society of cardiology/Italian society of palliative care (SIC/SICP)].
      ]. This is a very important topic, above all, for elderly patients, who take multiple medications and frequently have renal failure. FJ Martín-Sánchez also cites several possible interventions to decrease the risk of adverse drug events. These interventions should be implemented in the clinical practice.
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