Abstract
Aim: To perform clinical characterization of patients with chronic heart failure (CHF) in the Moscow Region and to assess if their current treatments meet the current clinical guidelines.Materials and methods: Based on the information submitted from 11 outpatient clinics in the Moscow Region in December 2019, we analyzed retrospective data on 286 patients with CHF, including their concomitant diseases, types of assessments and their results, as well as current treatments.Results: The most common concomitant disease was arterial hypertension (95.1% of the patients). 53.8% of the patients had previous myocardial infarction, 37.8%, diabetes mellitus, and 34.6%, atrial fibrillation. Chronic kidney disease was present in 18.5% of the patients, valvular heart disease in 11.9%, and past stroke in 10.5%. Of non-cardiovascular diseases, the most common were gastrointestinal disorders (25.2%), chronic obstructive pulmonary disease or asthma (9.8%), and anemia (5.2%). Only 8% of the patients had one concomitant disease, whereas 72% had 2 to 3 diseases, and 20% had at least 4 concomitant diseases. Mean number of comorbidities per patient was 2.7. Echocardiography had been performed in 82.9% of the cases. Mean left ventricular ejection fraction was 51.0±10.11%; in 11.5% of the patients it was≤40%. Glomerular filtration rate (GFR) was calculated in 58.7% of the patients. 35.9% of the patients had a GFR of less than 60 mL/min/1.73 m2 , in 3.6% it was≤30 mL/min/1.73 m2 . 83.2% of the patients were treated with renin angiotensin aldosterone system blockers (angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, sacubitril/valsartan), 79.0% with beta-blockers, 53.1% with mineralocorticoid receptor antagonists. Glycosides had been administered to 6.9% of the patients, and diuretics, to 51.1%. In most cases, the doses administered were below those recommended by the international clinical guidelines.Conclusion: We have confirmed the need to increase the adherence of doctors to the clinical guidelines on assessment and management of CHF patients.
Highlights
В большинстве случаев назначенные дозы были ниже рекомендованных в международных документах
Сравнивая полученные нами данные по Московской области с опубликованными результатами по Нижнему Новгороду, следует отметить как ряд схожих черт, например, высокую частоту артериальной гипертонии, так и различия, например, в количестве случаев выявления сахарного диабета (СД) [13,14,15]
Conflict of interestsThe authors declare no conflict of interests. Both authors have contributed to the manuscript, have read and approved the final version of the manuscript before submission, agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work have been appropriately investigated and resolved
Summary
Цель – дать клиническую характеристику пациентов с хронической сердечной недостаточностью (ХСН) в Московской области и оценить соответствие текущей терапии актуальным клиническим рекомендациям. Предоставленной 11 амбулаторно-поликлиническими организациями Московской области в декабре 2019 г., проанализированы данные об анамнезе 286 пациентов с диагнозом ХСН, включая сопутствующие заболевания, характер проведенного обследования и его результаты, а также о текущей терапии. Из сопутствующих не сердечно-сосудистых заболеваний наиболее часто регистрировали заболевания желудочно-кишечного тракта (25,2%), хроническую обструктивную болезнь легких или бронхиальную астму (9,8%), анемию (5,2%). Хроническая сердечная недостаточность (ХСН) представляет собой одну из актуальных проблем кардиологии в связи с нарастающей распространенностью среди населения, особенно в старших возрастных группах, что вносит весомый вклад в смертность от сердечно-сосудистых заболеваний и повышает количество госпитализаций [1,2,3]. Цель настоящего исследования – привести данные о клинической характеристике пациентов с ХСН в Московской области и оценить соответствие текущей терапии актуальным клиническим рекомендациям
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