Selected intriguing forms of treatment for chronic heart failure – data from international observational registries

The presented paper gathers the results of three publications based on prospective, international, observation registries of patients with heart failure (HF) – HF Pilot, HF Long-Term and QUALIFY (The quality of adherence to guideline recommendations for life-saving treatment in heart failure). The aim of the analysis was to assess the effect of beta-blockers on prognosis in HF with associated atrial fibrillation; to compare the effectiveness of furosemide and torasemide in HF; and to assess the adherence of physicians in Poland to European recommendations. 797 patients were included in the analysis assessing the effects of beta-blockers. Patients with a beta blocker compared to those without were less likely to achieve primary (all-cause death; 10.9% vs 25.6%, p = 0.001) and secondary (all-cause death or HF hospitalization; 30.6% vs 44.2%, p = 0.02) endpoints. Beta-blocker was an independent predictor of only the primary endpoint (HR 0.52; 95% CI, 0.31–0.89; p = 0.02). Both endpoints were least frequently observed in the group with a heart rate of 80–109/min. In the group of 1440 patients with HF, it was shown that patients treated with torasemide compared to furosemide were less likely to experience secondary (death from any cause or HF hospitalization; 26.4% vs 34.7%; p = 0.04), but not primary (death from any cause; 9.8% vs 14.1%; p = 0.13) endpoint. Patients treated with furosemide also had a greater severity of HF symptoms in NYHA class (p = 0.04). Adherence of physicians in Poland to HF treatment guidelines was also analyzed. An analysis of 209 HF outpatients with reduced left ventricular ejection fraction showed a satisfactory adherence to the recommended HF therapy in 72% of cases.