[Optimization of heart failure treatment in Abidjan heart institute].

IF 0.3 Q4 Medicine Annales de cardiologie et d'angeiologie Pub Date : 2025-01-10 DOI:10.1016/j.ancard.2024.101854

Marie Nina Koffi, Anicet Kassi Adoubi, Fatouma Sall, Loa Ambroise Gnaba, Florent Diby, Serge Armel Dakoi, Esaïe Soya

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Abstract

Introduction: The aim of the study was to assess the level of treatment optimization after follow-up at discharge.

Methods: We conducted a retrospective study carried out from January 1st, 2016 to December 31st, 2018 in Abidjan Heart Institute with patients hospitalized for heart failure and reviewed in consultation.

Results: The study involved 350 patients with an average age of 53.53 ± 16.38 years (54% were males). The prescription of diuretics (92%) after optimization was at the mean and with maximum doses of 29.1% and 7.7%. ACEIs/ARBs (77.1%) had optimal and mean doses for ACEIs of 14.3% and 29.7%. With beta-blockers (72.6%) there was an improvement in doses at 35.4% for the average doses and 3.1%. for the maximum dose. Spironolactone (44.3%) kept the same average dose at 5.7% The median time of optimization was 287.05 days with a median of 140 days. Only 13.4% of patients were receiving optimal treatment at optimal doses. By logistic regression, the presence of LVEF ≤ 0,40 or LVEF= 0.41-0.49 or global heart failure (P < 0.001) favored drug optimization (OR = 24.68[7.15-82.22], P < 0.001); (OR = 11.39[3.25-39.86], P < 0.001) on the other hand, a high serum creatinine level was an obstacle for treatment optimization (OR = 0.92[0.88-0.96], P < 0.001).

Conclusion: The optimization of the treatment of heart failure is insufficient with too long delays in our context. The optimization time was so long. It could be improved by setting up a clinic to optimize the treatment of heart failure.

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[阿比让心脏研究所心力衰竭治疗优化]。

前言：本研究的目的是评估出院后随访的治疗优化水平。方法：我们对2016年1月1日至2018年12月31日在阿比让心脏研究所因心力衰竭住院的患者进行回顾性研究，并进行会诊。结果：共纳入350例患者，平均年龄53.53±16.38岁，其中男性占54%。优化后的利尿剂处方（92%）平均、最大剂量分别为29.1%和7.7%。acei / arb（77.1%）的最佳和平均acei剂量分别为14.3%和29.7%。使用-受体阻滞剂（72.6%）时，平均剂量的改善率为35.4%,3.1%。最大剂量。螺内酯（44.3%）平均用量为5.7%，优化时间中位数为287.05 d，中位数为140 d。只有13.4%的患者接受了最佳剂量的最佳治疗。通过logistic回归分析，LVEF≤0,40或LVEF= 0.41-0.49或整体心力衰竭（P < 0.001）有利于药物优化（or = 24.68[7.15-82.22], P < 0.001）；（OR = 11.39[3.25-39.86], P < 0.001）另一方面，血清肌酐水平高是优化治疗的障碍（OR = 0.92[0.88-0.96], P < 0.001）。结论：我国对心力衰竭治疗的优化不足，延误时间过长。优化时间太长了。可以通过建立一个诊所来优化心力衰竭的治疗来改善这种情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annales de cardiologie et d'angeiologie 医学-外周血管病

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Organe scientifique de référence fondé en 1951, les Annales de cardiologie et d''angéiologie abordent tous les domaines qui intéressent quotidiennement les cardiologues et les angéiologues praticiens : neurologie et radiologie vasculaires, hémostase, diabétologie, médecine interne, épidémiologie et prévention. Les Annales de cardiologie et d''angéiologie sont indexées aux grandes bases de données et publient rapidement, et en conformité avec les normes internationales de publication scientifique, des articles en français sur la pathologie cardiaque.