%0 Journal Article %T The prospective multicentric observational study of patients with chronic heart failure who are intolerant to ACE inhibitors and/or betablockers in common medical practice in Slovakia 每 final results %A Kamensky Gabriel %J Kardiol車gia %D 2006 %I %X Aim: To follow-up prospectively over two years patients with chronic heart failure intolerant to ACE inhibitor and/or beta-blocker therapy; to evaluate the state of the current medical practice in Slovakia; to compare Slovak data with results of relevant clinical and epidemiologic studies, to compare therapeutic pharmacologic approaches with currently valid Guidelines; and simultaneously to evaluate the efficacy and safety of valsartan therapy. Patients and methods: Sixty-nine physicians from all over Slovakia, mainly internal specialists and cardiologists, participated in the PROMISZ Study conducted in 2002 每 2004. Out of total number of 1.453 followed-up patients with chronic heart failure 1.129 subjects were enrolled in the final follow-up (711 ㊣ 163 days); mean age of enrolled patients was 66.6 ㊣ 9.8 years (range from 26 to 91 years), 47% were males. Results: The following statistically significant changes took place after two years: a decrease in incidence of pulmonary congestion evaluated both physically and radiologically (both p < 0.0001), lower incidence of leg oedemas (p < 0.0001), improvement of NYHA functional class (p < 0.0001), reduced incidence of paroxysmal atrial fibrillation (p < 0.0001), decreased values both of systolic and diastolic blood pressure, pulse rate (p < 0.0001), total cholesterol (p < 0.0001), LDL cholesterol and triacylglycerols (p < 0.0001), increased values of HDL cholesterol (p < 0.0002) and decreased glycaemia (p < 0.024), decreased value of cardiothoracic index, increased ejection fraction with concomitantly reduced dimension of LVEDD (both p < 0.0001) and LVESD (p < 0.024). Independent predictors of total mortality are age (OR 1.027; p = 0.0089), serum creatinine levels (OR 1.010, p = 0.0001), serum glycaemia levels (OR 1.079, p = 0.0362), EF ≒ 30% (OR 2.127, p = 0.0001), and NYHA class (OR 2.011, p = 0.0216). Independent predictors of hospitalization for chronic heart failure are serum creatinine levels (OR 1.013, p = 0.0001), serum glycaemia levels (OR 1.113, p = 0.0126), EF ≒ 30% (OR 2.150, p = 0.0039), and permanent atrial fibrillation (OR 2.185, p = 0.0020). Independent predictors of any hospitalization for cardiac causes are serum creatinine levels (OR 1.009, p = 0.0001), diabetes mellitus (OR 1.229, p = 0.0023), EF ≒ 30% (OR 1.782, p = 0.0049), and NYHA class (OR 1.598, p = 0.0490). Total mortality after the first year of the follow-up was 6.3%, after two years 10.6%. Long-term valsartan therapy was sufficiently effective, well tolerated and safe. Conclusion: The two-year follow-up showed that intensification %K Chronic heart failure 每 Total mortality and hospitalizations 每 Independent predictors 每 Treatment of chronic heart failure %U www.cardiology.sk/casopis/506/pdf/03.pdf