Pharmacoepidemiological analysis of therapy for chronic heart failure

Abstract

The aim of the study was to examine the schemes proposed in the clinical guidelines and to compare them with inpatient treatment methods.Materials and method, the case histories of 40 patients of cardiology department of Saratov medical preventive institution were analyzed. Men and women, aged from 50 to 80 years, with functional class (FC) II to IV, with reduced left ventricular ejection fraction (< 40 %) and with such diseases in anamnesis as arterial hypertension, coronary heart disease, atherosclerosis, diabetes mellitus were in the inclusion group. The exclusion group included patients with noncardiac diseases, pediatric patients, patients under 50 and over 80 years old, patients with I class, preserved and intermediate LV ejection fraction (> 40 %). The results of immunochromatographic analysis of NT-proBNP marker were studied, the identity of prescribed drugs to a certain group and their frequency of use, as well as the similarity of prescribed regimen to clinical guidelines were determined.Results. NT-proBNP level over 125 pg/ml was revealed in 21 out of 40 patients, arterial hypertension, atherosclerosis, ischemic heart disease were in the anamnesis testifying to high probability of CHF. Perindopril (80 %) and fosinopril (20 %) were the main angiotensin-converting enzyme inhibitors (ACEIs). Spironolactone (a К + -saving diuretic), thorasemide, furosemide (a loop diuretic) and indapamide (a thiazide-like diuretic) were used as diuretics. Among blockers, metoprolol (20 %), nebivolol (30 %), bisoprolol (50 %) were prescribed. Patients suffering from CHF and with a history of atherosclerosis were prescribed statins (rosuvastatin, atorvastatin) in addition to the main groups of drugs in all cases. Warfarin (9.5 %) and rivaroxaban (23.8 %) were present in 7 of 21 cases (33 %). In addition, 17 patients (81 %) were prescribed acetylsalicylic acid as an antiaggregant. Those with a history of diabetes mellitus (19 %) received metformin for glycaemic control, as an adjunctive therapy to the main combinations of drugs.Conclusions. The inpatient regimen used to treat patients with CHF is more in line with the clinical guidelines.