[Therapeutic management of heart failure and left ventricular dysfunction following acute myocardial infarction in French intensive care units].
OBJECTIVE
To evaluate the therapeutic management of cardiac failure after myocardial infarction (MI) in French intensive cardiac care units (USIC) in 2005.


METHODS
French cross-sectional observational study conducted in USIC of University Hospital Centres (CHU), General Hospital Centres (CHG), and private clinics. Included patients were hospitalized for MI, with a systolic ejection fraction < or =40% and "having" or "having had" signs of acute heart failure during the hospitalization or diabetes.


RESULTS
Overall, 59 sites, including 10 CHU (16.9%), 37 CHG (62.7%), and 12 private clinics (20.3%) included 447 patients. The majority of patients were male (64.9%), > or =70 years (62.7%), hypertensive (53.5%) and diabetic (40.8%). They presented a class II (22.3%), class III (29.5%) and class IV (38.9%) cardiac failure severity according to NYHA classification and 20.4% had a creatinine clearance <30 ml/min. The most prescribed treatments were statines (75.4%), IEC (73.6%), diuretics (71.8%) and betablockers (66.7%). The least prescribed were aldosterone antagonist (16.3%) and calcium channel blockers (6.5%). Treatments were prescribed according to age, degree of cardiac failure and renal function of the patient.


CONCLUSIONS
The present observational study shows improved compliance with European and international guidelines, as regards the medications prescribed at hospital discharge after myocardial infarctions complicated with left ventricular dysfunction. Unfortunately, recommended medications remained less often prescribed in the patients with the most severe characteristics.
Cambou
J P
JP
Société française de cardiologie, Paris, France.
Vicaut
E
E
Papadopoulos-Degrandsart
A
A
Danchin
N
N
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000209:etiology; D003422:Critical Care; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005602:France; D006769:Hospitals, General; D016304:Hospitals, Private; D006785:Hospitals, University; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000150:complications*; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000209:etiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000451:Mineralocorticoid Receptor Antagonists