Investigation and Analysis on Current Status of Neuroendocrine Inhibitors in Patients with Chronic Heart Failure with Reduced Ejection Fraction

OBJECTIVE To investigate the use of neuroendocrine inhibitors‒‒angiotensin converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker(ARB), b-blocker(BB) and mineralocorticoid receptor antagonist(MRA) in patients with chronic heart failure with reduced ejection fraction(HFrEF) in Anhui Women and Child Health Care Hospital and the gap between the use and the guideline. METHODS Basic data of chronic HFrEF inpatients and the use of 3 types of neuroendocrine inhibitors were collected and analyzed from January to December 2018. RESULTS Among the 301 patients with chronic HFrEF included in this study, the usage rates of ACEI/ARB, BB and MRA were 77.4%, 60.5% and 94.0%, respectively. The rates of reaching standard dose were 44.2%, 22.5% and 100%, respectively. The 48.8% of patients received the recommended combination of drugs, including 1.3% of two-drug combination(ACEI/ARB+BB) and 47.5% of three-drug combination(ACEI/ARB+BB+MRA). CONCLUSION There is still a certain gap between clinical practice and guideline in the usage of three neuroendocrine inhibitors in patients with chronic HFrEF in author’s hospital. The usage rate, the rates of reaching standard dose and the rate of combined use of ACEI/ARB and BB are insufficient, while MRA is overused, which requires further improvement of physician’s adherence to guideline.