2002 年和 2021 年住院患者中的慢性心力衰竭：发病率、临床病程和药物治疗的对比分析。

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-03-31 DOI:10.18087/cardio.2024.3.n2595

A A Garganeeva, O V Tukish, K N Vitt, Yu V Mareev, E A Kuzheleva, V V Ryabov, M Yu Kondratiev, E E Syromyatnikova, B B Dorzhieva, V Yu Mareev

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The majority of patients with CHF in the study sample were patients with preserved left ventricular ejection fraction (HFpEF). The proportion of such patients significantly increased to reach 75.9% in 2021 compared to 58.6% in 2002 (p<0.001). At the same time, the number of severe forms of CHF (NYHA functional class (FC) IV) decreased by 10% and was 13.2% in 2002 and 1.3% in 2021 (p<0.001). In the majority of patients, ischemic heart disease (98.1 and 91.1% in 2002 and 2021, respectively, p<0.001) and hypertension (80.5 and 98.2%, respectively, p<0.001) were diagnosed as the cause for CHF. Furthermore, the incidence of comorbidity increased significantly: atrial fibrillation was detected in 12.3% of patients in 2002 and 26.4% in 2021 (p < 0.001); type 2 diabetes mellitus, in 14.3 and 32% of patients (p <0.001); and obesity, in 33.3 and 43.7% of patients, respectively (p=0.018). The frequency of using the major groups of drugs increased during the analyzed period: renin-angiotensin-aldosterone system blockers were administered to 71.9% of patients in 2002 and to 87.7% in 2021 (p<0.001); beta-blockers were administered to 53.3 and 82.4% of patients (p<0.001); and mineralocorticoid receptor antagonists, to 1.9 and 18.6% of patients, respectively (p=0.004).Conclusion: In 2021, the proportion of patients with a confirmed diagnosis of CHF in the patient cohort admitted to a cardiology hospital was twice as high as in 2002; the phenotype with preserved left ventricular ejection fraction predominated in the CHF structure. During the analyzed twenty-year period, the prevalence of comorbidities increased among CHF patients. 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引用次数: 0

摘要

目的：比较分析一家心脏病专科医院2002年和2021年收治的慢性心力衰竭（CHF）患者的患病率、临床和病史资料以及药物治疗情况：研究分析了一家心脏病专科医院 2002 年（210 人）和 2021 年（381 人）收治的确诊为慢性心力衰竭患者的病历：根据 2021 年的医疗记录，心脏专科医院收治的确诊为慢性阻塞性肺病的患者比例（87.6%）是 2002 年（46.4%；p<0.001）的两倍。在研究样本中，大多数慢性心力衰竭患者都是左心室射血分数保留（HFpEF）患者。与 2002 年的 58.6% 相比，2021 年此类患者的比例大幅上升至 75.9%（p<0.001）。与此同时，重度 CHF（NYHA 功能分级（FC）IV）的人数减少了 10%，2002 年为 13.2%，2021 年为 1.3%（p<0.001）。在大多数患者中，缺血性心脏病（2002 年为 98.1%，2021 年为 91.1%，p<0.001）和高血压（2002 年为 80.5%，2021 年为 98.2%，p<0.001）被诊断为导致慢性心力衰竭的原因。此外，合并症的发生率也显著增加：2002 年发现心房颤动的患者占 12.3%，2021 年占 26.4%（p<0.001）；发现 2 型糖尿病的患者分别占 14.3% 和 32%（p<0.001）；发现肥胖的患者分别占 33.3% 和 43.7%（p=0.018）。在分析期间，使用主要药物组的频率有所增加：2002 年，71.9% 的患者使用肾素-血管紧张素-醛固酮系统阻断剂，2021 年，87.7% 的患者使用（p<0.001）；53.3% 的患者使用β-受体阻断剂，82.4% 的患者使用（p<0.001）；1.9% 的患者使用矿物质皮质激素受体拮抗剂，18.6% 的患者使用（p=0.004）：2021年，在心脏病医院住院的患者队列中，确诊为慢性心力衰竭的患者比例是2002年的两倍；在慢性心力衰竭结构中，左心室射血分数保留的表型占主导地位。在分析的二十年间，CHF 患者的合并症发病率有所增加。到2021年，病因循证疗法的处方频率显著增加，但即使是左心室射血分数降低的慢性阻塞性肺病患者，其处方频率仍然不足。

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Chronic Heart Failure in Patients Hospitalized in 2002 and 2021: Comparative Analysis of Prevalence, Clinical Course and Drug Therapy.

Aim: Comparative analysis of the prevalence of chronic heart failure (CHF), clinical and medical history data, and drug therapy of patients admitted to a cardiology hospital in 2002 and 2021.

Material and methods: The study analyzed the medical records of patients with a confirmed diagnosis of CHF who were admitted in 2002 (n=210) and 2021 (n=381) to a specialized cardiology hospital.

Results: According to medical records of 2021, the proportion of patients with a confirmed diagnosis of CHF (87.6%) in the cohort of patients admitted to a cardiology hospital was twice as high as in 2002 (46.4%; p<0.001). The majority of patients with CHF in the study sample were patients with preserved left ventricular ejection fraction (HFpEF). The proportion of such patients significantly increased to reach 75.9% in 2021 compared to 58.6% in 2002 (p<0.001). At the same time, the number of severe forms of CHF (NYHA functional class (FC) IV) decreased by 10% and was 13.2% in 2002 and 1.3% in 2021 (p<0.001). In the majority of patients, ischemic heart disease (98.1 and 91.1% in 2002 and 2021, respectively, p<0.001) and hypertension (80.5 and 98.2%, respectively, p<0.001) were diagnosed as the cause for CHF. Furthermore, the incidence of comorbidity increased significantly: atrial fibrillation was detected in 12.3% of patients in 2002 and 26.4% in 2021 (p < 0.001); type 2 diabetes mellitus, in 14.3 and 32% of patients (p <0.001); and obesity, in 33.3 and 43.7% of patients, respectively (p=0.018). The frequency of using the major groups of drugs increased during the analyzed period: renin-angiotensin-aldosterone system blockers were administered to 71.9% of patients in 2002 and to 87.7% in 2021 (p<0.001); beta-blockers were administered to 53.3 and 82.4% of patients (p<0.001); and mineralocorticoid receptor antagonists, to 1.9 and 18.6% of patients, respectively (p=0.004).

Conclusion: In 2021, the proportion of patients with a confirmed diagnosis of CHF in the patient cohort admitted to a cardiology hospital was twice as high as in 2002; the phenotype with preserved left ventricular ejection fraction predominated in the CHF structure. During the analyzed twenty-year period, the prevalence of comorbidities increased among CHF patients. The prescription frequency of pathogenetic evidence-based therapy has significantly increased by 2021, however, it remains insufficient even in patients with CHF with reduced left ventricular ejection fraction.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.