In the first large European study to look at the effect of prescribing practices on outcome in heart failure outpatients outside of a clinical trial[1], Professor Michel Komajda and colleagues investigated the way that 1,410 patients with mild to moderate heart failure were treated by 150 randomly selected cardiologists or cardiology departments in six European countries (France, Germany, Italy, The Netherlands, Spain and the UK). They measured how closely the patients' treatment adhered to the guidelines issued by the European Society of Cardiology (ESC) for the use of the five most commonly used cardiac drugs: ACE-inhibitors[2], beta-blockers, spironolactone[3], diuretics and cardiac glycosides.
Prof Komajda, professor of cardiology at the Pitie-Salpetriere Hospital, Paris, France, and a specialist in heart failure, said: "We found that where doctors had treated their patients in accordance with the ESC guidelines, fewer patients had to be referred to the hospital due to deterioration of their heart failure or for cardiovascular symptoms, and there was a longer time before patients had to be readmitted to hospital because of their symptoms.
"However, the study showed that only 60% of patients were treated according to the ESC guidelines with ACE-inhibitors, beta-blockers or spironolactone the three cardiac drugs for which there is the strongest evidence of benefit and only 63% of patients were treated according to the guidelines for these three drugs plus the two other commonly used drugs, cardiac glycosides and diuretics.
"This means there is a high proportion of patients who are not receiving the best possible treat
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Contact: Emma Mason
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European Society of Cardiology
2-May-2005