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Varna Medical Forum

Medicament therapy tendencies in hospitalized patients with chronic acute heart failure with preserved and reduced ejection fraction

Nadezhda Hvarchanova, Marieta Georgieva, Branimir Kanazirev

Abstract

Introduction/Aim

The aim of our research was to establish the trends in the applied medicament therapy in hospitalized patients with heart failure (HF) and preserved and reduced ejection fraction (EF). The results were achieved by summarizing and comparing the information about the prescribed medicaments and the potential contraindications and reasons for not adhering to the recommendations for heart failure treatment.

Materials and Methods

This is a retrospective study involving 535 patients hospitalized at the St. Marina University Hospital in Varna for the period from January, 2010 to December, 2014. All of them were diagnosed with chronic acute heart failure. The comparison included the percentages of the prescribed cardioactive medicaments - renin-angiotensin system (RAS) blockers, beta blockers, mineralcorticoid receptor antagonists and calcium antagonists in patients with chronic HF and reduced and preserved EF.

Results

For the last year, 2014, the HF patients were predominantly older (average age of 72 years) women (54.5%), more frequently with HF with preserved EF (HFpEF) (37.6%). Among the patients with preserved EF (compared with those with reduced one), the intake of beta blockers, RAS blockers and mineralcorticoid receptor antagonists was significantly lower (82.3%, 58.1% and 25.8%, compared with 84.6%, 64.1% and 64.1%), whereas the percentage of the intake of calcium antagonists was higher (40.3% compared with 38.5%) than that of the group with HF with reduced EF (HFrEF). The percentage of non-adherence to the therapy recommendations for HFrEF, considering the contraindications, was 25.6%, 12.8% and 17.9%, respectively for RAS blockers, beta blockers and mineralcorticoid receptor antagonists.

Conclusion

There are significant differences in the treatment of HFrEF and HFpEF. The HFpEF patients take less beta blockers, RAS blockers and mineralcorticoid receptor blockers, but more calcium antagonists. There is a high percentage of non-adherence to the therapy recommendations for HFrEF compared with the rest of Europe, considering the contraindications. The tendency in hospitalizations due to HF is for the patients to be older, predominantly female and with HFpEF.


Keywords

heart failure; research; RAS blockers; beta blockers; mineralcorticoid receptor antagonists; calcium antagonists

Full Text


References

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DOI: http://dx.doi.org/10.14748/vmf.v7i1.4798

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