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Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2020 Apr 07; Vol. 9 (7), pp. e013982. Date of Electronic Publication: 2020 Mar 21. - Publication Year :
- 2020
-
Abstract
- Background The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or Z-drugs (zolpidem, zopiclone, or eszopiclone), were enrolled and divided on the basis of their hypnotics: benzodiazepine group (n=488 [59.1%]) and Z group (n=338 [40.9%]). We compared the patient characteristics and postdischarge prognosis between the groups. The primary end points were rehospitalization for HF and cardiac death. The benzodiazepine group was older (age, 72.0 versus 69.0 years; P =0.010), had a higher prevalence of depression (17.4% versus 8.9%; P <0.001), and showed a higher use of loop diuretics (77.9% versus 67.8%; P =0.001). In the laboratory data, the benzodiazepine group demonstrated lower levels of hemoglobin (12.3 versus 13.0 g/dL; P =0.001), sodium (139.0 versus 140.0 mEq/L; P =0.018), and albumin (3.7 versus 3.9 g/dL; P =0.003). Kaplan-Meier analysis showed that both end points were higher in the benzodiazepine group (rehospitalization for HF, log-rank P =0.001; cardiac death, log-rank P =0.043). Multiple Cox proportional hazard analysis revealed that the use of benzodiazepines was an independent predictor of rehospitalization for HF (hazard ratio, 1.530; 95% CI, 1.025-2.284; P =0.038). Furthermore, rehospitalization for HF was higher in the benzodiazepine group after propensity score matching (log-rank P =0.036). Conclusions Benzodiazepine is associated with higher risk of rehospitalization for HF compared with Z-drugs in patients with HF.
- Subjects :
- Aged
Azabicyclo Compounds adverse effects
Eszopiclone adverse effects
Female
Heart Failure diagnosis
Heart Failure mortality
Heart Failure physiopathology
Humans
Male
Middle Aged
Patient Readmission
Piperazines adverse effects
Prognosis
Risk Assessment
Risk Factors
Sleep Initiation and Maintenance Disorders diagnosis
Sleep Initiation and Maintenance Disorders mortality
Sleep Initiation and Maintenance Disorders physiopathology
Time Factors
Zolpidem adverse effects
Benzodiazepines adverse effects
Heart Failure therapy
Hypnotics and Sedatives adverse effects
Sleep drug effects
Sleep Initiation and Maintenance Disorders drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 9
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 32200713
- Full Text :
- https://doi.org/10.1161/JAHA.119.013982