Specialty Hospital, Amman, Jordan.
Al-Hayat Hospital, Amman, Jordan.
PeerJ. 2024 Nov 19;12:e18464. doi: 10.7717/peerj.18464. eCollection 2024.
Heart failure (HF) is a complex cardiovascular disease. Effective management typically involves four main medications: angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, angiotensin receptor-neprilysin inhibitors, and mineralocorticoid receptor antagonists, along with sodium-glucose co-transporter-2 inhibitors (SGLT2i). The primary objective of this article is to assess and identify the utilization of four-pillar regimen for HF managment and explore the characteristics of the patients being on the four-pillar regimen in Jordan.
Data from the Jordanian HF registry (JoHFR) was analyzed, encompassing records of HF patients treated in various cardiology centers from 2021 to 2023.
The medical records of 2,151 patients with HF who were admitted to cardiology centers throughout Jordan were collected. Males comprised 58.0% of the included patients. Moreover, 71.0% of patients had chronic HF, whereas the rest, 29.0%, had acute HF. Of these, only 0.6% received the complete four-pillar treatment of HF. Beta-blockers were the most frequently used medication, prescribed to 74% of patients, while SGLT2i were the least common, used by only 9%. Notably, patients with type 2 diabetes were more likely to be on the four-pillar regimen (-value = 0.016). Additionally, patients with a glomerular filtration rate (GFR) below 60 were more likely to be treated using the four-pillar (-values = 0.044). The analysis revealed no significant difference in mortality rates between the two groups (-value = 0.475).
Our study demonstrated an overall low utilization of the four-pillar regimen for HF treatment in Jordan with several patients' characteristics associated with it. This highlight the need for enhanced collaborative effort and governmental initiatives to address the challenges of the low utilization of these medications.
心力衰竭（HF）是一种复杂的心血管疾病。有效的管理通常涉及四种主要药物：血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂、β受体阻滞剂、血管紧张素受体-脑啡肽酶抑制剂和盐皮质激素受体拮抗剂，以及钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT2i）。本文的主要目的是评估和确定 HF 管理中四支柱方案的使用情况，并探讨约旦使用四支柱方案的患者的特征。
对约旦心力衰竭登记处（JoHFR）的数据进行了分析，其中包括 2021 年至 2023 年在各个心脏病中心治疗的 HF 患者的记录。
共收集了 2151 名在约旦各地心脏病中心住院的 HF 患者的病历。患者中男性占 58.0%。此外，71.0%的患者为慢性心力衰竭，其余 29.0%为急性心力衰竭。其中，只有 0.6%的患者接受了完整的 HF 四支柱治疗。β受体阻滞剂是最常用的药物，有 74%的患者使用，而 SGLT2i 则是最不常用的，只有 9%的患者使用。值得注意的是，患有 2 型糖尿病的患者更有可能使用四支柱方案（-值=0.016）。此外，肾小球滤过率（GFR）低于 60 的患者更有可能使用四支柱方案（-值=0.044）。分析显示，两组患者的死亡率无显著差异（-值=0.475）。
我们的研究表明，约旦 HF 治疗中四支柱方案的总体使用率较低，与一些患者的特征有关。这突显了需要加强合作努力和政府倡议，以应对这些药物低使用率的挑战。
