Back to Search
Start Over
Discharge treatment with angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker after a heart failure hospitalisation is associated with a better prognosis irrespective of left ventricular ejection fraction.
- Source :
- Internal Medicine Journal; Dec2019, Vol. 49 Issue 12, p1505-1513, 9p, 1 Diagram, 2 Charts, 2 Graphs
- Publication Year :
- 2019
-
Abstract
- Background: Medical therapy could improve the prognosis of real‐life patients discharged after a heart failure (HF) hospitalisation. Aim: To determine the impact of discharge HF treatment on mortality and readmissions in different left ventricular ejection fraction (LVEF) groups. Methods: Multicentre prospective registry in 20 Spanish hospitals. Patients were enrolled after a HF hospitalisation. Results: A total of 1831 patients was included (583 (31.8%) HF with reduced ejection fraction (HFrEF); 227 (12.4%) HF with midrange ejection fraction (HFmrEF); 610 (33.3%) HF with preserved ejection fraction (HFpEF), and 411 (22.4%) with unknown LVEF). Angiotensin‐converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB) at discharge were independently associated with a reduction in: (i) all‐cause mortality: hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.41–0.74, P < 0.001, with a similar effect in the four groups; (ii) mortality due to refractory HF HR 0.45, 95% CI 0.29–0.64, P < 0.001, with a similar effect in the three groups with known LVEF; (iii) mortality/HF admissions (HR 0.61; 95% CI: 0.50–0.74), more evident in HFrEF (HR 0.54; 95% CI: 0.38–0.78) compared with HRmEF (HR 0.64; 95% CI 0.40–1.02), or HFpEF (HR 0.70; 95% CI 0.53–0.92). In patients with HFrEF triple therapy (ACE inhibitor/ARB + beta blocker + mineralocorticoid receptor antagonist) was associated with the lowest mortality risk (HR 0.21; 95% CI: 0.08–0.57, P = 0.002) compared with patients that received none of these drugs. Conclusions: Discharge treatment with ACE inhibitor/ARB after a HF hospitalisation is associated with a reduction in all‐cause and refractory HF mortality, irrespective of LVEF. [ABSTRACT FROM AUTHOR]
- Subjects :
- ACE inhibitors
MORTALITY prevention
MORTALITY risk factors
CONFIDENCE intervals
LEFT heart ventricle
HEART physiology
HEART failure
HOSPITAL care
HOSPITAL admission & discharge
LONGITUDINAL method
MEDICAL cooperation
PATIENTS
RESEARCH
DISCHARGE planning
ANGIOTENSIN receptors
ODDS ratio
VENTRICULAR ejection fraction
Subjects
Details
- Language :
- English
- ISSN :
- 14440903
- Volume :
- 49
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Internal Medicine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 140212518
- Full Text :
- https://doi.org/10.1111/imj.14289