Impact of left ventricular ejection fraction on the effect of renin-angiotensin system blockers after an episode of acute heart failure: From the KCHF Registry
This observational study aimed to examine the prognostic association of angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARB) in different left ventricular ejection fraction (LVEF) categories. In 3717 patients enrolled in the KCHF Registry, a multicentre registry inclu...
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| creator | Yoshikawa, Yusuke Tamaki, Yodo Morimoto, Takeshi Yaku, Hidenori Yamamoto, Erika Inuzuka, Yasutaka Ozasa, Neiko Kitai, Takeshi Nagao, Kazuya Sato, Yukihito Kondo, Hirokazu Tamura, Toshihiro Nakagawa, Yoshihisa Kuwahara, Koichiro Kato, Takao Kimura, Takeshi |
| description | This observational study aimed to examine the prognostic association of angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARB) in different left ventricular ejection fraction (LVEF) categories. In 3717 patients enrolled in the KCHF Registry, a multicentre registry including consecutive patients hospitalized for acute heart failure (HF), we assessed patient characteristics and association between ACE-I/ARB and clinical outcomes according to LVEF. In the three LVEF categories (reduced LVEF [HFrEF], mid-range LVEF [HFmrEF] and preserved LVEF [HFpEF]), we compared the patients with ACE-I/ARB as discharge medication and those without, and assessed their 1-year clinical outcomes. We defined the primary outcome measure as a composite of all-cause death and HF hospitalization. The 1-year cumulative incidences of the primary outcome measure were 36.3% in HFrEF, 30.1% in HFmrEF and 33.8% in HFpEF (log-rank P = 0.07). The adjusted risks of the ACE-I/ARB group relative to the no ACE-I/ARB group for the primary outcome measure were significantly lower in HFrEF and HFmrEF (HR 0.66 [95%CI 0.54-0.79], P |
| doi_str_mv | 10.1371/journal.pone.0239100 |
| format | Article |
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In 3717 patients enrolled in the KCHF Registry, a multicentre registry including consecutive patients hospitalized for acute heart failure (HF), we assessed patient characteristics and association between ACE-I/ARB and clinical outcomes according to LVEF. In the three LVEF categories (reduced LVEF [HFrEF], mid-range LVEF [HFmrEF] and preserved LVEF [HFpEF]), we compared the patients with ACE-I/ARB as discharge medication and those without, and assessed their 1-year clinical outcomes. We defined the primary outcome measure as a composite of all-cause death and HF hospitalization. The 1-year cumulative incidences of the primary outcome measure were 36.3% in HFrEF, 30.1% in HFmrEF and 33.8% in HFpEF (log-rank P = 0.07). The adjusted risks of the ACE-I/ARB group relative to the no ACE-I/ARB group for the primary outcome measure were significantly lower in HFrEF and HFmrEF (HR 0.66 [95%CI 0.54-0.79], P<0.001, and HR 0.61 [0.45-0.82], P = 0.001, respectively), but not in HFpEF (HR 0.95 [0.80-1.14], P = 0.61). There was a significant interaction between the LVEF category and the ACE-I/ARB use on the primary outcome measure (P.sub.interaction = 0.01). ACE-I/ARB for patients who were hospitalized for acute HF was associated with significantly lower risk for a composite of all-cause death and HF hospitalization in HFrEF and HFmrEF, but not in HFpEF. ACE-I/ARB might be a potential treatment option in HFmrEF as in HFrEF.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0239100</identifier><identifier>PMID: 32925953</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Angiotensin ; Angiotensin converting enzyme inhibitors ; Angiotensin II receptor blockers ; Attorneys general ; Biology and Life Sciences ; Cardiac output ; Cardiology ; Clinical outcomes ; Congestive heart failure ; Drug therapy ; Ejection fraction ; Enzyme inhibitors ; Epidemiology ; Health aspects ; Health risks ; Heart failure ; Hospitalization ; Medicine ; Medicine and Health Sciences ; Patient outcomes ; Patients ; Peptidyl-dipeptidase A ; Physicians ; Prognosis ; Renin ; Statistical analysis ; Stroke ; Supervision ; University graduates ; Ventricle</subject><ispartof>PloS one, 2020-09, Vol.15 (9), p.e0239100-e0239100</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Yoshikawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Yoshikawa et al 2020 Yoshikawa