Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry.

To estimate the percentage of heart failure patients in Spain that received the European Society of Cardiology recommended treatments, and in those that did not, to determine the reasons why. The study included 2834 consecutive ambulatory patients with heart failure from 27 Spanish hospitals. We recorded general information, the treatment indicated, and the reasons why it was not prescribed in some cases. In patients who met the criteria to receive a certain drug, true undertreatment was defined as the percentage of patients who, without justification, did not receive the drug. In total, 92.6% of ambulatory patients with low ejection fraction received angiotensin converting enzyme inhibitors or angiotensin receptor blockers, 93.3% beta-blockers, and 74.5% mineralocorticoid receptor antagonists. The true undertreatment rates were 3.4%, 1.8%, and 19.0%, respectively. Target doses were reached in 16.2% of patients receiving angiotensin converting enzyme inhibitors, 23.3% of those with angiotensin receptor blockers, 13.2% of those prescribed beta-blockers, and 23.5% of those with mineralocorticoid receptor antagonists. Among patients who could benefit from ivabradine, 29.1% received this drug. In total, 36% of patients met the criteria for defibrillator implantation and 90% of them had received the device or were scheduled for implantation, whereas 19.6% fulfilled the criteria for resynchronization therapy and 88.0% already had or would soon have the device. In patients who met the criteria, but did not undergo device implantation, the reasons were not cost-related. When justified reasons for not administering heart failure drugs were taken into account, adherence to the guideline recommendations was excellent. Exclusive use of the percentage of treated patients is a poor indicator of the quality of healthcare in heart failure. Measures should be taken to improve the attainment of optimal dosing in each patient.

Crespo-Leiro MG ，Segovia-Cubero J ，González-Costello J ，Bayes-Genis A ，López-Fernández S ，Roig E ，Sanz-Julve M ，Fernández-Vivancos C ，de Mora-Martín M ，García-Pinilla JM ，Varela-Román A ，Almenar-Bonet L ，Lara-Padrón A ，de la Fuente-Galán L ，Delgado-Jiménez J ，project research team ... -  《-》

Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry.

Maggioni AP ，Anker SD ，Dahlström U ，Filippatos G ，Ponikowski P ，Zannad F ，Amir O ，Chioncel O ，Leiro MC ，Drozdz J ，Erglis A ，Fazlibegovic E ，Fonseca C ，Fruhwald F ，Gatzov P ，Goncalvesova E ，Hassanein M ，Hradec J ，Kavoliuniene A ，Lainscak M ，Logeart D ，Merkely B ，Metra M ，Persson H ，Seferovic P ，Temizhan A ，Tousoulis D ，Tavazzi L ，Heart Failure Association of the ESC ... -  《-》

[Hungarian Heart Failure Registry 2015-2016. Preliminary results].

Nyolczas N ，Heltai K ，Borbély A ，Habon T ，Járai Z ，Sziliczei E ，Stadler P ，Faludi R ，Herczeg B ，Papp E ，Lakatos F ，Nagy K ，Katona A ，Kovács I ，Tomcsányi J ，Nagy A ，Sepp R ... -  《-》

Comparison of medical therapy dosing in outpatients cared for in cardiology practices with heart failure and reduced ejection fraction with and without device therapy: report from IMPROVE HF.

Heywood JT ，Fonarow GC ，Yancy CW ，Albert NM ，Curtis AB ，Gheorghiade M ，Inge PJ ，McBride ML ，Mehra MR ，O'Connor CM ，Reynolds D ，Walsh MN ... -  《-》

Hyperkalemia in heart failure patients in Spain and its impact on guidelines and recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry.

Hyperkalemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction because it limits the use of effective drugs. We report estimates of the magnitude of this problem in routine clinical practice in Spain, as well as changes in potassium levels during follow-up and associated factors. This study included patients with acute (n=881) or chronic (n=3587) heart failure recruited in 28 Spanish hospitals of the European heart failure registry of the European Society of Cardiology and followed up for 1 year. Various outcomes were analyzed, including changes in serum potassium levels and their impact on treatment. Hyperkalemia (K+> 5.4 mEq/L) was identified in 4.3% (95%CI, 3.7%-5.0%) and 8.2% (6.5%-10.2%) of patients with chronic and acute heart failure, respectively, and was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonist use and for 10.8% of all cases of failure to reach the target dose. Serum potassium levels were not recorded in 291 (10.8%) of the 2693 chronic heart failure patients with reduced ejection fraction. During follow-up, potassium levels increased in 179 of 1431 patients (12.5%, 95%CI, 10.8%-14.3%). This increase was directly related to age, diabetes, and history of stroke and was inversely related to history of hyperkalemia. This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment.

Crespo-Leiro MG ，Barge-Caballero E ，Segovia-Cubero J ，González-Costello J ，López-Fernández S ，García-Pinilla JM ，Almenar-Bonet L ，de Juan-Bagudá J ，Roig-Minguell E ，Bayés-Genís A ，Sanz-Julve M ，Lambert-Rodríguez JL ，Lara-Padrón A ，Pérez-Ruiz JM ，Fernández-Vivancos Marquina C ，de la Fuente-Galán L ，Varela-Román A ，Torres-Calvo F ，Andrés-Novales J ，Escudero-González A ，Pascual-Figal DA ，Ridocci-Soriano F ，Sahuquillo-Martínez A ，Bierge-Valero D ，Epelde-Gonzalo F ，Gallego-Page JC ，Dalmau González-Gallarza R ，Bover-Freire R ，Quiles-Granado J ，Maggioni AP ，Lund LH ，Muñiz J ，Delgado-Jiménez J ... -  《-》