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Are the ESC and CKS guidelines for diagnostics and treatment of heart failure different?


Authors: prof. MUDr. Jindřich Špinar, CSc.;  Fesc 1;  prof. MUDr. Jindřich Vítovec, CSc.;  Fesc 2
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno 1;  Mezinárodní centrum klinického výzkumu – I. interní kardio-angiologická klinika LF MU a FN u sv. Anny v Brně jspinar@fnbrno. cz 2
Published in: Kardiol Rev Int Med 2013, 15(2): 99-103
Category:

Overview

In 2012, Czech and European guidelines for the diagnosis and treatment of heart failure were published. The authors of the Czech guidelines compared both documents. The main difference is that the European guidelines include acute heart failure, while our national guidelines include only chronic heart failure. The diffe­rence is already in the definition of heart failure: the European guidelines do not include natriuretic peptides in the diagnostic criteria and in case of controversial diagnosis, treatment response is not an additional criterion. There is also a partial difference in division of signs and symptoms of heart failure in both recommendations. In the diagnosis of heart failure, there are slight differences in the standards for echocardiographic parameters, especially the parameters of diastolic dysfunction. Standards for natriuretic peptides were changed for non-emergency incoming patients for whom the marginal value of NT-proBNP is below 125 pg/ml and 35 pg/ml for BNP. In the treatment of heart failure, there are the same drug groups. In the European guidelines, for ACE inhibitors, ramipril is not included and perindopril has a target dose of twice 5 mg, while in the Czech guidelines, it is once 10 mg. In the Czech guidelines, Losartan has a target dose of 100 mg, while in the European guidelines it is 150 mg once daily. Among diuretics, in European guidelines, there are triamterene and amiloride, which are not included in Czech guidelines.

Keywords:
guidelines – heart failure – differences


Sources

1. McMurray JJ, Adamopoulos S, Anker SD et al. ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33: 787– 1847.

2. Špinar J, Vítovec J, Hradec J et al. Czech Society of Cardiology guidelines for the diagnosis and treatment of chronic heart failure 2011. Cor et Vasa 2012; 54: e114– e1341.

3. Špinar J, Vítovec J, Hradec J et al. Doporučení pro diagnostiku a léčbu chronického srdečního selhání –  ČKS 2011. Cor et Vasa 2012; 54: 161– 182.

4. Špinar J, Vítovec J, Hradec J et al. Doporučení pro diagnostiku a léčbu chronického srdečního selhání –  ČKS 2011. Vnitř Lék 2012; 58 (Suppl 1): S4– S40.

5. Špinar J, Vítovec J, Hradec J. Co je nového v evropských doporučeních pro diagnostiku a léčbu srdečního selhání. Kardiol Rev 2012; 14: 2011– 2012.

6. Špinar J, Vítovec J, Hradec J et al. Srovnání doporučení pro diagnostiku a léčbu chronického srdečního selhání ČKS a ESC 2012. Cor et Vasa 2013 [Epub ahead of print].

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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