ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ ĐIỀU TRỊ Ở BỆNH NHÂN SUY TIM MẤT BÙ CẤP

Abstract

Background: Acute decompensated heart failure (ADHF) is a common clinical condition requiring hospitalization and intensive treatment. Understanding its clinical, paraclinical characteristics, and treatment practices is essential for improving patient management in Vietnam. Objective: To describe the clinical, paraclinical characteristics, and treatment of hospitalized ADHF patients. Methods: A prospective and retrospective cohort study was conducted on 223 ADHF patients admitted from January 2022 to September 2024. Data were collected and analyzed using SPSS 25.0. Results: The median patient age was 67 years, with 57.4% aged ≥65 years. Common comorbidities included dyslipidemia (72.2%), hypertension (68.6%), and atrial fibrillation (42.2%). The leading precipitating factors were arrhythmias (26.3%), infections (25.4%), and non-adherence to treatment (25.0%). The most frequent symptoms were dyspnea (84.3%), peripheral edema (50.7%), and pulmonary rales (53.4%), with 51.6% of patients classified as NYHA III at admission. Paraclinical findings showed anemia in 46.6% of patients, eGFR <60 mL/min/1.73 m² in 49.7%, and reduced left ventricular ejection fraction (LVEF) in 57.4%. Guideline-directed medical therapy at discharge was widely applied, with RAAS inhibitors (79.8%), beta-blockers (81.2%), SGLT2 inhibitors (77.6%), and MRAs (76.2%). Notably, 68% of patients with reduced LVEF received all four foundational therapies. Conclusion: ADHF patients had a high burden of comorbidities, severe symptoms at admission, and received treatment following guidelines. Optimizing medical therapy may improve ADHF management and outcomes.