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Eur J Heart Fail. 2013 Oct;15(10):1173-84. doi: 10.1093/eurjhf/hft134. Epub 2013 Aug 26.

Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry.

Collaborators (585)

Andarala M, Fiorucci E, Folkesson E, Glemot M, Gracia G, Konte M, Laroche C, McNeill P, Missiamenou V, Taylor C, Fruhwald F, Eberl A, Heller S, Dolze T, Platzer V, Ablasser K, Auer J, Poelzl G, Moertl D, Podczeck-Schweighofer A, Reiter S, Pravdic D, Fazlibegovic E, Muslibegovic A, Vitlianova K, Katova T, Kotirkov K, Petrov I, Velikov T, Kurteva T, Gatzov P, Kamenova D, Antova M, Tisheva S, Sirakova V, Krejci J, Spinar J, Mikolaskova M, Krupicka J, Malek F, Hegarova M, Pudil R, Monhart Z, Lazarova M, Reda A, Khairy T, Farag N, Saleh A, Said K, Abdel Hamid M, Halawa S, Ibrahim B, Hanna R, Hassanein M, Sobhy M, El Messiry F, El Shazly AH, Elrakshy Y, Aboleineen W, Gouda M, Youssef A, Elbahry A, Abdel A, Ebeid H, Nasr G, Sobhy H, Ashmawy M, Lefol C, Isnard R, Hagege A, Thevenin S, Jondeau G, Logeart D, Codjia R, Galinier M, Bauer F, Delahaye F, Lamblin N, Fertin M, de Groote P, Coisne D, Le Marcis V, Lequeux B, Ly JF, Lotton P, Donal E, Le Moal V, Basquin A, Reynaud A, Ridard C, Thebault C, Behar N, Mascle S, Schiele F, Seronde MF, Morel M, Meneveau N, Luporsi P, Bernard Y, Pillot M, Briand F, Damy T, Eicher JC, Avgeropoulou C, Panagiotis T, Tousoulis D, Kotrogiannis I, Stefanadis C, Chrysohoou C, Tsitsinakis G, Dimitroula T, Karavidas A, Matzaraki V, Terrovitis J, Kapelios C, Sfakianaki T, Filippatos G, Parissis JT, Ntai K, Papadopoulou A, Tziourganou H, Douras A, Ntertsas K, Karotsaki T, Nikoloulis N, Tsaknakis T, Patrianakos A, Nyktari E, Vardas P, Soos P, Nyolczas N, Csaba Nagy A, Halmosi R, Nemeth F, Amon G, Dinnyes J, Vazan Fuhrmann A, Shotan A, Alony I, Elber J, Olaru A, Valenti C, Reggianini L, Modena MG, Copelli S, Leuzzi C, Dei Cas L, Carubelli V, Lombardi C, Bulgari M, Tanghetti E, Quinzani F, Metra M, Rovetta R, Brasolin B, Fedele F, Sergi D, Romeo F, Scarfò I, Vellini M, Fabris E, Cinquetti M, Stolfo D, Sinagra G, Merlo M, Fucili A, Ferrari R, Vassanelli C, Torelli F, Marchese G, Zanolla L, Cicoira M, Anselmi M, Piccinino C, Sartori C, Di Ruocco MV, Marino PN, Giordano A, Brognoli S, Zanelli E, Cosmi F, Cadeddu C, Bandino S, Mercuro G, Deidda M, Salvemini G, Correale M, Di Biase M, Musio S, Passero T, Italiano G, Agostoni P, Salvioni E, Schiavina G, Squeri A, Bosi S, Barbieri A, Lemme E, Penco M, Marcon S, Romano S, Di Mauro M, Frisinghelli A, Veniani M, Pieri P, Novo S, Proclemer A, Fresco C, Miani D, Artico J, Gaita F, Bergerone S, Pirelli S, Di Tano G, Cattaneo S, Gualco A, Opasich C, Priori SG, Iori E, Leci E, Melandri F, Voronina N, Erglis A, Kalnins A, Kavoliuniene A, Rumbinaite E, Kazakauskaite E, Petraskiene I, Karaliute R, Smalinskas V, Tamakauskas V, Petraskiene D, Brazyte-Ramanauskiene R, Vysniauskas V, Nowicka A, Grabia J, Dankowski R, Szyszka A, Szymanowska K, Straburzynska-Migaj E, Kaluzna-Oleksy M, Grajek S, Kasztelowicz P, Orzel T, Bednarczyk G, Ruszkowski P, Klimkiewicz J, Majzner A, Matusiak A, Bylicka E, Kwiatkowska E, Kwiatkowska K, Ochnio M, Krzyzewska T, Tarnowska A, Komuda K, Sobieszczanska-Malek M, Leszek P, Rywik T, Wisniewska J, Kozar-Kaminska K, Piotrowska M, Zielinski T, Mamcarz A, Welnicki M, Folga A, Kaplon-Cieslicka A, Opolski G, Marchel M, Balsam P, Michalek A, Pawlak A, Byczkowska K, Mozenska O, Gil K, Gil RJ, Skrobowski A, Uzieblo-Zyczkowska B, Piotrowicz K, Krzesinski P, Stanczyk A, Ciurzynski M, Bienias P, Pruszczyk P, Juszczyk Z, Switala P, Stankala S, Polonski L, Rozentryt P, Gabryel J, Lazorko-Piega M, Kardaszewicz P, Poprawa I, Komorowska E, Lauko-Rachocka A, Abdulkarim AF, Dudzik-Plocica A, Zolbach A, Sajnaga D, Komorowska K, Baczynska K, Samcik M, Wolniewicz