Thanh bên bài viết

PDF
Ngày xuất bản: 25/07/2023
Ngày xuất bản Online: 25/07/2023
Số lượt xem tóm tắt: 215
Số lượt xem PDF: 139
DOI: https://doi.org/10.47972/vjcts.v42i.899
Số xuất bản
Tập 42
Chuyên mục
Bài báo
Trích dẫn bài báo
Nga, V. Q., Thinh, D. D., & Hoa, T. T. (2023). Adherence to gdmt treatment for heart failure out-patients – single center registry. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 42, 32-42. https://doi.org/10.47972/vjcts.v42i.899

Adherence to gdmt treatment for heart failure out-patients – single center registry

Nga Vu Quynh, Thinh Do Duc, Hoa Tran Thanh

Nội dung chính của bài viết

Tóm tắt

 Background: GDMT treament has demonstrated to heart failure can improve heart failure survival and reduce hospital admission.


Objective: This study evaluated the use of guideline-directed medical therapy (GDMT) for heart failure with reduced and mild reduced ejection fraction (HFrEF) in outpatient department in Hanoi Heart Hospitaland its impact on patients’ midterm outcome.  


Method: Medical records of 1131 patients with HFrEF and HFmrEF followed at Hanoi Heart Hosspital, facility 1 From September 2019 to March 2021 were reviewed. The prescription rates of recommended pharmacological agents and their dosages were evaluated.


Results: The population includes 711 male (62.9%) and 420 female (37.1%), with an average age of 64,96 ± 14,49 years. The mean and median time of follow up were 10,59 ± 2,77 month (the shortest follow-up time was 3 months, the longest was 15 months). The prescription rate of β-blockers, ACEI/ARB/ARNI, MRA were 74.36%, 80.9% and 69.5% respectively. After follow-up, these rates were 86.75%, 86.52% and 68.9%, correspondingly. After follow-up, the highest rate of prescription over 50% dosages of these drugs in the range given were Spiranolactone, it was achieved 56.15%, followed by Losartan, Bisoprolol, Nebivolol, all above 30%. The initial LVEF was 37.93 ± 8.58%, and at the end of the follow – up period, the LVEF achieved 40.26 ± 9.44%, significantly improved. 168 patients (14.85%) were admitted to the hospital at least once during the follow-up period; mong them, 133 patients (79.2%) were hospitalized once, 30 patients (17.8%) were hospitalized twice, and five patients (3.0%) were hospitalized at least three times. Mortality was 1.9% (18 patients) during the follow-up period. [1]


Conclusion: The rate of heart failure GDMT drugs using for outpatients in our center is rather high but there are gaps that need to be filled to enhance the outcome of HFrEF and HFmrEF patients.

Chi tiết bài viết

Từ khóa

Heart failure, guideline, GDMT

Tài liệu tham khảo

1. Kosiborod M, Lichtman JH, Heidenreich PA, Normand SL, Wang Y, Brass LM, Krumholz HM(2006), “National trends in out comes among elderly patients with heart failure”. Am J Med 2006 ;119 ( 7 ) : 616 .e1-7.
2. Rathore SS, Masoudi FA, Wang Y, Curtis JP, Foody JM, Havranek EP, Krumholz ,HM(2006), “Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: findings from the National Heart Failure Project”. Am Heart J 2006;152(2):371-8.
3. Massie BM, Shah NB(2006), “Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management”. Am Heart J 1997;133 (6):703-12.
4. Patricia P. Chang et al (2018), “Trends in Hospitalizations and Survival of Acute Decompensated Heart Failure in Four US Communities (2005-2014): The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance”. Circulation. 2018 July 03; 138(1): 12–24. doi:10.1161/CIRCULATIONAHA.117.027551.
5. Zannad F Mebazaa A, Juilliere Y (2006), “Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study”. Eur J of Heart Failure; 8: 697 – 705.
6. Markku S et al. (2006), “EuroHeart Failure Survey II (EHFS II): a survey onhospitalized acute heart failure patients: description of population”. European Heart Journal (2006)27, 2725–2736.
7. Prasart Laothavorn et al (2010), “Thai Acute Decompensated Heart Failure Registry (Thai ADHERE)”. CVD Prevention and Control (2010) 5, 89–95.
8. Chan PS, Oetgen WJ, Buchanan D, Mitchell K, Fiocchi FF, Tang F, et al(2010), “Cardiac performance measure compliance in outpatients: the American College of Cardiology and National Cardiovascular Data Registry’s PINNACLE (Practice Innovation And Clinical Excellence) program”. J Am Coll Cardiol 2010;56(1):8-14.
9. Fonarow GC, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, et al(2008). “Heart failure care in the outpatient cardiology practice setting: findings from IMPROVE HF”. Circ Heart Fail 2008;1(2):98-106.
10. El Hadidi S., Darweesh E., et al. (2018), "A tool for assessment of heart failure prescribing quality: A systematic review and meta-analysis", Pharmacoepidemiol Drug Saf, 27(7), pp. 685-694.
11. Chun-Chieh Wang,Hung-Yu Chang, Wei-Hsian Yin, et al (2016), “TSOC-HFrEF Registry: A Registry of Hospitalized Patients with Decompensated Systolic Heart Failure: Description of Population and Management”. Acta Cardiol Sin. 2016 Jul; 32(4): 400–411.doi: 10.6515/ACS20160704A
12. Poelzl G, Altenberger J, Pacher R et al. (2014), “Dose matters! Optimisation of guideline adherence is associated with lower mortality in stable patients with chronic heart failure”. Int J Cardiol:175:83–9. doi: 10.1016/j.ijcard.2014.04.255.
13. Jarjour M, Henri C, de Denus S(2020); “Care Gaps in Adherence to Heart Failure Gudelines: Clinical Inertia or Physiological Limitations?” JACC: Heart Failure 8, (9): 725-738
14. Greene SJ , Adam D. DeVore AD.( 2020); “The Maximally Tolerated Dose: The Key Context for Interpreting Subtarget Medication Dosing for Heart Failure”. JACC: Heart Failure 8 (9): 739-741
15. Min-Soo Ahn , Byung-Su Yoo , Jung-Woo Son et al (2021), “Evaluation of Adherence to Guideline for Heart Failure with Reduced Ejection Fraction in Heart Failure with Preserved Ejection Fraction and with or without Atrial Fibrillation”. J Korean Med Sci 18;36(40):e252 https://doi.org/10.3346/jkms.2021.36.e252.