Clinical characteristics and quality assessment of the treatment of patients with chronic heart failure with diabetes mellitus

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Abstract


Aim. A study of the clinical and instrumental characteristics and quality of treatment of patients with chronic heart failure (CHF) with diabetes mellitus.

Materials and methods. The study was conducted by using the CHF register method, which is a computer program with remote access, which allows on-line data collection on patients who have been examined and treated in primary care and in hospitals. The study included 8272 patients with CHF II–IV FC (functional class) (New York Heart Association – NYHA); among them 62% of patients were treated in hospital.

Results. The study showed that the frequency of diabetes was 21%. The main causes of CHF in diabetic patients are coronary artery disease, myocardial infarction (in anamnesis) and hypertension. These patients are more often diagnosed with III and IV CHF FC according to (NYHA) and retained LV (left ventricular) ejection fraction. The reduced ejection fraction was observed in 6.8% of cases, and the frequency of the “intermediate” LV was significantly higher than among patients with CHF and with diabetes and accounted for 18.9%. At patients with CHF with diabetes in comparison with patients with CHF without diabetes, atherosclerosis of the peripheral arteries, stroke (in anamnesis) and chronic kidney disease of stage III and IV were significantly more common.

Conclusion.Under the treatment, patients with CHF with diabetes have higher levels of SBP (systolic blood pressure), lipids and glucose in the blood plasma, indicating a lack of quality of treatment and, accordingly, the doctors are not optimally performing the clinical guidelines on treating this category of patients.


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About the authors

N. V. Lazareva

National Medical Research Center for Cardiology

Author for correspondence.
Email: n.lazareva@list.ru
ORCID iD: 0000-0002-3253-0669

Russian Federation, Moscow

к.м.н., с.н.с. лаб. мониторинга программ по снижению смертности от сердечно-сосудистых заболеваний

E. V. Oshchepkova

National Medical Research Center for Cardiology

Email: n.lazareva@list.ru
ORCID iD: 0000-0003-4534-9890

Russian Federation, Moscow

д.м.н., проф., гл.н.с. отд. гипертоний

A. A. Orlovsky

National Medical Research Center for Cardiology

Email: n.lazareva@list.ru
ORCID iD: 0000-0002-0794-4683

Russian Federation, Moscow

ред. научно-организационного отд.

S. N. Tereschenko

National Medical Research Center for Cardiology

Email: n.lazareva@list.ru
ORCID iD: 0000-0001-9234-6129

Russian Federation, Moscow

д.м.н., проф., рук. отд. заболеваний миокарда и сердечной недостаточности

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Age distribution of patients with heart failure without diabetes and with diabetes.

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2.
Fig. 2. The distribution of patients with heart failure with diabetes / without diabetes by FC CHF (NYHA).

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3.
Fig. 3. LVEF in patients with heart failure II – IV FC with diabetes / without diabetes.

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4.
Fig. 4. Drug therapy in patients with heart failure (II – IV FC) with diabetes / without diabetes.

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