318 Specialist awareness of and adherence to clinical guidelines for management of chronic heart failure (CHF)

Despite the development and implementation of clinical guidelines, emergence of modern effective drugs for the treatment of chronic heart failure (CHF), this pathology is characterized by stable progression, directly worsening the quality of life and decreasing the life expectancy. With that, treatment efficacy directly depends on high treatment compliance in patients with CHF both at the treatment start and upon its subsequent correction. One should also not underestimate the value of patient readiness to modify their lifestyle. Besides, the complete physician compliance with clinical guidelines also plays a significant role. The absence of correspondence between principles defined in the guidelines and really administered drugs excludes the possibility of achieving control over CHF symptoms and positive impact on the prognosis. This review is aimed at evaluating treatment compliance among both patients with CHF and their physicians with a focus on Russian studies and good clinical practice (GCP) compared to studies of foreign authors. Unfortunately, the problem of compliance in CHF in the Russian Federation has not been sufficiently analyzed in large-scale studies up to the present time: CHF patient registries mainly allow to detect clinical and epidemiological disease features, while almost not covering compliance issues. It should also be noted that the problem of compliance in both physicians and patients is undoubtedly up-to-date, as it often defines further prognosis in patients with CHF, which explains the scientific practical value of large trials with subsequent thorough analysis and searches regarding increasing its efficiency.

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CHRONIC HEART FAILURE: CLINICAL GUIDELINES AND REAL CLINICAL PRACTICE

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2016-12-6-631-637 ◽

2016 ◽

Vol 12 (6) ◽

pp. 631-637 ◽

Cited By ~ 2

Author(s):

E. K. Shavarova ◽

L. A. Babaeva ◽

S. S. Padaryan ◽

N. N. Soseliya ◽

O. I. Lukina ◽

...

Keyword(s):

Heart Failure ◽

Clinical Practice ◽

Chronic Heart Failure ◽

Clinical Guidelines ◽

Real Clinical Practice

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Clinical and demographic characteristics of an outpatient Russian population with chronic heart failure at the time of enrollment in the QUALIFY registry for evaluating consistency with clinical guidelines on drug therapy

Kardiologiia ◽

10.18087/cardio.2363 ◽

2017 ◽

Vol 17 (S2) ◽

pp. 324-330

Author(s):

S. N. Tereshchenko ◽

◽

I. V. Zhirov ◽

A. A. Petrukhina ◽

◽

...

Keyword(s):

Heart Failure ◽

Drug Therapy ◽

Chronic Heart Failure ◽

Clinical Guidelines ◽

Demographic Characteristics ◽

Russian Population

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Comparison of clinical guidelines for the diagnosis and treatment of chronic heart failure of ČKS and ESC 2012

Cor et Vasa ◽

10.1016/j.crvasa.2013.03.011 ◽

2013 ◽

Vol 55 (4) ◽

pp. e301-e308

Author(s):

Jindřich Špinar ◽

Jiří Vítovec ◽

Jaromír Hradec ◽

Ivan Málek ◽

Jaroslav Meluzín ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Guidelines ◽

Diagnosis And Treatment

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Anemia in Patients with Heart Failure: Current State of the Problem

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2019-8-1-68-73 ◽

2019 ◽

Vol 8 (1) ◽

pp. 68-73 ◽

Cited By ~ 1

Author(s):

S. R. Gilyarevsky ◽

M. V. Golshmid ◽

I. M. Kuzmina ◽

N. G. Bendeliani

Keyword(s):

Heart Failure ◽

Clinical Trials ◽

Chronic Heart Failure ◽

Intravenous Administration ◽

Clinical Guidelines ◽

Randomized Clinical Trials ◽

Current State ◽

Patients With Heart Failure

The article reports the modern tactics of treating patients with chronic heart failure and concomitant anemia. The results of the most important randomized clinical trials that are the basis for developing approaches to the treatment of anemia in such cases are discussed. Attention is also paid to unresolved problems in the treatment of anemia in patients with heart failure. The data on the intravenous administration of iron preparations as the most effective approach to the treatment of anemia in patients with heart failure in the presence of iron defciency are given. The main provisions of modern clinical guidelines on the management of patients with heart failure and anemia are considered.

