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Heart failure due to left ventricular systolic dysfunction: treatment at discharge from hospital and at one year

D Houpe1, M Peltier, A Cohen-Solal

  • 1Department of Cardiology, South Hospital, Amiens, France.

International Journal of Cardiology
|August 16, 2005
PubMed

Insights

Treatment for heart failure (HF) with reduced ejection fraction largely uses diuretics and ACE inhibitors. However, beta-blocker use remains low in both patient numbers and prescribed dosages, indicating a need for better guideline adherence.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Pharmacology

Background:

  • Guidelines for heart failure (HF) with left ventricular systolic dysfunction exist but are not consistently applied in practice.
  • The ETICS study aimed to assess medical treatment adherence in HF patients post-hospitalization.

Purpose of the Study:

  • To evaluate the prescription patterns of HF medications at discharge and one year post-hospitalization.
  • To identify areas of underutilization of guideline-recommended therapies.

Main Methods:

  • Prospective inclusion of 179 patients (63% male, mean age 69±13 years) with ejection fraction ≤ 40%.
  • Primary etiology of HF was ischemic heart disease (44%).
  • Medication use and dosages were recorded at discharge and 1-year follow-up.

Main Results:

  • Loop diuretics (95%) and ACE inhibitors (82%) were highly prescribed at discharge.
  • Beta-blocker prescription increased from 25% at discharge to 41% at 1 year, but dosages remained suboptimal (26% and 35% of recommended, respectively).
  • Spironolactone use was consistent (35-37%), while digitalis and nitrates saw decreased use.

Conclusions:

  • Diuretics and ACE inhibitors are widely used for HF with left ventricular systolic dysfunction.
  • Beta-blockers are underutilized in terms of patient numbers and prescribed doses.
  • Enhanced dissemination of clinical practice guidelines is crucial for improving HF management.
Abstract

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