Prescription and dosing of diuretics in patients with chronic heart failure in the FAR NHL register

Czech version

Authors: Špinarová M. ¹; Špinar J. ¹; Pařenica J. ²; Ludka O. ³; Lábr K. ¹; Krejčí J. ¹; Málek F. ⁴; Ošťádal P. ⁴; Tomandl J. ⁵; Benešová K. ⁶; Jarkovský J. ⁶; Špinarová L. ¹
Authors‘ workplace: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně ¹; Interní kardiologická klinika LF MU a FN Brno ²; Fakultní nemocnice Brno ³; Kardiocentrum, Nemocnice Na Homolce, Praha ⁴; Biochemický ústav, LF MU Brno ⁵; Institut biostatistiky a analýz, LF a PřF MU, Brno ⁶
Published in: Kardiol Rev Int Med 2020, 22(2): 58-62

Overview

Background: Congestive heart failure with reduced ejection fraction is a common clinical condition with a serious prognosis. The treatment focuses on improving the symptoms and preventing the progression of the disease. Diuretics, together with RAAS blockers and beta-blockers provide the basic therapy in most patients with pulmonary or systemic congestion.

Methods: These data come from the FAR NHL register (FARmacology and NeuroHumoraL activation). This is a multicentre database of patients with stable systolic heart failure (EF < 50%) included between November 2014 and November 2015.

Results: A population of 1,100 patients was evaluated, the mean age was 65 years, 80.8% were male. The aetiology of heart failure was ischaemic heart disease (49.7%), dilated cardiomyopathy (41.7%) and other (8.6%). Diuretics were the third most frequently prescribed therapy. Furosemide alone or in combination was the most commonly administered diuretic (80.6%). 746 (67.8%) patients also received verospirone or eplerenone. The prescription of diuretics increased with the severity of the disease according to the NYHA classification (all 87.3%, NYHA I 65.8%, NYHA II 88.2%, NYHA III-IV 95.5%, p<0.001). High doses of furosemide were administered to patients with a higher NYHA classification, lower EF (25 vs. 30%, p<0.001), higher level of NT-proBNP (1,176 vs 378 pg / ml, p<0.001) and higher level of creatinine (102 vs. 93 [mu] mol/l, p<0,001).

Conclusions: These data show the tendency of pharmacological prescription of diuretics, which reflects especially the severity of heart failure and renal functions, and show the importance of an individual attitude to correct dosing for every patient.

Keywords:

pharmacotherapy – heart failure – Diuretics – furosemide – FAR NHL register – target dose

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