Euro heart failure survey. Medical treatment not in line with current guidelines.

K Drechsler, R Dietz, H Klein, K C Wollert, D Storp, J Molling, U Zeymer, J Niebauer
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引用次数: 23

Abstract

Unlabelled: It was the aim of the Euro Heart Survey on Heart Failure to assess whether patients are being treated according to current guidelines.

Methods: In Germany, patients were screened in 7 medical centers if their discharge diagnoses were myocardial infarction, a new episode of atrial fibrillation, or diabetes mellitus. Patients were enrolled if at least one additional criterion was fulfilled: (1) clinical diagnosis of heart failure, (2) hospital admission due to heart failure within the last 3 years, (3) therapy with loop diuretic, (4) medication for heart failure or ventricular dysfunction documented by echocardiography within the past 24 hours prior to death.

Results: 2166 patients were screened of whom 747 were included in the study (478 men, 269 women). 93% of the patients suffered from heart failure. Despite the high number of patients with known heart failure (ischemic heart failure in 71%), only 72% received ACE inhibitors and 62% beta-blockers. Average daily dose met recommendations in only 63% of patients on ACE inhibitors and 54% on beta-blockers. 74% of the patients received diuretics (furosemide 36%, thiazide 34%, spironolactone 17%).

Conclusion: An inadequately low number of patients with heart failure receives medical therapy according to guidelines, despite all the overwhelming evidence for improved morbidity and mortality. Awareness of physicians needs to be improved.

欧洲心力衰竭调查。不符合现行指导方针的医疗。
未标记:欧洲心脏衰竭调查的目的是评估患者是否按照现行指南进行治疗。方法:在德国7个医疗中心对出院诊断为心肌梗死、新发房颤或糖尿病的患者进行筛查。如果至少满足一个附加标准,则纳入患者:(1)心力衰竭的临床诊断,(2)最近3年内因心力衰竭住院,(3)循环利尿剂治疗,(4)在死亡前24小时内超声心动图记录的心力衰竭或心室功能障碍药物。结果:筛选了2166例患者,其中747例纳入研究(男性478例,女性269例)。93%的患者出现心力衰竭。尽管已知心力衰竭的患者数量很多(缺血性心力衰竭占71%),但只有72%的患者接受了ACE抑制剂和62%的受体阻滞剂治疗。平均每日剂量只有63%的ACE抑制剂和54%的受体阻滞剂达到推荐剂量。74%的患者使用利尿剂(速尿36%,噻嗪34%,螺内酯17%)。结论:尽管有大量证据表明可以改善发病率和死亡率,但根据指南接受药物治疗的心力衰竭患者数量不足。医生的意识有待提高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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