Abstract 16682: Regional Differences in Heart Failure Medication Changes During Acute Heart Failure Hospitalization: Findings From the PROTECT Trial
Background: International differences in the outcome of patients hospitalized with acute heart failure (HF) exist, but the cause is uncertain. We explored medication changes by region during HF hospitalizations in the PROTECT trial.
Methods: The PROTECT trial enrolled patients with acute HF and mild/moderate renal dysfunction (creatinine clearance 20-80 ml/min) and randomized them to rolofylline vs. placebo. We grouped countries into 6 regions: North America, Israel, Russia, Western Europe, Eastern Europe and Argentina. In-hospital HF medication changes were described by region.
Results: Of 2033 patients, 33% were from Eastern Europe, 19% Western Europe, 16% Israel, 15% North America, 14% Russia, and 3% Argentina. There were regional differences in baseline HF medication use (i.e., 2 weeks prior to admission) as well as continuation and initiation during hospitalization (Table). Baseline differences in age, ejection fraction, and renal function may have influenced these findings. Of those patients not taking evidence-based HF medications at baseline, the largest increases in medication use during hospitalization were in Russia.
Conclusion: In a large international trial of acute HF, differences in medication usage were observed during hospitalization amongst regions that may have influenced patient outcomes.
- © 2013 by American Heart Association, Inc.