L, Wozakowska-Kaplon B, Sosnowska-Pasiarska B, Bartkowiak R, Fiega A, Serwicka A, Szymczyk A, Fitas G, Zysko D, Poliwczak A, Broncel M, Bala A, Kasprzak JD, Jankowski L, Rudzinska M, Zycinski P, Retwinski A, Pietka I, Drozdz J, Wojtczak Soska K, Jankowska E, Ponikowski P, Cichy A, Kostka A, Kaminski L, Weglarz J, Bodys A, Flis P, Kleinrok A, Prokop-Lewicka G, Mosakowska K, Rynkiewicz A, Bellwon J, Dabrowska-Kugacka A, Lewicka E, Raczak G, Skorek E, Szabowski S, Krysiak W, Pietrzak J, Gilewski W, Sinkiewicz W, Furman A, Zalewski J, Nessler J, Bury K, Grzegorzko A, Zabojszcz M, Mirek-Bryniarska E, Klys J, Przybylska K, Szulik M, Kalarus Z, Kuczaj A, Nowalany-Kozielska E, Krzeminski A, Ventosa A, Tavares Aguiar C, Moura B, Cardoso JS, De Jesus I, Chin J, Faria R, Pereira S, Lima G, Oliveira Guimarães T, Francisco AR, Brito D, Placido R, Martins S, Fonseca C, Marques F, Araujo I, Proenca M, Cardiga R, Andrade A, Castro A, Pereira A, Queirós C, Silva P, Santos R, Lourenço C, Moreno N, Almeida F, Quelhas I, Baptista A, Ferreira A, Magalhaes P, Ferreira C, Moreira I, Durao D, Severino D, Ferreira da Silva G, Marta L, Peres M, Stanescu C, Dan A, Dan GA, Daha I, Popescu R, Vinereanu D, Sinescu CJ, Macarie C, Radoi M, Nechita E, Christodorescu R, Datcu M, Craiu E, Otasevic P, Ristic AD, Simeunovic D, Seferovic P, Pencic B, Andric A, Stojcevski B, Lebedinski E, Suzic Lazic J, Celic V, Krotin M, Radovanovic S, Iric-Cupic V, Milanov S, Davidovic G, Jovic M, Radin A, Mihajlovic B, Stojiljkovic J, Cankovic M, Cemerlic Adic N, Dodic S, Kecojevic S, Stojsic S, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Antic S, Stanojevic D, Pavlovic M, Atanaskovic V, Mitic V, Kovar F, Goncalvesova E, Murin J, Pernicky M, Klabnik A, Kmec J, Rajtman D, Kovac D, Horvat S, Krunic B, Bombek M, Krajnc I, Losic R, Glavic T, Komel J, Cernic Suligoj N, Ravnikar T, Letonja M, Cencic V, Savnik Iskra M, Strasek M, Leskovar B, Drnovsek B, Klen J, Marolt A, Kladnik M, Slemenik Pusnik C, Pusnik Vrckovnik M, Jug B, Fras Z, Bartolic A, Melihen-Bartolic C, Valentincic M, Winkler R, Blanco-Canosa P, Grille-Cancela Z, Crespo-Leiro M, Paniagua-Martin MJ, Marzoa-Rivas R, Barge-Caballero E, Torres Calvo F, Bravo Marques R, Epelde Gonzalo F, Recio Platero A, de la Fuente Galan L, Lopez Diaz J, Goncalvez Ramirez LR, Cubero Gallego H, Sliwiski Herrera JF, Bierge Valero D, Salmeron FM, Gallego Page JC, Jose Fernandez M, Sahuquillo A, Garcia de la Villa B, Castro Conde A, Iniesta Manjavacas AM, Salvador Montanes O, Gonzalez-Gallarza RD, Ofelia Rosillo S, Araujo A, Briceno A, Alonso-Pulpon L, Cobo M, Soria T, Gomez-Bueno M, Garcia-Pavia P, Gonzalez-Segovia A, Sayago I, Segovia Cubero J, Delgado Jiménez JF, Angel Gomez Sanchez M, Escribano Subias P, Barrios Garrido-Lestache E, Ruiz Cano MJ, Vicente Hernandez M, Puga-Martinez M, Lopez-Moreno E, Serrano-Martinez JL, Fernandez-Alvarez M, Rivera-Lopez R, Lopez-Fernandez S, Alcade-Martinez V, Sanmartin M, Pellicer-Cabo A, Garcia-Escriva D, Ridocci-Soriano F, Perez-Silvestre J, Facila-Rubio L, Garcia-Gonzalez P, Sanchez-Lazaro IJ, Almenar-Bonet L, Garcia Pinilla JM, Andres J, Bayes Genis A, Roig E, Mirabet S, Mendez A, Garcia-Cosio L, Garay A, Muntane G, Gonzalez-Costello J, Leon V, Diaz Molina B, Famara Hernandez I, Lara Padron A, Laynez Cerdena I, Mateo I, Quiles J, Bertomeu V, Elamrani A, Angel Rodrigez-Ortega J, Martinez-Abellan R, Valero R, Fernandez-Vivancos C, Sanz Julve M, Perez-Martinez MT, Pascual-Figal DA, Martinez Martinez-Espejo MD, Rosario Gracia-Rodenas M, Pastor-Perez F, Melin M, Hägglund E, Stenberg A, Lindahl IM, Asserlund B, Olsson L, Dahlström U, Afzelius M, Karlström P, Tengvall L, Wiklund PA, Olsson B, Temizhan A, Kalayci S, Bozkurt M, Taraktas M, Cavusoglu Y, Gunes H, Birhan Yilmaz M, Demir B, Gencer E.