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Clinical guidelines performance in patients with chronic heart failure: the data of 2015 registry in Ivanovo region

Cardio-IT ◽

10.15275/cardioit.2016.0104 ◽

2016 ◽

Vol 3 (1) ◽

pp. e0104

Author(s):

Elena A. Shutemova ◽

Olga A. Belova ◽

Svetlana A. Rachkova ◽

Svetlana V. Romanchuk

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Guidelines

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Clinical characteristics and treatment of outpatients with chronic heart failure in the Moscow Region

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2021-49-023 ◽

2020 ◽

Vol 49 ◽

Author(s):

T. K. Chernyavskaya ◽

M. G. Glezer

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Guidelines ◽

Left Ventricular ◽

Moscow Region ◽

Left Ventricular Ejection ◽

Chronic Obstructive ◽

Concomitant Disease ◽

Receptor Antagonists ◽

Ventricular Ejection Fraction

Aim: To perform clinical characterization of patients with chronic heart failure (CHF) in the Moscow Region and to assess if their current treatments meet the current clinical guidelines.Materials and methods: Based on the information submitted from 11 outpatient clinics in the Moscow Region in December 2019, we analyzed retrospective data on 286 patients with CHF, including their concomitant diseases, types of assessments and their results, as well as current treatments.Results: The most common concomitant disease was arterial hypertension (95.1% of the patients). 53.8% of the patients had previous myocardial infarction, 37.8%, diabetes mellitus, and 34.6%, atrial fibrillation. Chronic kidney disease was present in 18.5% of the patients, valvular heart disease in 11.9%, and past stroke in 10.5%. Of non-cardiovascular diseases, the most common were gastrointestinal disorders (25.2%), chronic obstructive pulmonary disease or asthma (9.8%), and anemia (5.2%). Only 8% of the patients had one concomitant disease, whereas 72% had 2 to 3 diseases, and 20% had at least 4 concomitant diseases. Mean number of comorbidities per patient was 2.7. Echocardiography had been performed in 82.9% of the cases. Mean left ventricular ejection fraction was 51.0±10.11%; in 11.5% of the patients it was≤40%. Glomerular filtration rate (GFR) was calculated in 58.7% of the patients. 35.9% of the patients had a GFR of less than 60 mL/min/1.73 m2 , in 3.6% it was≤30 mL/min/1.73 m2 . 83.2% of the patients were treated with renin angiotensin aldosterone system blockers (angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, sacubitril/valsartan), 79.0% with beta-blockers, 53.1% with mineralocorticoid receptor antagonists. Glycosides had been administered to 6.9% of the patients, and diuretics, to 51.1%. In most cases, the doses administered were below those recommended by the international clinical guidelines.Conclusion: We have confirmed the need to increase the adherence of doctors to the clinical guidelines on assessment and management of CHF patients.

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Modern view on chronic heart failure therapy: guidelines‑2020 key messages and adjuvant therapy

Medical alphabet ◽

10.33667/2078-5631-2021-1-8-16 ◽

2021 ◽

pp. 8-16

Author(s):

A. I. Kochetkov ◽

O. D. Ostroumova ◽

A. V. Arablinsky ◽

G. P. Kovaleva

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Adjuvant Therapy ◽

Clinical Guidelines ◽

Systolic Function ◽

Rational Approach ◽

Aldosterone Antagonists ◽

Wide Range ◽

Failure Conditions ◽

Therapy Strategies

Objective. Data analysis on modern therapy strategies of chronic heart failure (CHF) and the possibilities of adjuvant therapy with phosphocreatine. Methods. Analysis and systematization of the positions of the year 2020 Russian Ministry of Health clinical guidelines on CHF and modern local and international literature data.Results. Currently, for the treatment of CHF, a wide range of drugs are used that can improve the prognosis and reduce mortality in patients, including β-blockers, blockers of the renin-angiotensin-aldosterone system, diuretics, aldosterone antagonists and neprilisin inhibitors. At the same time, based on the peculiarities of the pathogenesis of CHF and the characteristics of the myocardial energy metabolism in heart failure conditions, a promising direction is the use of additional (adjuvant) drugs in this category of patients. Here, a special place is occupied by phosphocreatine, which is essential in maintaining the energy balance of cardiomyocytes and has been widely studied in a large number of studies that have confirmed its ability not only to increase exercise tolerance in patients with CHF, but also to improve heart systolic function and prognosis, improving patient survival. Conclusion. Based on the reviewed body of evidence, a rational approach in the management of patients with CHF is to add adjuvant phosphocreatine therapy to the standard treatment strategy according to the current clinical guidelines, which provides an additional improvement in prognosis and a decrease in mortality rates in patients.

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