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[Retrospective analysis of drug treatment on inpatients with chronic heart failure]
Jin-ping Ma1, Lin Wang, Qun Dang
1Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Insights
Conventional drugs like nitrates, diuretics, and digitalis still dominate chronic heart failure (CHF) treatment. While ACE inhibitors and beta-blockers are increasingly used, a gap remains between optimal strategies and current practice for CHF management.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Context:
- Chronic heart failure (CHF) poses a significant burden on healthcare systems.
- Understanding long-term treatment trends is crucial for optimizing patient care.
- This study analyzes 30 years of CHF drug treatment in hospitalized patients.
Purpose:
- To investigate drug treatment patterns for hospitalized chronic heart failure (CHF) patients over three decades.
- To provide insights into the evolving treatment strategies for CHF.
Summary:
- A retrospective study of 5189 inpatients revealed coronary heart disease as the leading cause of CHF.
- Nitrates, diuretics, and digitalis remain dominant therapies, though ACE inhibitors and beta-blockers show increasing use.
- Despite advances, a gap persists between ideal CHF management guidelines and clinical practice.
Impact:
- Highlights the persistent reliance on conventional CHF medications.
- Identifies trends in the adoption of evidence-based therapies like ACE inhibitors and beta-blockers.
- Underscores the need to bridge the gap between optimal medical strategy and clinical practice in CHF management.
Objective:
To investigate drug treatment of inpatients with chronic heart failure(CHF) during the past 30 years in some areas and to provide more information on the treatment strategy of CHF.
Methods:
In two centers a retrospective study was conducted. All data were taken from the hospitalized cases with chronic heart failure. The medication distributions in different decade, gender, age heart function grade and etiology were analyzed.
Results:
5189 cases were enrolled with the ratio of male to female as 1:1.02. The mean age was (62.93 +/- 13.49) years old. The general causes of chronic heart failure were as follows: coronary heart disease (44.2%), rheumatic heart disease (24.1% ) , pulmonary heart disease (19.0%) and cardiomyopathy (4.8%). The admission cardiac function was mostly seen as grade NYHA IlI and IV, and their proportions were 40.6% and 44.5%. Major medication would include nitride (80.0%), diuretics (71.8% ), digitalis (68.1% ), angiotensin conversion enzyme inhibitors (ACEI) (52.2% ) and beta-blockers (19.5% ) etc. Moreover the frequency of above used medication was essentially increasing decade by decade. The major drug treatment of pulmonary heart disease also included diuretics, nitride, digitalis. ACEI was more commonly used in male than in female cases. The frequency of ACEI and ARB were more commonly used in the group > or = 60 years old than that in the group < 60 years old. The administration frequency of beta- blockers had no significant difference among different age and sexes.
Conclusion:
The conventional drugs such as nitride, diuretics, digitalis were still dominated the treatment of CHF. Although the administration frequency of ACEI and beta-blockers increased quickly, there had been a great gap between the optimal medical strategy and clinical practice in the management of CHF. Data showed the treatment strategy was changing.
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