Chronic heart failure management in primary healthcare in Poland: Results of a nationwide cross-sectional study

Figures & data

Table 1. Clinical characteristics of CHF patients in primary care settings in 2013 in comparison to 2005. Data are presented as means ± standard deviation or number (percentage).

	2013	2005	P-value
Number of patients’ medical records surveyed	2006	2000
Women, n (%)	861 (44.8)	904 (47.0)	0.381
Age, years	71.9 ± 11.0	68.8 ± 11.8
Age categories, n (%)
<60 years	315 (15.7)	487 (24.3)	<0.001
60 − 69 years	414 (20.6)	433 (21.6)
70 − 79 years	687 (34.3)	695 (34.8)
80+ years	584 (29.1)	374 (18.8)
Missing data	6 (0.3)	11 (0.5)
NYHA class, n (%)
I	41 (2.0)	79 (4.0)	<0.001
II	1117 (55.7)	936 (46.8)
III	763 (38.0)	876 (43.8)
IV	62 (3.1)	98 (4.9)
Missing data	23 (1.2)	11 (0.5)
Cardiovascular comorbidities, n (%)
Hypertension	1646 (82.1)	1678 (83.9)	0.129
Coronary heart disease	1476 (73.6)	1632 (81.6)	<0.001
Myocardial infarction	748 (37.3)	682 (34.1)	0.035
Stroke or TIA	337 (16.8)	335 (16.8)	1.000
Dilated cardiomyopathy	312 (15.6)	349 (17.5)	0.106
Other cardiomyopathies	284 (14.2)	313 (15.7)	0.183
Valvular heart disease	583 (29.1)	402 (20.1)	<0.001
Atrial fibrillation	1010 (50.3)	768 (38.4)	<0.001
Other comorbidities, n (%)
Diabetes	678 (33.8)	617 (30.9)	0.049
Chronic kidney disease	413 (20.6)	188 (9.4)	<0.001
Thyroid diseases	345 (17.2)	238 (12.0)	<0.001

CHF: chronic heart failure; NYHA: New York Heart Association; TIA: transient ischaemic attack.

Table 2. Accessibility of echocardiography and NT-proBNP for the surveyed primary care centres and presentation of the available results. Data are presented as means ± standard deviation, median [upper - lower quartile] or number (percentage).

	2013	2005	P-value
Number of surveyed primary care centres	390	400
Accessibility of the diagnostic procedures:
Echocardiography, n (%)
<1 month	53 (13.5)	52 (13.0)	<0.001
1–3 months	61 (15.6)	90 (22.5)
>3 months	74 (19.1)	55 (13.8)
Not available	176 (45.2)	166 (41.5)
Missing data	26 (6.7)	37 (9.3)
NT-proBNP, n (%)
<1 month	77 (19.7)	14 (3.5)	<0.001
1–3 months	25 (6.5)	7 (1.8)
>3 months	8 (2.1)	4 (1.0)
Not available	232 (59.6)	311 (77.7)
Missing data	48 (12.2)	64 (16.0)
Results available to primary care physicians
LVEF, %
Available data, n (%)^a	1342 (66.9)	683 (34.2)	<0.001
LVEF, mean ± SD	44.8 ± 13.1	45.4 ± 14.1	0.285
Reduced (<40%)	419 (31.2)	222 (32.5)	0.527
Borderline (40–49%)	347 (25.9)	161 (23.6)
Preserved (≥50%)	576 (42.9)	300 (43.9)
NT-proBNP, pg/ml
Available data, n (%)^b	79 (3.9)	–
NT-proBNP, median [Q1–Q3]	1492 [850–3128]	n.a.

NT-proBNP: N-terminal prohormone brain natriuretic peptide; LVEF: left ventricular ejection fraction; n.a.: not available.

^a The last available examination.

^b Measured within the last three months before the inclusion in the survey.

Table 3. Pharmacological management of CHF and concomitant therapy of cardiovascular diseases in primary care settings – data from 2005 and 2013.

Pharmacotherapy in CHF patients^a	2013	2005	P-value
Available data n	1384	2000
Drugs used in the CHF patients, n (%)
ACEIs or ARBs	1104 (79.8)	1641 (82.1)	0.093
sz-blockers	1213 (87.6)	1362 (68.1)	<0.001
ACEIs or ARBs and sz-blockers	982 (71.0)	1138 (56.9)	<0.001
Diuretics	1117 (80.7)	1490 (74.5)	<0.001
MRAs	577 (41.7)	963 (48.2)	<0.001
Digitalis	225 (16.3)	644 (32.2)	<0.001
Ivabradine	5 (0.4)	n.a.
Other CV drugs, n (%)
Lipid-lowering drugs	949 (68.6)	894 (44.7)	<0.001
Anti-arrhythmic drugs	87 (6.3)	107 (5.4)	0.270
Antiplatelet drugs	711 (51.4)	1004 (50.2)	0.492
Oral vitamin K antagonists	500 (36.1)	382 (19.1)	<0.001
NOACs	52 (3.8)	n.a.
Potassium supplementation	422 (30.5)	505 (25.5)	0.001
Ca-channel blockers, dihydropyridine	345 (24.9)	368 (18.4)	<0.001
Ca-channel blockers non-dihydropyridine	14 (1.0)
Alpha-blockers	120 (8.7)	105 (5.3)	<0.001
Trimetazidine	94 (6.8)	176 (8.8)	0.035
Nitrates	132 (9.5)	841 (42.1)	<0.001
Vasodilators (peripheral)^b	132 (3.9)	n.a.

CHF: chronic heart failure; ACEIs: angiotensin-converting enzyme inhibitors; ARBs: angiotensin II receptor blockers; MRAs: mineralocorticoid receptor antagonists; CV: cardiovascular; NOACs: non-vitamin K antagonist oral anticoagulants.

^a Data based on the medical records indicating drugs taken by the patients.

^b Vasodilators (peripheral): nicergoline, pentoxifylline.