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Neurohormonal Blockade During Left Ventricular Assist Device Support
- Source :
- ASAIO Journal. 66:881-885
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Neurohormonal blockade (NHB) is the mainstay of therapy for patients with systolic heart failure (HF). However, the efficacy in patients with left ventricular assist devices (LVADs) remains unknown. Of all, 114 LVAD patients (57 [48, 65] years old and 78% male) were enrolled and followed during the early period (6 months after index discharge), and 98 were followed during the late period (6-12 months following index discharge). Of them, 46% were on beta-blocker (BB), 49% on angiotensin-converting enzyme inhibitor (ACEi) and/or angiotensin II receptor blocker (ARB), and 51% on aldosterone antagonist at baseline. Prevalence of BB and ACEi/ARB use increased during the study period. During the early period, similar event rates were found irrespective of the NHB uses. During the late period, BB was associated with reduced HF readmission, and ACEi/ARB was associated with reduced HF readmission and gastrointestinal bleeding (p < 0.05 for all). In conclusion, BB and ACEi/ARB use during the late period was associated with a reduction in HF recurrence in LVAD patients. Further prospective randomized control trials are warranted to clarify the utility of NHB therapy in LVAD patients.
- Subjects :
- Male
Angiotensin receptor
medicine.medical_specialty
Gastrointestinal bleeding
medicine.drug_class
medicine.medical_treatment
Adrenergic beta-Antagonists
Biomedical Engineering
Biophysics
Hemodynamics
Angiotensin-Converting Enzyme Inhibitors
Bioengineering
030204 cardiovascular system & hematology
Biomaterials
Angiotensin Receptor Antagonists
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
medicine
Humans
cardiovascular diseases
Beta blocker
Aged
Retrospective Studies
Heart Failure
Neurotransmitter Agents
Aldosterone
business.industry
General Medicine
Middle Aged
medicine.disease
Blockade
030228 respiratory system
chemistry
Heart failure
Ventricular assist device
Cardiology
Female
Heart-Assist Devices
business
Subjects
Details
- ISSN :
- 10582916
- Volume :
- 66
- Database :
- OpenAIRE
- Journal :
- ASAIO Journal
- Accession number :
- edsair.doi.dedup.....1a41088b32b84aa06ae985e1ac32835b