Cor Vasa 2009, 51(4):268-273 | DOI: 10.33678/cor.2009.066

The characteristics and drug therapy of patients with chronic systolic heart failure of ischemic etiology in the Czech Republic

Jaromír Hradec^1,*, John Wikstrand², Lubica Černáková³

¹ 3. interní klinika, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

² Wallenberg -Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Göteborg, Švédsko

³ AstraZeneca Clinical Research Unit, Praha, Česká republika

Introduction: There is a lack of reliable information about the clinical characteristics and treatment of patients with chronic heart failure in the Czech Republic (CR). Nationwide data from the IMPROVEMENT-HF survey carried out in the offices of general practitioners, and the EUROHEART-HF survey in hospitals are inaccurate and have numerous limitations.

Aim: To obtain data about the clinical status and drug therapy of patients with chronic systolic heart failure of ischemic origin in the CR.

Methods: Data from a total of 497 patients enrolled within the CR into the international multicenter clinical CORONA trial were analyzed. The characteristics of Czech patients were compared with those of 5,011 patients included into the trial in a total of 19 European countries.

Results: The mean age of Czech patients was 73 ± 7 years, with 78% of them being men. Their mean EF was 0.31 ± 0.06; using the NYHA classification, 33% of patients were Class II, 66% in Class III, and 0.4% in Class IV; mean NT-proBNP levels were 293 ± 350 pg/ml, with a median of 173 pg/ml. The mean blood pressure was 130 ± 13/76 ± 8 mmHg; mean body mass index 27.6 ± 4.2 kg/m2; total cholesterol 5.3 ± 1.0; LDL-cholesterol 3.5 ± 0.9; HDL-cholesterol 1.2 ± 0.3, and triglycerides 2.0 ± 1.2 mmol/l. Seventy percent of patients had had a myocardial infarction, hypertension was present in 67%, diabetes mellitus in 45%, atrial fibrillation or flutter in 43%, and 21% of patients had a permanent pacemaker. The patients were treated properly, with 89% taking diuretics, 43% spironolactone, 92% an ACE inhibitor or an angiotensin receptor blocker, 71% a beta-blocker, and 32% digoxin. However, the mean daily doses were usually lower than recommended. The overall mortality of Czech patients throughout a mean follow-up period of almost 33 months was lower compared with that of patients in the other European countries (26.2% vs. 29.7%; p < 0.01).

Conclusion: The present analysis has furnished detailed information about the clinical status and drug therapy of patients with chronic systolic heart failure of ischemic origin in the Czech Republic. While, compared with similar patients in other European nations, Czech patients had more risk factors, their overall mortality was lower.

Keywords: Systolic heart failure; CORONA trial; Drug therapy

Published: April 1, 2009  Show citation