Clinical and biochemical characteristics of patients with chronic heart failure depending on the variant of polypharmacy

Abstract

Objective: to study the features of the clinical course of chronic heart failure (CHF) and laboratory and biochemical characteristics of patients, depending on the variant of polypharmacy.Materials and methods: the study included 73 patients with CHF aged 74.58±10.05 years. Venous blood was taken from all patients on the 1st day of hospitalization in order to determine the levels of NT-proBNP, sST2, NGAL, cystatin C. Patients were divided into groups depending on the type of polypharmacy (corresponding and inappropriate) according to the criteria of the EURO-FORTA system (2018) and on based on national clinical guidelines.Results: depending on the type of polypharmacy at the outpatient stage, according to the EURO-FORTA criteria (2018), 2 groups of patients were distinguished: 1st (corresponding) — 47.94% of patients; 2nd (inappropriate) — 52.06%; based on national clinical guidelines: group 1 (corresponding) — 53.42% and group 2 (inappropriate) — 46.58%. When evaluating polypharmacy according to the EURO-FORTA criteria, patients of the 2nd group more often had joint diseases (p=0.035), acute kidney injury (AKI) according to baseline creatinine (47.37% vs. 20%; p=0.014) and 4 times more often than patients of the 1st group were hospitalized due to atrial fibrillation (AF) (p=0.048). When dividing patients based on national clinical guidelines into groups of appropriate (1) and inappropriate (2) polypharmacy, it was found that in group 2, compared to group 1, there were more patients with joint diseases (44.12% versus 15.38%; p=0.007), anemia of 1–2 degrees (67.65% vs. 35.90%; p=0.025) and CKD of 3–5 stages (76.47% vs. 53.85%; p=0.044), more often observed OPP (p=0.008).Conclusion: a comparative analysis of the clinical and laboratory status of patients with appropriate and inappropriate polypharmacy revealed that the main difference between patients with inappropriate polypharmacy is more pronounced renal dysfunction and the prevalence of anemia, as well as a higher rate of hospitalization with paroxysmal AF/AFL. The division of patients into groups of appropriate and inappropriate polypharmacy based on clinical recommendations does not require additional evaluation using the EURO-FORTA system.