Heart failure patients from hospital settings in Poland: population characteristics and treatment patterns, a multicenter retrospective study.
BACKGROUND
Despite physicians' increasing knowledge regarding heart failure (HF), a significant percentage of patients still do not receive adequate treatment. The aim of this multicentre, retrospective descriptive study was to reveal the pharmacotherapy patterns in HF patients hospitalized in cardiology (CARD) and internal medicine (INT) wards in Poland.


METHODS
Included into the study were 800 consecutive patients who were admitted to the hospitals: 350 patients from 7 CARD wards and 450 patients from 9 INT wards.


RESULTS
The average age in the study group was about 70 years (youngest participant under 40 and oldest at 95 years of age). Decompensation of HF or acute HF were the most frequent causes of hospitalization (in both groups > 50%). The main etiology was coronary artery disease, either alone or together with hypertension (from about 60% in INT patients to about 78% in CARD patients, p = NS). With regard to pharmacotherapy, angiotensin converting enzyme inhibitors were used in 81% of cases (77% CARD and 83% INT; p = 0.05); out of this group, doses were at optimal or larger in 39.3% of patients (38% CARD patients and 39.4% INT patients). Beta-blockers were administered in 31.4% and 19.1% of patients from the CARD and INT groups respectively (p < 0.0001), but optimal dosing was negligible.


CONCLUSIONS
Compared with an assessment conducted several years ago, the past education initiatives have significantly improved the quality of standard-based HF treatment. However, suboptimal dosing and the use of drugs that do not improve prognosis remain an unresolved issue in this population.
Rywik
Tomasz M
TM
Heart Failure and Transplantology Department, Institute of Cardiology, Warsaw, Poland. trywik@ikard.pl
Zieliński
Tomasz
T
Piotrowski
Walerian
W
Leszek
Przemysław
P
Wilkins
Arleta
A
Korewicki
Jerzy
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D011044:Poland; D012189:Retrospective Studies; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors