[Medical treatment of heart failure at a tertiary hospital of São Paulo].
OBJECTIVE
To study how patients with heart failure (HF) are treated in a tertiary hospital in São Paulo.


METHODS
One hundred patients with HF during ambulatory care were analyzed. Seventy-six were men, and the average population age was 56.8 years old. All patients were submitted to echocardiogram, which identified ventricular diameters ranging between 48 and 89 mm (average 65.9) and ejection fraction (EF) between 0.22 and 0.59 (average 0.43). The cause of HF was ischemic in 42 cases, dilated cardiomyopathy in 28, valvular heart disease in 12, Chagas' disease in 10 and systemic hypertension in 8 patients. The prescribed treatment was analyzed, with attention to the prescription and dosage of angiotensin converting enzyme (ACE) inhibitors. We also analyzed whether the cause and/or the degree of HF influenced the treatment chosen.


RESULTS
Eighty-seven patients received ACE inhibitors, 31 received doses below those recommended in the large trials. Digoxin was prescribed in 69 cases, diuretics in 85, and aspirin in 33. When dividing the patients according to EF, the group with EF below 0.45 was prescribed more often ACE inhibitors (91.5% vs 80.4%) and had more often usage of adequate doses (61% vs 48.7%).


CONCLUSIONS
In this sample the majority of the patients were treated according to modern recommendations and tolerated well ACE inhibitors, however 1/3 did not receive ACE inhibitors in the recommended doses. Treatment based on betablockers or angiotensin II inhibitors were not routinely employed.
Barretto
A C
AC
Instituto do Coração do Hospital das Clínicas-FMUSP.
Wajngarten
M
M
Serro-Azul
J B
JB
Pierri
H
H
Nussbacher
A
A
Gebara
O C
OC
D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000209:etiology
D000806:Angiotensin-Converting Enzyme Inhibitors
Tratamento medicamentoso da insuficiência cardíaca em hospital terciário de São Paulo.