The practice of the clinical guidelines for the diagnosis and treatment of chronic heart failure applying in the city hospitals of Saint Petersburg

Abstract

Chronic heart failure is one of the main causes of mortality in Russia. Improving the medical care system for patients with chronic heart failure is currently associated with the introduction of guidelines, the application of which has become mandatory in Russia since of 2022. Aim to study whether the prescriptions set out in the discharge records of the St Petersburg city hospitals correspond to the provisions of the current guidelines on the chronic heart failure diagnosis and treatment. The material for the study was the discharge records of 101 patients with chronic heart failure who were treated in the city hospitals of St Petersburg in 2022. Echocardiography was performed in all patients, while brain natriuretic peptides were not measured in either case. Drugs from various groups of the renin-angiotensin-aldosterone system blockers were recommended in 86.1 % of patients. Patients with reduced left ventricular ejection fraction most often received a Sacubitril/Valsartan (56.9 %). Beta-blockers in 84.2 %, and mineralocorticoid receptor antagonists were — in 94.1 % of cases. Therapy with the use of these three groups of drugs was received by 67.3 % of patients. Inhibitors of sodium-glucose co-transporter type 2 were recommended in 7.9 %, in 2 cases in addition to triple therapy. Loop diuretics were recommended in 88.1 % of cases. Therapy of patients with chronic heart failure who were treated in 2022 is more in line with the provisions of the current guidelines than in previous years, however, a number of problems remain unresolved.