et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c779t-f460c9ee0d4e33cb54c25f7cc729d5ab7c436de579dc8a07dbb438252648a9ac3</citedby><cites>FETCH-LOGICAL-c779t-f460c9ee0d4e33cb54c25f7cc729d5ab7c436de579dc8a07dbb438252648a9ac3</cites><orcidid>0000-0001-8082-2036</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489562/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489562/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Lionetti, Vincenzo</contributor><creatorcontrib>Yoshikawa, Yusuke</creatorcontrib><creatorcontrib>Tamaki, Yodo</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Yaku, Hidenori</creatorcontrib><creatorcontrib>Yamamoto, Erika</creatorcontrib><creatorcontrib>Inuzuka, Yasutaka</creatorcontrib><creatorcontrib>Ozasa, Neiko</creatorcontrib><creatorcontrib>Kitai, Takeshi</creatorcontrib><creatorcontrib>Nagao, Kazuya</creatorcontrib><creatorcontrib>Sato, Yukihito</creatorcontrib><creatorcontrib>Kondo, Hirokazu</creatorcontrib><creatorcontrib>Tamura, Toshihiro</creatorcontrib><creatorcontrib>Nakagawa, Yoshihisa</creatorcontrib><creatorcontrib>Kuwahara, Koichiro</creatorcontrib><creatorcontrib>Kato, Takao</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><title>Impact of left ventricular ejection fraction on the effect of renin-angiotensin system blockers after an episode of acute heart failure: From the KCHF Registry</title><title>PloS one</title><description>This observational study aimed to examine the prognostic association of angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARB) in different left ventricular ejection fraction (LVEF) categories. 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The adjusted risks of the ACE-I/ARB group relative to the no ACE-I/ARB group for the primary outcome measure were significantly lower in HFrEF and HFmrEF (HR 0.66 [95%CI 0.54-0.79], P<0.001, and HR 0.61 [0.45-0.82], P = 0.001, respectively), but not in HFpEF (HR 0.95 [0.80-1.14], P = 0.61). There was a significant interaction between the LVEF category and the ACE-I/ARB use on the primary outcome measure (P.sub.interaction = 0.01). ACE-I/ARB for patients who were hospitalized for acute HF was associated with significantly lower risk for a composite of all-cause death and HF hospitalization in HFrEF and HFmrEF, but not in HFpEF. ACE-I/ARB might be a potential treatment option in HFmrEF as in HFrEF.</description><subject>Angiotensin</subject><subject>Angiotensin converting enzyme inhibitors</subject><subject>Angiotensin II receptor blockers</subject><subject>Attorneys general</subject><subject>Biology and Life Sciences</subject><subject>Cardiac output</subject><subject>Cardiology</subject><subject>Clinical outcomes</subject><subject>Congestive heart failure</subject><subject>Drug therapy</subject><subject>Ejection fraction</subject><subject>Enzyme inhibitors</subject><subject>Epidemiology</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Heart failure</subject><subject>Hospitalization</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Peptidyl-dipeptidase A</subject><subject>Physicians</subject><subject>Prognosis</subject><subject>Renin</subject><subject>Statistical 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of left ventricular ejection fraction on the effect of renin-angiotensin system blockers after an episode of acute heart failure: From the KCHF Registry</title><author>Yoshikawa, Yusuke ; Tamaki, Yodo ; Morimoto, Takeshi ; Yaku, Hidenori ; Yamamoto, Erika ; Inuzuka, Yasutaka ; Ozasa, Neiko ; Kitai, Takeshi ; Nagao, Kazuya ; Sato, Yukihito ; Kondo, Hirokazu ; Tamura, Toshihiro ; Nakagawa, Yoshihisa ; Kuwahara, Koichiro ; Kato, Takao ; Kimura, Takeshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c779t-f460c9ee0d4e33cb54c25f7cc729d5ab7c436de579dc8a07dbb438252648a9ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Angiotensin</topic><topic>Angiotensin converting enzyme inhibitors</topic><topic>Angiotensin II receptor blockers</topic><topic>Attorneys general</topic><topic>Biology and Life Sciences</topic><topic>Cardiac output</topic><topic>Cardiology</topic><topic>Clinical outcomes</topic><topic>Congestive heart failure</topic><topic>Drug therapy</topic><topic>Ejection fraction</topic><topic>Enzyme inhibitors</topic><topic>Epidemiology</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>Heart failure</topic><topic>Hospitalization</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Peptidyl-dipeptidase A</topic><topic>Physicians</topic><topic>Prognosis</topic><topic>Renin</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Supervision</topic><topic>University graduates</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshikawa, Yusuke</creatorcontrib><creatorcontrib>Tamaki, Yodo</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Yaku, Hidenori</creatorcontrib><creatorcontrib>Yamamoto, 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshikawa, Yusuke</au><au>Tamaki, Yodo</au><au>Morimoto, Takeshi</au><au>Yaku, Hidenori</au><au>Yamamoto, Erika</au><au>Inuzuka, Yasutaka</au><au>Ozasa, Neiko</au><au>Kitai, Takeshi</au><au>Nagao, Kazuya</au><au>Sato, Yukihito</au><au>Kondo, Hirokazu</au><au>Tamura, Toshihiro</au><au>Nakagawa, Yoshihisa</au><au>Kuwahara, Koichiro</au><au>Kato, Takao</au><au>Kimura, Takeshi</au><au>Lionetti, Vincenzo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of left ventricular ejection fraction on the effect of renin-angiotensin system blockers after an episode of acute heart failure: From the KCHF Registry</atitle><jtitle>PloS one</jtitle><date>2020-09-14</date><risdate>2020</risdate><volume>15</volume><issue>9</issue><spage>e0239100</spage><epage>e0239100</epage><pages>e0239100-e0239100</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>This observational study aimed to examine the prognostic association of angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARB) in different left ventricular ejection fraction (LVEF) categories. In 3717 patients enrolled in the KCHF Registry, a multicentre registry including consecutive patients hospitalized for acute heart failure (HF), we assessed patient characteristics and association between ACE-I/ARB and clinical outcomes according to LVEF. In the three LVEF categories (reduced LVEF [HFrEF], mid-range LVEF [HFmrEF] and preserved LVEF [HFpEF]), we compared the patients with ACE-I/ARB as discharge medication and those without, and assessed their 1-year clinical outcomes. We defined the primary outcome measure as a composite of all-cause death and HF hospitalization. The 1-year cumulative incidences of the primary outcome measure were 36.3% in HFrEF, 30.1% in HFmrEF and 33.8% in HFpEF (log-rank P = 0.07). The adjusted risks of the ACE-I/ARB group relative to the no ACE-I/ARB group for the primary outcome measure were significantly lower in HFrEF and HFmrEF (HR 0.66 [95%CI 0.54-0.79], P<0.001, and HR 0.61 [0.45-0.82], P = 0.001, respectively), but not in HFpEF (HR 0.95 [0.80-1.14], P = 0.61). There was a significant interaction between the LVEF category and the ACE-I/ARB use on the primary outcome measure (P.sub.interaction = 0.01). ACE-I/ARB for patients who were hospitalized for acute HF was associated with significantly lower risk for a composite of all-cause death and HF hospitalization in HFrEF and HFmrEF, but not in HFpEF. ACE-I/ARB might be a potential treatment option in HFmrEF as in HFrEF.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32925953</pmid><doi>10.1371/journal.pone.0239100</doi><orcidid>https://orcid.org/0000-0001-8082-2036</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-09, Vol.15 (9), p.e0239100-e0239100 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2442589650 |
| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Angiotensin Angiotensin converting enzyme inhibitors Angiotensin II receptor blockers Attorneys general Biology and Life Sciences Cardiac output Cardiology Clinical outcomes Congestive heart failure Drug therapy Ejection fraction Enzyme inhibitors Epidemiology Health aspects Health risks Heart failure Hospitalization Medicine Medicine and Health Sciences Patient outcomes Patients Peptidyl-dipeptidase A Physicians Prognosis Renin Statistical analysis Stroke Supervision University graduates Ventricle |
| title | Impact of left ventricular ejection fraction on the effect of renin-angiotensin system blockers after an episode of acute heart failure: From the KCHF Registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T20%3A26%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20left%20ventricular%20ejection%20fraction%20on%20the%20effect%20of%20renin-angiotensin%20system%20blockers%20after%20an%20episode%20of%20acute%20heart%20failure:%20From%20the%20KCHF%20Registry&rft.jtitle=PloS%20one&rft.au=Yoshikawa,%20Yusuke&rft.date=2020-09-14&rft.volume=15&rft.issue=9&rft.spage=e0239100&rft.epage=e0239100&rft.pages=e0239100-e0239100&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0239100&rft_dat=%3Cgale_plos_%3EA635428600%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2442589650&rft_id=info:pmid/32925953&rft_galeid=A635428600&rft_doaj_id=oai_doaj_org_article_27104198639642c7b3ddbfbfc85adbec&rfr_iscdi=true |