© 2001 European Society of Cardiology
Ambulatory heart failure management in private practice in France
a Service de Cardiologie, Hôpital Pitié Salpétrière 47-83 Bd de l'Hôpital, 75013 Paris, France
b Service de Cardiologie CHU, Bd Jacques Monod St Herblain, 44093 Nantes, Cedex 1, France
c Unité d'épidémiologie, Institut Pasteur 1 rue du Pr. Calmette BP. 245, 59019 Lille, Cedex, France
d Hôpital Cardiovasculaire et Pneumologique BP Lyon Montchat, 69394 Lyon, Cedex 03, France
e Service de Biophysique, Hôpital Fernand Widal 200 rue du Fg Saint Denis, 75010 Paris, France
f Lipha Santé 37 rue Saint Romain, 69379 Lyon, Cedex 08, France
g MediSCAN 15 rue de Turbigo, 75002 Paris, France
* Corresponding author. Tel.: +33-1-42-17-67-21; fax: +33-1-42-17-67-37. E-mail address: michel.komajda{at}psl.ap-hop-paris.fr (M. Komajda).
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Abstract |
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Management of ambulatory heart failure was assessed in a group of 600 patients, mean age 73, 64% males, NYHA I: 9%; II: 52%; III: 33%; IV: 6%; followed up by a representative sample of private cardiologists. Fifty-two percent of patients had been previously hospitalised for worsening heart failure with a mean duration of stay of 13.1 days, for those hospitalised in the year preceding the survey (26%). First diagnosis of heart failure had been performed by a cardiologist (57%), a general practitioner (37%) or another category of physician (6%). Seventy percent of patients received three or more different classes of heart failure medications. Diuretics were prescribed to 71%, angiotensin converting enzyme inhibitors to 54% and digitalis to 35% of the population. Beta-blockers were given to only 14% of the patients. In patients aged over 80 years, only 45% received angiotensin converting enzyme inhibitors.
Conclusion: This survey of ambulatory heart failure patients confirms that the disease is predominantly observed in elderly patients, and associated with prolonged and recurrent hospitalisations. The underuse of recommended therapeutic classes including angiotensin converting enzyme inhibitors and beta-blockers deserves further investigation.
Key Words: Ambulatory • Heart failure • Management
Received November 10, 2000; Revised March 14, 2001; Accepted April 26, 2001
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