查詢結果分析
相關文獻
頁籤選單縮合
題名 | Gap between Guidelines and Clinical Practice in Heart Failure with Reduced Ejection Fraction: Results from TSOC-HFrEF Registry |
---|---|
作者 | Chang, Hung-yu; Wang, Chun-chieh; Wei, Jeng; Chang, Chong-yi; Chuang, Yi-cheng; Huang, Chien-long; Chong, Eric; Lin, Jiunn-lee; Mar, Guang-yuan; Chan, Kuei-chuan; Kuo, Jen-yuan; Wang, Ji-hung; Chen, Zhih-cherng; Tseng, Wei-kung; Cherng, Wen-jin; Yin, Wei-hsian; | 書刊名 | Journal of the Chinese Medical Association |
卷期 | 80:12 2017.12[民106.12] |
頁次 | 頁750-757 |
分類號 | 415.319 |
關鍵詞 | Adherence; Beta-blocker; Guidelines; Heart failure; Renin-angiotensin blockade; Taiwan; |
語文 | 英文(English) |
英文摘要 | Background Heart failure (HF) is a global health problem. Guidelines for the management of HF have been established in Western countries and in Taiwan. However, data from the Taiwan Society of Cardiology-Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry showed suboptimal prescription of guideline-recommended medications. We aimed to analyze the reason of non-prescription and clinical outcomes as a result of under-prescription of medications. Methods A total of 1509 patients hospitalized for acute HFrEF were recruited in 21 hospitals in Taiwan by the end of October 2014. Prescribed guideline-recommended medications and other relevant clinical parameters were collected and analyzed at discharge and 1 year after index hospitalization. Results At discharge, 62% of patients were prescribed with either angiotensin-converting enzyme-inhibitors (ACEI) or angiotensin receptor blockers (ARB); 60% were prescribed with beta-blockers and 49% were prescribed with mineralocorticoid receptor antagonists (MRA). The proportions of patients at ≥50% of the target dose for ACEI/ARB, beta-blockers and MRA were 24.4%, 20.6%, 86.2%, respectively. At 1-year follow-up, dosages of ACEI/ARB and MRA were up-titrated in about one-fourth patients, and dosages of beta-blocker were up-titrated in about 40% patients. One-year mortality rate was lowest in patients who received at least 2 classes of guideline-recommended medications with ≥50% of the target dose, and highest in those who received 0 or 1 class of medications. Conclusion The TSOC-HFrEF registry demonstrated the under-prescription of guideline-recommended medications and reluctance of physicians to up-titrate medications to target dose. Action plan needs be formulated in order to improve physician's adherence to HF guidelines. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。