Heart failure treatment patterns: A pharmacoepidemiological descriptive study in Colombia (The HEATCO study)

Abstract

Introduction Heart failure is a common condition associated with significant mortality. Objective: to determine the prescription patterns of medications for the treatment of heart failure in a cohort of patients from Colombia. Methods This was a retrospective study based on the clinical records of patients diagnosed with heart failure between 2019 and 2020. Sociodemographic, clinical, paraclinical, and pharmacological variables and the specialty of the treating physician were identified. Patients were classified according to functional class, stage, and left ventricular ejection fraction (LVEF). Results A total of 4742 patients were evaluated, with a mean age of 68.2 ± 13.8 years and a male predominance (61.3%). A total of 92.0% were classified as stage C and 54.8% as functional class I, the mean LVEF was 42.9 ± 14.8%, and 32.53% had reduced LVEF. 30.7% did not have LVEF data. The most common causes were ischemic heart disease (44.0%) and arterial hypertension (29.7%). A total of 5.2% had hospitalizations for heart failure in the last year, and 75.6% were attended by a general practitioner. These patients were treated with β-blockers (88.3%), renin-angiotensin-aldosterone system inhibitors (RAASis) (83.1%), loop diuretics (46.8%), and mineralocorticoid receptor antagonists (MRAs) (46.5%). Triple therapy with RAASis + β-blockers+MRAs was received by 56.4% of patients with reduced LVEF, 32.8% with mildly reduced LVEF and19.5% with preserved LVEF, while quadruple therapy adding a sodium-glucose cotransporter-2 inhibitor (SGLT2i) was given just to 4.6% with reduced LVEF. Conclusion The treatment that patients with heart failure with preserved LVEF is relatively simpler and is closer to the recommendations, while the proportion of indicated therapies according to guidelines is lower among those with reduced LVEF.