Abstract

AIMS:

To evaluate how recommendations of European guidelines regarding pharmacological and non-pharmacological treatments for heart failure (HF) are adopted in clinical practice.

METHODS AND RESULTS:

The ESC-HF Long-Term Registry is a prospective, observational study conducted in 211 Cardiology Centres of 21 European and Mediterranean countries, members of the European Society of Cardiology (ESC). From May 2011 to April 2013, a total of 12,440 patients were enrolled, 40.5% with acute HF and 59.5% with chronic HF. Intravenous treatments for acute HF were heterogeneously administered, irrespective of guideline recommendations. In chronic HF, with reduced EF, renin-angiotensin system (RAS) blockers, beta-blockers, and mineralocorticoid antagonists (MRAs) were used in 92.2, 92.7, and 67.0% of patients, respectively. When reasons for non-adherence were considered, the real rate of undertreatment accounted for 3.2, 2.3, and 5.4% of the cases, respectively. About 30% of patients received the target dosage of these drugs, but a documented reason for not achieving the target dosage was reported in almost two-thirds of them. The more relevant reasons for non-implantation of a device, when clinically indicated, were related to doctor uncertainties on the indication, patient refusal, or logistical/cost issues.

CONCLUSION:

This pan-European registry shows that, while in patients with acute HF, a large heterogeneity of treatments exists, drug treatment of chronic HF can be considered largely adherent to recommendations of current guidelines, when the reasons for non-adherence are taken into account. Observations regarding the real possibility to adhere fully to current guidelines in daily clinical practice should be seriously considered when clinical practice guidelines have to be written.

KEYWORDS:

ACE inhibitors; Beta-blockers; CRT; Heart failure; ICD; MRAs

PMID:
23978433
DOI:
10.1093/eurjhf/hft134
[Indexed for MEDLINE]
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