Current status of medication and implantable device treatment for heart failure patients in China
Objective To investigate and analyze the etiology,comorbidities,clinical characteristics,implantation of devices,and drug treatment of hospitalized patients with heart failure in China.Methods Research data were obtained from the Chinese Heart Failure Center Registration Study,which enrolled heart failure patients from 169 hospitals betweenn January 2017 and August 2022.This cross-sectional survey focused on patients with left ventricular ejection fraction(LVEF)≤35%,and specifically analyzed patients receiving implanted devices.Clinical data of patients,including neurological information,diagnosis,electroencephalogram,echocardiogram,laboratory indicators,etiology of heart failure,comorbidities,and treatment were collected.Results Among 32,777 patients LVEF≤35%,3 646 patients(11.1%)received instrument therapy,with 1,494(4.6%)receiving ICD implantation,642(2.0%)receiving CRT-P implantation,and 1 510(4.6%)patients receiving CRT-D implantation.The leading causes of heart failure were dilated cardiomyopathy[57.1%(1 881/3 297)],coronary heart disease[30.5%(1 007/3 297)],hypertension[7.5%(248/3 297)],and valvular heart disease[4.3%(143/3 297)].The main combined cerebrovascular diseases were atrial fibrillation/atrial flutter 31.9%(1 163/3 646)and stroke/transient ischemic attack 9.6%(348/3 536).Other comorbidities are diabetes[28.7%(1 039/3 625)],anemia[27.7%(973/3 520)],Chronic kidney disease[14.2%(518/3 640)],hyponatremia[9.0%(317/3 522)],malignant tumor[2.2%(81/3 631)].During the hospitalization of heart failure patients,the rate of using loop Diuretic was 87.2%(3 163/3 627),and the rate of using positive muscle drugs was 10.4%(378/3 640).At discharge,the utilization rate of angiotensin converting enzyme inhibitor(ACEI)was 31.5%(1 149/3 646),that of angiotensin Ⅱ receptor blocker(ARB)was 23.9%(871/3 646),that of Angiotensin Receptor-Neprilysin Inhibitor(ARNI)was 29.5%(1 076/3 646),that of β receptor blocker was 90.3%(3 239/3 642),and that of Aldosterone receptor blocker was 84.8%(3 087/3 642).Conclusion Drug therapy remains the primary treatment for heart failure patients in China,with a relatively low implantation rate of device therapy,which falls behind domestic and international guidelines recommendations.Among patients receiving receive implantable device treatment,most also receive guideline-recommendation drug therapy,indicating good compliance.
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