| Abstract | Cilj istraživanja: Utvrditi postoji li značajna razlika u propisivanju ACE-inhibitora i ARB-a u
bolesnika sa zatajivanjem srca uz očuvanu i onih uz sniženu sistoličku funkciju lijeve klijetke.
Ustroj istraživanja: Istraživanje je provedeno kao presječna studija podataka Hrvatskog
registra bolesnika sa zatajivanjem srca.
Mjesto istraživanja: Istraživanje je provedeno na Klinici za unutarnje bolesti KBC-a Split, na
osnovi podataka iz Registra prikupljenih u KBC-u Split.
Sudionici: U istraživanje je uključeno 705 ispitanika (400 muškaraca i 305 žena) koji su bili
primljeni na bolničko liječenje u KBC Split s dijagnozom zatajivanja srca uz očuvanu ili sniženu
sistoličku funkciju lijeve klijetke, čiji su podatci uneseni u Registar u vremenu od 1. listopada
2005. do 1. veljače 2011. godine. Kriterij isključenja ispitanika iz studije je: ispitanici s
nepotpuno ispunjenim podatcima u Registru.
Glavne mjere ishoda: Učestalost propisivanja ACE-inhibitora i ARB-a u ispitanika sa
zatajivanjem srca uz očuvanu ili sniženu sistoličku funkciju lijeve klijetke.
Rezultati: Od zatajivanja srca su češće oboljeli muškarci, koji su brojniji u skupini onih sa
sniženom sistoličkom funkcijom lijeve klijetke, dok su žene i stariji zastupljeniji u skupini s
očuvanom sistoličkom funkcijom lijeve klijetke. U 79,7% ispitanika sa zatajivanjem srca uz
očuvanu i 75,6% ispitanika uz sniženu sistoličku funkciju lijeve klijetke bio je propisan ACEinhibitor
ili ARB, međutim, ne postoji statistički značajna razlika u učestalosti propisivanja
ACE-inhibitora i ARB-a između te dvije skupine (χ2=1,294, df=2, P=0,524). Također, ne postoji
statistički značajna razlika u učestalosti propisivanja beta-blokatora i diuretika u ispitanika sa
zatajivanjem srca uz očuvanu i onih uz sniženu sistoličku funkciju lijeve klijetke. Ta razlika je
utvrđena u slučaju aldosteronskih antagonista (χ2=6,389, df=2, P=0,033), koji se češće
propisuju ispitanicima sa sniženom sistoličkom funkcijom. Nisu utvrđene značajne razlike u
propisivanju ACE-inhibitora i ARB-a u bolesnika sa zatajivanjem srca uz očuvanu (ACEihibitori:
χ2=0, df=2, P=1; ARB-i: χ2=2,223, df=2, P=0,329) i sniženu (ACE-inhibitori: χ2=0,355,
df=2, P=0,837; ARB-i: χ2=0,29, df=2, P=0,867) sistoličku funkciju s obzirom na spol.
Zaključci: U Hrvatskom registru bolesnika sa zatajivanjem srca, nema razlike u učestalosti
propisivanja ACE-inhibitora, ARB-a, beta-blokatora i diuretika između ispitanika s očuvanom i onih sa sniženom sistoličkom funkcijom lijeve klijetke. Također, nema razlike u učestalosti
propisivanja ACE-inhibitora i ARB-a između muškaraca i žena. |
| Abstract (english) | Objective: To determine whether there is a significant difference in prescribing ACEinhibitors
and ARBs in patients with heart failure with preserved and with reduced left
ventricular systolic function.
Design: This research was conducted as an intersection study based on data of the Croatian
Registry of patients with heart failure.
Setting: The study was conducted at the Department of Internal Medicine, Clinical Hospital
in Split (KBC Split), on the basis of data obtained from the Croatian Registry of patients with
heart failure in the Clinical Hospital in Split.
Participants: The study included 705 subjects (400 men and 305 women) who were
hospitalized at Split University Hospital with a diagnosis of heart failure with preserved or
reduced left ventricular systolic function, whose data are entered in the Registry in the
period from 1 October 2005 to 1 February 2011 year. Exclusion criterion applied to study
participants: patients with incomplete data in the Registry.
Main Outcome Measures: The frequency of prescribing ACE inhibitors and ARBs in patients
with heart failure and preserved or reduced systolic left ventricular function.
Results: The heart failure patients are more oftenly men who are more numerous in the
group of those with reduced left ventricular systolic function, while women and the eldery
are more represented in the group with preserved left ventricular systolic function. 79,7% of
patients with heart failure with preserved and 75,6% of patients with reduced left
ventricular systolic function was prescribed ACE inhibitor or ARB. However, there isn't any
significant statistical difference in the frequency of prescription of ACE inhibitors and ARBs
between these two groups (χ2=1,294, df=2, P=0,524). Also, there is no statistically significant difference in the frequency of prescribing beta-blockers and diuretics in patients with heart
failure with preserved and those with reduced systolic left ventricular function. This
difference was found in aldosterone antagonists (χ2=6,389, df=2, P=0,033), which are more
oftenly prescribed to subjects with reduced systolic function. There were no significant
differences in regards to prescribing ACE-inhibitors and ARBs in patients with heart failure
with preserved (ACE-ihibitors: χ2=0, df=2, P=1; ARBs: χ2=2,223, df=2, P=0,329) and reduced
(ACE-inhibitors: χ2=0,355, df=2, P=0,837; ARBs: χ2=0,29, df=2, P=0,867) systolic function with
respect to gender.
Conclusions: In the Croatian registry of patients with heart failure, there is no difference in
the frequency of prescription of ACE inhibitors, ARBs, beta-blockers and diuretics between
patients with preserved and those with reduced systolic left ventricular function. Also, no
differences were found regarding the frequency of prescription of ACE inhibitors and ARBs,
to men and women. |
