Document Detail


Critical evaluation of the optimal medical therapy in the cardiac resynchronization therapy candidates--single centre experience.
MedLine Citation:
PMID:  22097686     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
METHODS: The optimal medical therapy was analysed retrospectively from the medical records of 179 consecutive CHF patients NYHA class III-IV. Beta-blockers (BB) were used only in 81% subjects referred for CRTD, ACE inhibitors (ACEI) were used only in 68% patients Angiotensin receptor blockers (ARB) were used in 18% subjects. ACEI or ARB were used in 81%, spironolacton was use in 59%. Recommended target DD for BB (carvedilol 25 mg bid) was used only in 13% subjects, recommended target DD for ACEI (enalapril 10 mg bid) was used only in 9.4% patients.
RESULTS: In the Department of Cardiology, the optimal medical therapy was changed after CRTD, BB were used in 95% subjects at discharge (p < 0.01) and the number of patients reaching at least of 50% of recommended daily dose (DD) of BB increased (p < 0.05). ACEI were recommended after CRTD in 80% subjects after implantation (p < 0.05), the number of patients reaching at least of 50% of recommended DD for ACEIs increased too (p < 0.05). There was no significant difference in ARB use recomended in the hospital (19% after CRTD - NS). ACEI or ARB were used in 98% patients after the device implanted (p < 0.05) and spironolacton in 77% after CRTD (p < 0.05).
CONCLUSIONS: Despite optimal composition of the optimal medical heart failure therapy only small number of CRTD candidates are reaching recommended drug dose. The optimization of the medical therapy in the specialized center lead to significantly higher proportion of CHF using the optimal therapy with the increased dose of BB and ACEI.
Authors:
D Vondráková; F Málek; J Dvorák; L Sedivá; J Kupec; J Petrů; M Táborský; P Neuzil
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Vnitr̆ní lékar̆ství     Volume:  57     ISSN:  0042-773X     ISO Abbreviation:  Vnitr Lek     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413602     Medline TA:  Vnitr Lek     Country:  Czech Republic    
Other Details:
Languages:  eng     Pagination:  799-802     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Cardiovascular Centre, Na Homolce Hospital, Prague.
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