A portrait of a typical patient suffering from heart failure
AbstractThe aim of the study – on the basis of medical reports to make a typical portrait of a patient suffering from heart failure (HF) in St. Petersburg, as well as to analyze the recommended therapy for this category of patients.
Material and methods. The database analysis of the St. Petersburg “Regional fragment of the unified state information system in the field of healthcare” State Information System for 2020 was carried out on code I50.x. In total, 46 866 patients with HF of any etiology aged 18 and over were selected. In order to determine the most characteristic groups of patients with HF observed in medical organizations in St. Petersburg, a cluster analysis was carried out. The depersonalized medical documentation of 22 457 patients, who were treated in hospitals of the city, was selected and processed. In St. Petersburg about HF in 2020, on the basis of which an analysis of the ongoing therapy aimed at the treatment of heart failure was carried out.
Results. Cluster analysis conducted in 2020 on the basis of medical documentation of 46 866 patients revealed 7 patients clusters. The cluster distribution is generally uniform, there are 2 clusters (3rd and 5th) with the maximum number of observations, the remaining clusters are similar in the number of observations. The gender distribution showed that women predominate in the majority (63.9%). 2nd cluster is dominated by men. Most of the patients belong to the age group of 60–74 years. Most patients suffer from hypertension, coronary artery disease and other heart diseases, cerebrovascular diseases. Diabetes mellitus occurred in 15.9% of cases, atrial fibrillation in 15.4% of cases, thyroid pathology in 9.38% of cases, iron deficiency anemia in 5.32% of cases, obesity in 4.78% of cases, myocardial infarction in 4.43% of cases, chronic obstructive pulmonary disease in 3.97% of cases, bronchial asthma 3.0% of cases, chronic rheumatic heart disease in 1.12% of cases, cardiomyopathy in 0.35% of cases. The appointment of drugs aimed at the HF treatment is systematic, but only half of the patients are prescribed optimal-minimal therapy, determined by clinical recommendations for the treatment of HF. The appointment of modern groups of drugs such as angiotensin receptors-neprilysine inhibitor and sodium-glucose co-transporter type 2 inhibitor is of a single nature.
Conclusion. In most cases, patients with HF in St. Petersburg are women in the age group of 60–74 years, who have a fairly large set of concomitant diseases. At the same time, this cohort of patients often goes to the polyclinic and calls an ambulance much less often, and the number of hospitalizations to the hospital is on average 1–2 and does not exceed 3 times a year. No more than half of this category of patients take optimal therapy aimed at the treatment of HF. The male half of the patients will be characterized by a large number of cardiovascular catastrophes, as well as a large number of requests for medical help, due to the severity of their condition.
Keywords:heart failure; patient portrait; therapy; quadritherapy; comorbid pathology; St. Petersburg
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
Authors’ contribution. Development of the study design, data collection, implementation of the practical part of the study, analysis and interpretation of statistical data, writing the manuscript – Koltsov A.V.; scientific management of the work, critical revision with the introduction of valuable intellectual content into the article – Tyrenko V.V.; critical revision of the text of the article with the introduction of valuable intellectual content – Bologov S.G.; data analysis and interpretation – Kachnov V.A.
For citation: Koltsov A.V., Tyrenko V.V., Bologov S.G., Kachnov V.A. A portrait of a typical patient suffering from heart failure. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2023; 11 (1): 25–33. DOI: https://doi.org/10.33029/2309-1908-2023-11-1-25-33 (in Russian)
References
1. Tereshchenko S.N., Galyavich A.S., Uskach T.M., et al. Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Chronic heart failure. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2020; 25 (11): 311–74. DOI: https://doi.org/10.15829/1560-4071-2020-4083 (in Russian)
2. Ageev F.T., Belenkov Yu.N., Fomin I.V., et al. The prevalence of chronic heart failure in the European part of the Russian Federation – EPOCH-CHF. Serdechnaya nedostatochnost’ [Heart Failure]. 2006; 7 (3): 112–5. (in Russian)
3. Ageev F.T., Danielyan M.O., Mareev V. Yu., Belenkov Yu.N. Patients with chronic heart failure in Russian outpatient practice: features of the contingent, diagnosis and treatment (based on the materials of the EPOCH-O-CHF study). Serdechnaya nedostatochnost’ [Heart Failure]. 2004; 5 (1): 4–7. (in Russian)
4. Polyakov D.S., Fomin I.V., Belenkov Yu.N., et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiya [Cardiology]. 2021; 61 (4): 4–14. DOI: https://doi.org/10.18087/cardio.2021.4.n1628 (in Russian)
5. Drapkina O.M., Boytsov S.A., Omelyanovsky V.V., et al. Socio-economic impact of heart failure in Russia. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2021; 26 (6): 81–9. DOI: https://doi.org/10.15829/1560-4071-2021-4490 (in Russian)