2016


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2016/№5

The EPOCH-CHF epidemiological program: decompensated chronic heart failure in real-life clinical practice (EPOCH-D-CHF)

Polyakov D. S., Fomin I. V., Valikulova F. Yu., Vaysberg A. R., Kraiem N., Badin Yu. V., Shechrbinina E. V., Ivanchenko E. Yu.
State Budgetary Educational Institution of Higher Professional Education, "Nizhny Novgorod State Medical Academy"of the RF Ministry of Healthcare, Pl. Minina i Pozharskogo 10/1, Nizhny Novgorod 603005

Keywords: CHF, decompensated CHF, etiology, reason for hospitalization, treatment efficacy

DOI: 10.18087/rhfj.2016.5.2239

Background. Decompensated CHF increases risks for readmission, which makes therapy for CHF much more expensive and worsens the life prognosis. Aim. To evaluate patients with decompensation of existing CHF, which required hospitalization. Materials and methods. We created a sample of patients with decompensated CHF (852 hospitalization; 750 respondents). The sample contained 56.8% of women and 43.2% of men. Mean age was 72.9±10.5. Results. IHD was diagnosed in 70.6% of patients; every second of them had heart rhythm disorders in the form of atrial fibrillation (AF). 9.6% of patients had dilated cardiomyopathy (DCMP) of different etiology. Among causes of CHF decompensation, hypertensive crisis accounted for only 2.7% of cases. 58.2% of patients were admitted with uncontrolled hypertension; 19.4% of patients had BP below 120/80 mm Hg. 70.5% of patients had pronounced tachycardia (heart rate higher than 80 bpm). Life prognosis was analyzed for one year following the discharge of patients from the hospital. Total death rate of CHF patients was 25.1%; 46.4% of patients with hypotension and 22.1% of patients with preserved BP level died within one year. The in-hospital death rate was 6.8%. Risks for fatal outcomes depended on the number of readmissions for decompensation (HR, 1.35; р=0.04), absence of the treatment with RAAS blockers (HR, 4.5; р<0.0001) or β-blockers (HR, 2.2; р<0.0001). Absence of the treatment with mineralocorticoid receptor (MCR) antagonists did not result in increased death rate (HR, 1.1; р=0.80).
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Polyakov D.S., Fomin I.V., Valikulova F.Yu., Vaysberg A.R., Kraiem N., Badin Yu.V. et al. The EPOCH-CHF epidemiological program: decompensated chronic heart failure in real-life clinical practice (EPOCH-D-CHF). Russian Heart Failure Journal. 2016;17 (5):299–305

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