Heart Failure Treatment at Hospital Discharge. Do we Adhere to Guidelines? A Sub-analysis of the ARGEN-IC Registry

pp. 495-500

Abstract

Background: Heart failure (HF) can be classified in different ways. The most used classification is based on left ventricular ejection fraction (LVEF) and involves groups with therapeutic options that impact on morbidity and mortality. The information about adherence to the recommendation of specific treatment at hospital discharge for HF comes from other countries but not ours.

Objectives: To evaluate the prescription of specific drugs for HF with reduced LVEF (HFrEF) at discharge in hospitalized patients for acute heart failure (AHF), as well as the clinical parameters related to the indication.

Methods: Patients with diagnosis of AHF incorporated to the prospective ARGEN-IC registry were included. Reduced LVEF was defined as that ≤40%. Prescription rate of drugs recommended for HFrEF at discharge and its association with clinical parameters was analyzed. Data was incorporated to the Survey Monkey electronic database and analyzed using STATA^® software package. The Student’s t test or chi-square test were used, as applicable.

Results: A total of 871 patients were included; mean age was 68.1 years and 72.4% were men. LEVF was reduced in 53.3%. Length of hospital stay was 8 days (IQR 5-12) and mortality rate was 7.32%. At discharge, systolic blood pressure was >130 mm Hg in 12.6% of the patients and 64.4% had heart rate >70 beats per minute; 22.5% were discharged without beta-blockers, 29.1% without vasodilators and 43.7% without aldosterone antagonists. Comorbidities included chronic obstructive pulmonary disease (COPD) in 12.6%, glomerular filtration rate <30 mL/min in 12.5 %, serum creatinine >2.5 mg/dL in 8,9% and hyperkalemia in 0.44%.

Conclusions: We documented suboptimal prescription rate and poor adherence to the recommendations; thus, it is extremely important to implement strategies to change the reality in our region.

Caruso N, Pérez Terns P, Soricetti J, Bortman G, Coronel ML, Benavídez A, et al. Heart Failure Treatment at Hospital Discharge. Do we Adhere to Guidelines? A Sub-analysis of the ARGEN-IC Registry. Rev Argent Cardiol 2021;89:495-500.

http://dx.doi.org/10.7775/rac.v89.i6.20453