부산대학교 도서관

Introduction:Despite recent advancement in management of Heart failure (HF), the accessibility and affordability of this treatment is still an issue in developing countries.Hypothesis:We aimed to assess etiological and pharmacological profile of heart failure patients in our study.Methods:The study population consisted of 407 patients with chronic heart failure aged >18 years attending as outpatient. Acute Heart Failure and patients hospitalized for Acute Heart Failure within 4 weeks were excluded. The diagnosis of heart failure was made in accordance with 2016 ESC guidelines for the Heart failure. Patients were stratified into those with reduced ejection fraction(HFrEF: when EF < 40%), preserved ejection fraction (HFpEF: when EF > 50%), and those with mid-range ejection fraction (HFmrEF; when EF = 40-50%).Results:The mean age of the cohort was 58.8 years & 64.4% (n = 262) were males. The overall mean left ventricular ejection fraction (LVEF) of the cohort was 38.47±9.24%. Heart failure with reduced ejection fraction (HFrEF) was seen in 58.5% of patients. The two most prevalent etiologies of HF were ischemic heart disease (IHD) (53.6%; n = 218),) and idiopathic cardiomyopathy (34.2%; n = 133).The percentage of patients who received diuretics, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), aldosterone antagonists, ARNI and Beta blockers as treatment were 93.12%, 71.99%, 8.11%, 82.31% , 6.63 % and 90.42 % respectively.The most commonly prescribed ACEI was ramipril (68.8%), Betablocker was carvedilol (45.7%) and MRA was Spironolactone (82.33%).Guideline directed medical therapy (beta-blocker,RAAS blocker and MRA-all 3) was prescribed in 63.88 % of patients. The median dose of ramipril was 2.86 mg (28% of target),carvedilol was 6.4 mg (12.8% of target), ARNI was 88.89mg (44.4% of target ) & spironolactone was 49.3mg (98.6% of target).Conclusions:Ischemic Heart Disease is the most common etiology of HF in the region.Despite the encouragement to follow the ESC Heart Failure Guidelines, only 63.88 % of patients were on prescribed guideline based therapy. Even among those getting drug, majority drugs failed to reach even 50% of the target doses with the exception of MRA.