Clinical portrait of a patient with acute decompensation of heart failure

Authors: Okunev I.M., Kochergina А.М., Kashtalap V.V., Barbarash О.L.

Company: 1Kemerovo State Medical University, Kemerovo, Russian Federation
2Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
3Kuzbass Clinical Cardiology Dispensary named after Academician L.S. Barbarash, Kemerovo, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2022-16-3-385-393

For citation: Okunev I.M., Kochergina А.М., Kashtalap V.V., Barbarash О.L. Clinical portrait of a patient with acute decompensation of heart failure. Creative Cardiology. 2022; 16 (3): 385–93 (in Russ.). DOI: 10.24022/1997-3187-2022-16-3-385-393

Received / Accepted:  07.06.2022 / 26.08.2022

Keywords: heart failure acute decompensation of heart failure comorbidity adherence to drug therapy

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Abstract

Objective. To study the clinical and anamnestic characteristics and adherence to prehospital drug therapy in patients with acute decompensated heart failure (ADHF).

Material and methods. 315 patients admitted to the Department of Emergency Cardiology No. 2 of the Kuzbass Clinical Cardiology Dispensary named after Academician L.S. Barbarash in 2020. The assessment of clinical and anamnestic features of patients and adherence to drug therapy was performed.

Results. The average age was 68.28 ±12.19 years, the proportion of men was 51.11% (n =161). Arterial hypertension was detected in 89.2% (n = 281), previously suffered myocardial infarction 33.33% (n =105), atrial fibrillation in 74.29% (n = 234) patients; dilated cardiomyopathy – in 4.44% (n =14) and heart defects – in 27.3% (n = 86). Active smokers were 9.52% (n = 30) of patients. The most common comorbid disease was type 2 diabetes mellitus (DM2) 27.94% (n = 88). Almost half of patients with ADHF (45.39%, n = 143) have preserved left ventricular ejection fraction (LVEF), moderately reduced LVEF – 20.32% (n = 64), reduced LVEF – 34.28% (n = 108). More than a third (36.83%, n = 116) had signs of anemia of varying severity. Adherence to drug therapy at the prehospital stage was low. Beta-blockers received 53.33% (n = 168) of patients, statins – 33.33% (n = 105), angiotensin-converting enzyme inhibitors – 22.54% (n = 71) of patients, sartans – 19.68% (n = 62), loop diuretics – 43.81% (n = 138) of patients, mineralocorticoid receptor antagonists – 24.44% (n = 77) of patients. None of the patients received angiotensin receptor and neprilysin inhibitor (ARNI) preparations. Inhibitors of sodiumdependent glucose cotransporter type 2 were taken only by 2 patients with concomitant DM2.

Conclusion. Patients hospitalized with ADHF are characterized by a high incidence of anemia and type 2 diabetes, as well as low adherence to the main groups of drug therapy that affects the prognosis.

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About Authors

  • Igor’ M. Okunev, Cardiologist, Postgraduate; ORCID
  • Anastasiya M. Kochergina, Cand. Med. Sci., Assistant Professor, Researcher; ORCID
  • Vasiliy V. Kashtalap, Dr. Med. Sci., Professor of Chair, Head of Department; ORCID
  • Ol’ga L. Barbarash, Dr. Med. Sci., Chief of Chair, Academician of Russian Academy of Sciences, Director; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery