Sökning: id:"swepub:oai:DiVA.org:liu-196109" >
Heart failure pharm...
Heart failure pharmacological treatments and outcomes in heart failure with mildly reduced ejection fraction
-
- Stolfo, Davide (författare)
- Vasc & Neuro Theme Karolinska Univ Hosp, Sweden; Azienda Sanitaria Univ Giuliano Isontina ASUGI, Italy; Univ Hosp Trieste, Italy
-
- Lund, Lars H. (författare)
- Karolinska Institutet
-
- Sinagra, Gianfranco (författare)
- Azienda Sanitaria Univ Giuliano Isontina ASUGI, Italy; Univ Hosp Trieste, Italy
-
visa fler...
-
- Lindberg, Felix (författare)
- Karolinska Institutet
-
- Dahlström, Ulf (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
-
- Rosano, Giuseppe (författare)
- IRCCS San Raffaele, Italy
-
- Savarese, Gianluigi (författare)
- Karolinska Institutet
-
visa färre...
-
(creator_code:org_t)
- OXFORD UNIV PRESS, 2023
- 2023
- Engelska.
-
Ingår i: European Heart Journal - Cardiovascular Pharmacotherapy. - : OXFORD UNIV PRESS. - 2055-6837 .- 2055-6845. ; 9:6, s. 526-535
- Relaterad länk:
-
https://liu.diva-por... (primary) (Raw object)
-
visa fler...
-
https://urn.kb.se/re...
-
https://doi.org/10.1...
-
http://kipublication...
-
visa färre...
Abstract
Ämnesord
Stäng
- Background Guideline recommendations for the treatment of heart failure with mildly reduced ejection fraction (HFmrEF) derive from small subgroups in post-hoc analyses of randomized trials. Objectives We investigated predictors of renin-angiotensin system inhibitors/angiotensin receptor neprilysin inhibitors (RASI/ARNI) and beta-blockers use, and the associations between these medications and mortality/morbidity in a large real-world cohort with HFmrEF. Methods and results Patients with HFmrEF (EF 40-49%) from the Swedish HF Registry were included. The associations between medications and cardiovascular (CV) mortality/HF hospitalization (HFH), and all-cause mortality were assessed through Cox regressions in a 1:1 propensity score-matched cohort. A positive control analysis was performed in patients with EF < 40%, while a negative control outcome analysis had cancer-related hospitalization as endpoint. Of 12 421 patients with HFmrEF, 84% received RASI/ARNI and 88% beta-blockers. Shared-independent predictors of RASI/ARNI and beta-blockers use were younger age, being an outpatient, follow-up in specialty care, and hypertension. In the matched cohorts, use of both RASI/ARNI and beta-blocker use was separately associated with lower risk of CV mortality/HFH [hazard ratio (HR) = 0.90, 95% confidence interval (CI): 0.83-0.98 and HR = 0.82, 95% CI: 0.74-0.90, respectively] and of all-cause mortality (HR = 0.75, 95% CI: 0.69-0.81 and HR = 0.79, 95% CI: 0.72-0.87, respectively). Results were consistent at the positive control analysis, and there were no associations between treatment use and the negative control outcome. Conclusions RASI/ARNI and beta-blockers were extensively used in this large real-world cohort with HFmrEF. Their use was safe since associated with lower mortality and morbidity. Our findings confirm the real-world evidence from previous post-hoc analyses of trials, and represent a further call for implementing guideline recommendations.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Heart failure; Mildly reduced ejection fraction; SwedeHF; Registry; Beta-blockers; Renin-angiotensin system inhibitors
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas