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Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure
Background: This study investigated whether combination therapy (CT) with renin-angiotensin system inhibitors and β-blockers improved endpoints in acute heart failure (AHF). Methods and Results: AHF patients were recruited to this prospective multicenter cohort study between April 2015 and August 20...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Circulation Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024019/ https://www.ncbi.nlm.nih.gov/pubmed/33842727 http://dx.doi.org/10.1253/circrep.CR-20-0123 |
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author | Takabayashi, Kensuke Kitaguchi, Shouji Yamamoto, Takashi Fujita, Ryoko Takenaka, Kotoe Takenaka, Hiroyuki Okuda, Miyuki Nakajima, Osamu Koito, Hitoshi Terasaki, Yuka Kitamura, Tetsuhisa Nohara, Ryuji |
author_facet | Takabayashi, Kensuke Kitaguchi, Shouji Yamamoto, Takashi Fujita, Ryoko Takenaka, Kotoe Takenaka, Hiroyuki Okuda, Miyuki Nakajima, Osamu Koito, Hitoshi Terasaki, Yuka Kitamura, Tetsuhisa Nohara, Ryuji |
author_sort | Takabayashi, Kensuke |
collection | PubMed |
description | Background: This study investigated whether combination therapy (CT) with renin-angiotensin system inhibitors and β-blockers improved endpoints in acute heart failure (AHF). Methods and Results: AHF patients were recruited to this prospective multicenter cohort study between April 2015 and August 2017. Patients were divided into 3 categories based on ejection fraction (EF), namely heart failure (HF) with reduced EF (HFrEF), HF with midrange EF (HFmrEF), and HF with preserved EF (HFpEF), and a further into 2 groups according to physical status (those who could walk independently outdoors and those who could not). The composite endpoint included all-cause mortality and hospitalization for HF. Data at the 1-year follow-up were available for 1,018 patients. The incidence of the composite endpoint was significantly lower in the CT than non-CT group for HFrEF patients, but not among HFmrEF and HFpEF patients. For patients who could walk independently outdoors, a significantly lower rate of the composite endpoint was recorded only in the HFrEF group. The differences were maintained even after adjustment for comorbidities and prescriptions, with hazard ratios (95% confidence intervals) of 0.39 (0.20–0.76) and 0.48 (0.22–0.99), respectively. Conclusions: In this study, CT was associated with the prevention of adverse outcomes in patients with HFrEF. Moreover, CT prevented adverse events only among patients without a physical disorder, not among those with a physical disorder. |
format | Online Article Text |
id | pubmed-8024019 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japanese Circulation Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-80240192021-04-08 Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure Takabayashi, Kensuke Kitaguchi, Shouji Yamamoto, Takashi Fujita, Ryoko Takenaka, Kotoe Takenaka, Hiroyuki Okuda, Miyuki Nakajima, Osamu Koito, Hitoshi Terasaki, Yuka Kitamura, Tetsuhisa Nohara, Ryuji Circ Rep Original article Background: This study investigated whether combination therapy (CT) with renin-angiotensin system inhibitors and β-blockers improved endpoints in acute heart failure (AHF). Methods and Results: AHF patients were recruited to this prospective multicenter cohort study between April 2015 and August 2017. Patients were divided into 3 categories based on ejection fraction (EF), namely heart failure (HF) with reduced EF (HFrEF), HF with midrange EF (HFmrEF), and HF with preserved EF (HFpEF), and a further into 2 groups according to physical status (those who could walk independently outdoors and those who could not). The composite endpoint included all-cause mortality and hospitalization for HF. Data at the 1-year follow-up were available for 1,018 patients. The incidence of the composite endpoint was significantly lower in the CT than non-CT group for HFrEF patients, but not among HFmrEF and HFpEF patients. For patients who could walk independently outdoors, a significantly lower rate of the composite endpoint was recorded only in the HFrEF group. The differences were maintained even after adjustment for comorbidities and prescriptions, with hazard ratios (95% confidence intervals) of 0.39 (0.20–0.76) and 0.48 (0.22–0.99), respectively. Conclusions: In this study, CT was associated with the prevention of adverse outcomes in patients with HFrEF. Moreover, CT prevented adverse events only among patients without a physical disorder, not among those with a physical disorder. The Japanese Circulation Society 2021-03-13 /pmc/articles/PMC8024019/ /pubmed/33842727 http://dx.doi.org/10.1253/circrep.CR-20-0123 Text en Copyright © 2021, THE JAPANESE CIRCULATION SOCIETY This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.https://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Original article Takabayashi, Kensuke Kitaguchi, Shouji Yamamoto, Takashi Fujita, Ryoko Takenaka, Kotoe Takenaka, Hiroyuki Okuda, Miyuki Nakajima, Osamu Koito, Hitoshi Terasaki, Yuka Kitamura, Tetsuhisa Nohara, Ryuji Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure |
title | Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure |
title_full | Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure |
title_fullStr | Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure |
title_full_unstemmed | Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure |
title_short | Association Between Physical Status and the Effects of Combination Therapy With Renin-Angiotensin System Inhibitors and β-Blockers in Patients With Acute Heart Failure |
title_sort | association between physical status and the effects of combination therapy with renin-angiotensin system inhibitors and β-blockers in patients with acute heart failure |
topic | Original article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024019/ https://www.ncbi.nlm.nih.gov/pubmed/33842727 http://dx.doi.org/10.1253/circrep.CR-20-0123 |
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