News Release

Taking the pulse of heart failure treatment

Peer-Reviewed Publication

Canadian Medical Association Journal

Quality of congestive heart failure treatment at a Canadian teaching hospital
—- E. Weil, J.V. Tu
Management of congestive heart failure: How well are we doing?
-— N. Giannetti

Much progress has been made in controlling the epidemic of coronary artery disease, an important contributing to congestive heart failure (CHF) that affects between 200 000 and 300 000 Canadians. Due to the prevalence of CHF, guidelines have been issued to optimize diagnosis and management of the disease by emphasizing the assessment of left ventricular function and treatment with an angiotensin-converting enzyme (ACE) inhibitor. In their review of the charts of 200 patients admitted to Sunnybrook & Women’s College Health Sciences Centre in Toronto for whom CHF was the diagnosis most responsible for admission, Evette Weil and Jack Tu found that 177 (88.5%) patients underwent left ventricular testing before or during their hospital stay. Of the 100 patients considered to be ideal candidates for ACE therapy, 89 received the treatment. This rate compares favourably with those reported in studies from Europe and the US (52%-83%).

However, the authors also found that of the 100 ideal candidates for ACE therapy, only 23 were prescribed target doses comparable to those used in clinical trials. In a related commentary, Nadia Giannetti discusses the current practice, the results of the study and some of the potential explanations for the underdosing.

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Contact: Dr. Jack Tu, Institute for Clinical and Evaluative Sciences, Toronto; tel. 416-480-4055, email: tu@ices.on.ca

Dr. Nadia Giannetti, Medical Director, Heart Failure and Heart Transplant Centre, McGill University Health Centre, Montreal; tel. 514 843-2850, email: nadia.giannetti@muhc.mcgill.ca


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