title: Comparison of clinical profile and management of outpatients with heart failure with reduced left ventricular ejection fraction treated by general practitioners and cardiologists in contemporary Poland: the results from the DATA-HELP registry.
abstract: OBJECTIVE
  We sought to determine and compare clinical profile and management of outpatients with heart failure with reduced ejection fraction (HFREF) treated by cardiologists and general practitioners (GPs) in Poland.
  
  
  METHODS
  All the 790 randomly selected cardiologists and GPs in the DATA-HELP registry, which included 5563 patients, filled out questionnaires about 10 consecutive outpatients with HFREF.
  
  
  RESULTS
  Outpatients managed by GPs were older (69±10 vs 66±12 years), and the prevalence of men was less marked (58% vs 67%). They also had higher left ventricular ejection fraction (38±6% vs 35±8%) and had more pulmonary congestion (63% vs 49%) and peripheral oedema (66% vs 51%), compared with those treated by cardiologists (all p<0.001). Hypertension (74% vs 66%), previous stroke and/or transient ischaemic attack (21% vs 16%), diabetes (40% vs 30%), and chronic obstructive pulmonary disease (14% vs 11%) were more common in outpatients of GPs (all p<0.001). GPs were less likely to prescribe β-blocker (95% vs 97%, p<0.01), mineralocorticoid receptor antagonist (MRA) (56% vs 64%, p<0.001), and loop diuretic (61% vs 64%, p<0.05) or use PCI (33% vs 44%, p<0.001), CABG (11% vs 16%, p<0.001), ICD (4% vs 10%, p<0.001), or CRT (1% vs 5%, p<0.001). Prescription of renin-angiotensin system inhibitors (94% vs 94%, p>0.2) and digoxin (20% vs 21%, p>0.2) by GPs and cardiologists was similar.
  
  
  CONCLUSIONS
  In contemporary Poland, most outpatients with HFREF receive drugs that improve survival and undergo revascularisation procedures, although devices are rare, but the clinical profiles and management of those treated by GPs and cardiologists differ. Outpatients treated by GPs are older and have more co-morbidities. Outpatients treated by cardiologists more commonly receive β-blocker, MRA, ICD, and CRT, and undergo coronary revascularisations.
authors.affiliation: Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland. Electronic address: ewa.jankowska@umed.wroc.pl.
authors.forename: Ewa A
authors.initials: EA
authors.lastname: Jankowska
authors.affiliation: Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Kalicinska
authors.affiliation: Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Drozd
authors.affiliation: Merck, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kurian
authors.affiliation: Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Banasiak
authors.affiliation: Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D002309:Cardiology / Q000379:methods*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D058005:General Practitioners; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D013318:Stroke Volume; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents
keywords: Cardiologist; DATA-HELP registry; General practitioner; Heart failure with reduced ejection fraction; Management; Poland