[Management of heart failure in Piedmont Region].
BACKGROUND
Congestive heart failure (CHF) represents an emerging problem in industrialized countries: it continues to be diagnosed at high rates and has an decreased survival time, raising new problems, such as the need of an adequate medical service organization and resource expenditure. Aim of this analysis was a quantitative evaluation of diagnostic and therapeutic resource use for CHF in outpatient departments in Piedmont, Italy.


METHODS
We performed a cross-sectional observational study, based on a two-month data collection in 12 outpatient departments dedicated to congestive heart failure. Information was obtained on each patient using a specific anonymous data collection form.


RESULTS
We obtained and analyzed for the study 547forms. Mean patient age was 66.1 years, mean ejection fraction was 36.6%. Coronary artery disease accounted for 34.6% of congestive heart failure cases, followed by idiopathic etiology (26.4%). Main comorbidities were diabetes (22.3%) and chronic obstructive pulmonary disease (17.7%). Sixty-nine% of patients received a medical treatment with angiotensin-converting enzyme (ACE) inhibitors, 72.6% with beta-blockers, 48.8% with aldosterone antagonists. As far as diagnostic resource use during a six-month period preceeding observation, 46.8% of patients underwent echocardiographic examination, 9.9% Holter ECG, 6.0% coronary angiography. Therapy was more often increased in patients who underwent an instrumental evaluation during the preceeding six-month period.


CONCLUSIONS
Data suggests that in Piedmont outpatients with chronic heart failure receive a high drug prescription level and a small number of instrumental evaluations, as suggested in main international guidelines.
Montali
Nicolò
N
Cardiologia Universitaria Osp. Molinette (TO), Via Santorre di Santarosa 19-I-10131 Torino, Italy. nicolo.montali@gmail.com
Bobbio
Marco
M
Cerrato
Enrico
E
Azzaro
Giuseppe
G
Bianchini
Bianca
B
Bonzano
Alessandro
A
Calì
Maria Vincenza
MV
Cavaliere
Rodolfo
R
Correndo
Livio
L
Deorsola
Antonella
A
Guillevin
Regine
R
Mainardi
Loredana
L
Montagna
Laura
L
Pistono
Massimo
M
Trevi
Gian Paolo
GP
D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003925:Diabetic Angiopathies / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007558:Italy; D010044:Outpatient Clinics, Hospital; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology