Pharmacological treatment changes of chronic heart failure during cardiac resynchronization therapy: A 1-year follow-up study

• Published in: International journal of cardiology 2017-07, Vol.238, p.92-96
• Main Authors: Rinkuniene, Diana, Krivickiene, Ausra, Laukaitiene, Jolanta, Jurkevicius, Renaldas
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Aged, 80 and over; Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Cardiac resynchronization therapy; Cardiac Resynchronization Therapy - methods; Cardiac Resynchronization Therapy - trends; Cardiovascular; Female; Follow-Up Studies; Heart failure; Heart Failure - diagnostic imaging; Heart Failure - therapy; Humans; Male; Medication; Middle Aged; Mineralocorticoid Receptor Antagonists - therapeutic use; Pharmacological treatment; Time Factors; Treatment Outcome
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2017.03.051

Abstract Background Cardiac resynchronization therapy (CRT) is associated with improved morbidity and mortality in patients with chronic heart failure (HF) on optimal medical therapy. We aimed to evaluate changes of medical therapy during CRT and its influence on the CRT response. Methods We evaluated 85 HF patients pharmacological treatment changes during 1-year follow-up of CRT. Statistical analysis was performed using IBM SPSS statistical software (SPSS v.21.0 for Mac OS X). Results Beta-blockers (BAB) were used in 81.2% of patients before CRT, consumption in-creased after CRT implantation (96.5% at 1-year follow-up visit) (p < 0.002). Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) consumption and dose didn't changed statistically significant during study. 55.3% of patients were taking spironolac-tone before CRT, this number increased at discharge till 76.5% (p < 0.001) and till 70.6% (p = 0.01) at 1-year follow-up visit. The average dose of spironolactone during the study decreased statistically significant. The use of diuretics was higher after CRT device implantation, compared with period before CRT 80% to 84.7% (p < 0.001), but torasemide dose hadn‘t changed statistically significant and remained almost the same. Cardiovascular medications consumption was significantly lower before CRT, compared with discharge (p < 0.001) and follow-up (p < 0.001) periods. But no statistical significant relation between pharmacological treatment and echocardiographic response was found. Conclusions The present study confirmed that pharmacological treatment has changed during period before and after CRT. But no statistical significant relation between pharmacological treatment and echocardiographic response was found.