Treatment of heart failure in the elderly in Poland. The results of the Polish part of EURObservational Research Programme: The Heart Failure Pilot Survey.


Journal

Advances in clinical and experimental medicine : official organ Wroclaw Medical University
ISSN: 1899-5276
Titre abrégé: Adv Clin Exp Med
Pays: Poland
ID NLM: 101138582

Informations de publication

Date de publication:
Oct 2019
Historique:
pubmed: 9 5 2019
medline: 13 11 2019
entrez: 9 5 2019
Statut: ppublish

Résumé

Pharmacotherapy remains the fundamental method of treating heart failure (HF). Treatment of the elderly is less based on the principles of evidence-based medicine (EBM) and doses do not reach the prescribed value. The aim of the study was to identify any distinct treatment of HF in the elderly compared to those under 65 years of age. This study describes the Polish part of the EURObservational Research Programme: The Heart Failure Pilot Survey (ESC-HF Pilot). Eligibility to the program was limited to people with HF in 26 centers in Poland. After the first phase, more data was collected at 3 and 12 months. It covered a total of 893 people. Treatment of HF is conducted largely in accordance with the applicable guidelines. The percentage of people over 65 years of age who use angiotensin-converting-enzyme inhibitors/angiotensin-II receptor blockers (ACE-I/ARB), β-blockers and mineralocorticoid-antagonists remains high. Also, during the 12-month follow-up the frequency of the use of β-blockers did not decrease, and a decrease in the number subjects treated with ACE-I was compensated by increasing percentage of the use of ARB. A major problem also seems to be the appropriate treatment to prevent thromboembolic complications in the case of coexistence of atrial fibrillation (AF). There is a large group of older people who do not receive proper anticoagulation. The study showed the existence of differences in the treatment of HF in the elderly. It partly does not proceed in accordance with the guidelines, especially in the presence of multiple comorbidities.

Sections du résumé

BACKGROUND BACKGROUND
Pharmacotherapy remains the fundamental method of treating heart failure (HF). Treatment of the elderly is less based on the principles of evidence-based medicine (EBM) and doses do not reach the prescribed value.
OBJECTIVES OBJECTIVE
The aim of the study was to identify any distinct treatment of HF in the elderly compared to those under 65 years of age.
MATERIAL AND METHODS METHODS
This study describes the Polish part of the EURObservational Research Programme: The Heart Failure Pilot Survey (ESC-HF Pilot). Eligibility to the program was limited to people with HF in 26 centers in Poland. After the first phase, more data was collected at 3 and 12 months. It covered a total of 893 people.
RESULTS RESULTS
Treatment of HF is conducted largely in accordance with the applicable guidelines. The percentage of people over 65 years of age who use angiotensin-converting-enzyme inhibitors/angiotensin-II receptor blockers (ACE-I/ARB), β-blockers and mineralocorticoid-antagonists remains high. Also, during the 12-month follow-up the frequency of the use of β-blockers did not decrease, and a decrease in the number subjects treated with ACE-I was compensated by increasing percentage of the use of ARB. A major problem also seems to be the appropriate treatment to prevent thromboembolic complications in the case of coexistence of atrial fibrillation (AF). There is a large group of older people who do not receive proper anticoagulation.
CONCLUSIONS CONCLUSIONS
The study showed the existence of differences in the treatment of HF in the elderly. It partly does not proceed in accordance with the guidelines, especially in the presence of multiple comorbidities.

Identifiants

pubmed: 31066243
doi: 10.17219/acem/104527
doi:

Substances chimiques

Adrenergic beta-Antagonists 0
Angiotensin Receptor Antagonists 0
Angiotensin-Converting Enzyme Inhibitors 0
Mineralocorticoids 0

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1351-1358

Auteurs

Adam Rafał Poliwczak (AR)

Department of Human Physiology, Medical University of Lodz, Poland.

Janusz Śmigielski (J)

State Higher Vocational School of Konin, Poland.

Agnieszka Bała (A)

Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland.

Ewa Straburzyńska-Migaj (E)

1st Department of Cardiology, Poznan University of Medical Sciences, Poland.

Agata Tymińska (A)

1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.

Paweł Balsam (P)

1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.

Krzysztof Ozierański (K)

1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.

Agnieszka Kapłon-Cieślicka (A)

1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.

Joanna Zaprutko (J)

2nd Department of Cardiology, Poznan University of Medical Sciences, Poland.

Jarosław Drożdż (J)

Department of Cardiology, Medical University of Lodz, Poland.

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Classifications MeSH