A Survey And Analysis Of Characteristic And Drug Therapy In Patients With Heart Failure At Different Stages

ObjectiveTo investigate and analyze the patients at department of cardiology in our hospital from 2008.5.1─2008.10.31 To understand (1) the the constituent ratio of risk factors for heart failure;(2)the drug therapies for heart failure at different stages;(3)the difference of NT-proBNP level among the heart failure stages.MethodInpatients at department of cardiology in our hospital from 2008.5.1─2008.10.31 were enrolled.Variables including patients'general items, etiology, smoking, drinking,diabetes, hypertension, coronary heart disease(excluding myocardial infarction),body mass index, blood lipids, cardiotoxic agents, family history of cardiomyopathy,echocardiogram,NT-proBNP,clinical status,categories of drugs were recorded in detail.According to the stages and NYHA classification, the patients were divided into A,B,C,D and NYHA classⅡ,Ⅲ,Ⅳgroup respectively.Results(1) A total of 1149 patients were enrolled in the study.There were 329 patients(28.6%),244 patients(21.2%),551 patients(48.0%),25 patients(2.2%) in A,B,C and D group repectively.There were 359 patients(62.3%),171 patients(29.7%),46 patients(8.0%) in NYHA classⅡ,Ⅲ,Ⅳgroup repectively.(3)The age of onset at each stage(A,B,C,D) was distributed respectively in <55 years,65-74years,65-74 years,≥75 years.(4)hypertension,Coronary heart disease,Diabetes, Obesity were the major risk factors of stage A,and were the major cause of stage B,C,D;(5)The usage rate of ACEI/ARB, diuretics, aldosterone receptor antagonists was higher in group C and D than that in group A and B,but it was still low;The usage rate ofβ-blocker was higher in group C than that in groupA, B,D(57.4% vs 44.7%,45.9%,36.0%);The utilization ratio of Stains in group B,C was higher than group A,D;The utilization ratio of anti-platelet drugs in each group (A,B,C,D) was 56.5%,75.4%,81.1%,68.0%;(6)The NYHA classification had no influence on the use of ACEI/ARB andβ-blocker;Aldosterone receptor antagonists, Diuretics, Digitalis drugs were more administered in patients with worse heart function,but stains were on the contrary.(7)The concentration of NT-proBNP (pg/ml) in each group(Ⅱ,Ⅲ,Ⅳgroup) was 79.1±37.0,86.5±38.6,2684.5±1588.8,4032.3±1467.5.ConclusionsThe age of onset in stage A was the youngest, it was grdually increased wtih stage B,C,D of Heart Failure. Hypertension, Coronary heart disease,Diabetes and Obesity were the major risk factors for heart failure in the study;study;The usage rates of ACEI/ARB,β-blocker,stains and anti-platelet drugs in stage A and B was low,and it was insufficient to prevent heart failure development;The usage rates of Aldosterone receptor antagonists, Diuretics,β-blocker was low,and there was a gap between the clinical practice and the guidelines for Heart Failure;Aldosterone receptor antagonists, Diuretics, Digitalis drugs were more used in NYHAⅢ,Ⅳthan thoes in NYHAⅡ,but the usage rate of those was respectively insufficient in NYHAⅢ,Ⅳ;NT-proBNP holds promise as a tool to screen the patients with risk factors (stage A and B) and the patients with impaired cardiac function (stage C and D),and it also has reference values to distinguish C from D.