Ammara Avais, Imtiaz Ahmed Khan, Hafiza Sonia Iqbal, Anam Fatima Janjua, Javeria Asghar, Javeria Kamran, Samina Rashid, Erum Un Nisa, Naseer Samore, Sohail Aziz.
Frequency of compliance to guideline recommended treatment in heart failure patients with LVEF <40%.
Pak Armed Forces Med J Jan ;70(Sup-4):S772-75.

Objective: To determine the frequency of compliance to guideline recommended treatment among patients with STAGE-C or STAGE-D heart failure and LVEF<40%. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Adult cardiology department of AFIC/NIHD, Rawalpindi, from Sept to Dec 2019. Methodology: Eighty Four patients of Heart Failure with reduced LVEF after satisfying inclusion and exclusion criteria were recruited in this study through non-probability consecutive sampling technique. Data was collected from ER and OPD patients through complete history based on demographics (i.e. age and gender), co-morbidities (i.e. diabetes, hypertension, CAD and smoking history), previous EF record measured on 2D-echo, functional improvement of the patients using NYHA dyspnea class and guideline recommended medication history with compliance. The data was analyzed using SPSS version 23. Results: A total of 84 patients of Heart Failure with LVEF = 31.61 ± 7.61% were enrolled out of whom 62 (73.8%) were male and 22 (26.2%) female patients. The mean age of patients was 62.26 ± 9.879 years. About 30 (35.7%) patients were diabetic, 44 (52.4%) were hypertensive, 19 (22.6%) were current smokers, 16 (19%) were ex-smokers and 49 (58.2%) were nonsmokers. Those with history of CAD were (SVCAD=8 (9.5%), DVCAD=14 (16.7%), TVCAD 15 (17.9%). Compliance of patients to treatment was 74 (88.1%) good. Patients presenting with NYHA Class I/II 3 (3.6%)/20 (23.6%) showed significant improvement after medical therapy 34 (40.5%)/30 (35.7%), whereas those with class III/IV did not show significant improvement in functional status. Conclusion: This survey shows that patient’s compliance is relatively goods but patients with NYHA III/IV were receiving suboptimal treatment. Secondly patients presenting with NYHAI/II after medical therapy showed significant improvement in functional status as compared to those with NYHA III/IV. Thereby further actions are needed for improving quality of life and standard of care among HF patients by optimization of treatment according to guidelines.

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