engleski

Croatian heart failure registry: initial results – part II

Objective: Heart failure (HF) is a common syndrome with high morbidity and mortality. Although the ESC guidelines for HF have been published, it seems that they have been poorly applied in daily practice. This was the reason why the Croatian Cardiac Society established its own Heart Failure Registry. The aim of this study was to analyse informations about the causes, diagnostic procedures and treatment characteristics of HF patients in Croatia, and compare them with the latest ESC guidelines. Methods: The study population consisted of 226 HF patients (mean age 66.7+/-14.2 years) hospitalized in Split, Rijeka and Zagreb University Hospitals. The Registry analysed on line data. Results: There were 59% male (mean age 63.6+/-13.5 years), and 41 female patients (mean age 75.9+/-10.2 years). Acute (de novo) HF was diagnosed in 29% cases, while 68% manifested as a chronic HF. History of coronary disease (CAD) was present in 30.4%, diabetes in 34.9%, smoking in 35%, hypertension in 47.3%, chronic obstructive pulmonary disease in 23% and renal insufficiency in 26% of patients. Leading triggers of HF were atrial fibrilation/flutter onset (37.6%), uncontrolled arterial hypertension (22.5%), and acute coronary syndroms (20.7%). Mean hospitalisation time was 10.5 days. NYHA class I was recorded in 8%, NYHA class II in 31%, NYHA III in 34% and NYHA IV in 27% of our patients. Atrial fibrillation/flutter was present in 45%, and cardiomegaly (on x-ray) in 71.7% of patients. Echocardiography was performed in 74% of the study population. Mean LVEDd measured 59.5+/-12.6 mm in 48% of patients. LV diastolic dysfunction recorded as a relaxation abnormality was present in 48% of patients. BNP and NT-proBNP tests were performed in only 12% of our patients. Diuretics (77%) and beta blockers (61%), followed by ACE inhibitors (48%), spironolactone (31%), digoxin (30%) and dose of ACE inhibitors (for ramipril 3.45 mg) and beta blockers (for carvedilol 12.63 mg) were below the recommended target doses. In-hospital mortality was 10.2%. Conclusion: The leading precipitating factor for HF in Croatia are occurrence of atrial arrhythmias, acute coronary syndroms, and ACE inhibitors, beta blockers and angiotensin receptor blockers are still underprescribed in our HF patients.

heart failure; diagnosis; treatment; cardiac arrhythmias; acute coronary syndrome; hypertension

nije evidentirano