Treatment with renin‐angiotensin system inhibitors and prognosis of heart failure with preserved ejection fraction: A propensity‐matched study in the community
Aims There is currently no consensus on the effect of treatment with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analysed the relationship of com...
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| Veröffentlicht in: | International journal of clinical practice (Esher) 2019-06, Vol.73 (6), p.e13317-n/a |
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| container_title | International journal of clinical practice (Esher) |
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| creator | Egido, Jose J. Gomez, Rocio Romero, Sotero P. Andrey, Jose L. Ramirez, Daniel Rodriguez, Ana Pedrosa, Maria J. Gomez, Francisco |
| description | Aims
There is currently no consensus on the effect of treatment with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analysed the relationship of commencing treatment with ACEIs or ARBs and the prognosis of patients with incident HFpEF.
Methods
Retrospective study over 15 years on 3864 patients with HFpEF (GAMIC cohort). Main outcomes were mortality (all‐cause and cardiovascular) and hospitalisations for HF. The independent relationship between CT‐RASIs and the prognosis, stratifying patients for cardiovascular comorbidity after propensity score‐matching was analysed.
Results
During a median follow‐up of 7.94 years, 2960 died (76.6%) and 3138 were hospitalised (81.2%). Therapy with RASIs was associated with a lower mortality, all‐cause (RR [95% CI] for ACEIs: 0.76 [0.66‐0.86], and RR for ARBs: 0.88 [0.80‐0.96]; P |
| doi_str_mv | 10.1111/ijcp.13317 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2179448677</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2239482652</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3937-81a42c08e60e961534429ab9182024eeec919ff5137648e243edae85650247a03</originalsourceid><addsrcrecordid>eNp9kU9u1TAQhy1ERUthwwGQJTYIKcX_EtvsqqcCrSrBoqwjv2TS-Cmxg-20yo4j9A7cjJPg17QsumA2HsnffDPSD6E3lJzQXB_trplOKOdUPkNHVApWUCbo89zzShUl4fQQvYxxRwgrS0VeoENOKi1KqY_Q76sAJo3gEr61qccBnHV_ft0Zd219Ahetw3GJCUZsXW-3NvkQsXEtnoK_dj7aiH2HezAh4c7YYQ6wmqYAEcINtBh20CTrHe6CuW8-4dP9-LTXpyVvG01q-kzGNLdLXoRTD7jx4zi7DLxCB50ZIrx-eI_Rj89nV5uvxeW3L-eb08ui4ZrLQlEjWEMUVAR0RUsuBNNmq6lihAkAaDTVXVdSLiuhgAkOrQFVVmX-lobwY_R-9ebbfs4QUz3a2MAwGAd-jjWjUguhKikz-u4JuvNzcPm6mjGuhWJVyTL1YaWa4GMM0NVTsKMJS01JvY-u3kdX30eX4bcPynk7QvsPfcwqA3QFbu0Ay39U9fnF5vsq_QvLgaij</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2239482652</pqid></control><display><type>article</type><title>Treatment with renin‐angiotensin system inhibitors and prognosis of heart failure with preserved ejection fraction: A propensity‐matched study in the community</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Egido, Jose J. ; Gomez, Rocio ; Romero, Sotero P. ; Andrey, Jose L. ; Ramirez, Daniel ; Rodriguez, Ana ; Pedrosa, Maria J. ; Gomez, Francisco</creator><creatorcontrib>Egido, Jose J. ; Gomez, Rocio ; Romero, Sotero P. ; Andrey, Jose L. ; Ramirez, Daniel ; Rodriguez, Ana ; Pedrosa, Maria J. ; Gomez, Francisco</creatorcontrib><description>Aims
There is currently no consensus on the effect of treatment with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analysed the relationship of commencing treatment with ACEIs or ARBs and the prognosis of patients with incident HFpEF.
Methods
Retrospective study over 15 years on 3864 patients with HFpEF (GAMIC cohort). Main outcomes were mortality (all‐cause and cardiovascular) and hospitalisations for HF. The independent relationship between CT‐RASIs and the prognosis, stratifying patients for cardiovascular comorbidity after propensity score‐matching was analysed.
Results
During a median follow‐up of 7.94 years, 2960 died (76.6%) and 3138 were hospitalised (81.2%). Therapy with RASIs was associated with a lower mortality, all‐cause (RR [95% CI] for ACEIs: 0.76 [0.66‐0.86], and RR for ARBs: 0.88 [0.80‐0.96]; P < 0.001 in both cases), and cardiovascular (RR for ACEIs: 0.72 [0.66‐0.78], and RR for ARBs: 0.87 [0.80‐0.94]; P < 0.001), a lower hospitalisation rate (RR for ACEIs: 0.82 [0.74‐0.90], and RR for ARBs: 0.90 [0.82‐0.98]; P < 0.001), and a lower 30‐day readmission rate (RR for ACEIs: 0.66 [0.60‐0.73], and RR for ARBs: 0.86 [0.75‐0.97]; P < 0.001), after adjustment for the propensity to take RASIs or other medications, comorbidities and other potential confounders. Results on the effect of ARBs are compromised by the small number of patients. Analyses of recurrent hospitalisations gave larger treatment benefits than time‐to‐first‐event analyses.
Conclusion
In this propensity‐matched study, commencing treatment with ACEIs is associated with an improved prognosis of patients newly diagnosed with incident HFpEF.</description><identifier>ISSN: 1368-5031</identifier><identifier>EISSN: 1742-1241</identifier><identifier>DOI: 10.1111/ijcp.13317</identifier><identifier>PMID: 30694579</identifier><language>eng</language><publisher>England: Hindawi Limited</publisher><subject>Angiotensin ; angiotensin receptors blockers ; angiotensin‐converting enzyme inhibitors ; Cardiovascular diseases ; Congestive heart failure ; Ejection fraction ; Enzyme inhibitors ; Heart failure ; Medical prognosis ; Mortality ; preserved ejection fraction ; Prognosis ; Renin ; renin‐angiotensin system inhibitors</subject><ispartof>International journal of clinical practice (Esher), 2019-06, Vol.73 (6), p.e13317-n/a</ispartof><rights>2019 John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3937-81a42c08e60e961534429ab9182024eeec919ff5137648e243edae85650247a03</citedby><cites>FETCH-LOGICAL-c3937-81a42c08e60e961534429ab9182024eeec919ff5137648e243edae85650247a03</cites><orcidid>0000-0002-1326-0392</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fijcp.13317$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fijcp.13317$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30694579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egido, Jose J.</creatorcontrib><creatorcontrib>Gomez, Rocio</creatorcontrib><creatorcontrib>Romero, Sotero P.</creatorcontrib><creatorcontrib>Andrey, Jose L.</creatorcontrib><creatorcontrib>Ramirez, Daniel</creatorcontrib><creatorcontrib>Rodriguez, Ana</creatorcontrib><creatorcontrib>Pedrosa, Maria J.</creatorcontrib><creatorcontrib>Gomez, Francisco</creatorcontrib><title>Treatment with renin‐angiotensin system inhibitors and prognosis of heart failure with preserved ejection fraction: A propensity‐matched study in the community</title><title>International journal of clinical practice (Esher)</title><addtitle>Int J Clin Pract</addtitle><description>Aims
There is currently no consensus on the effect of treatment with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analysed the relationship of commencing treatment with ACEIs or ARBs and the prognosis of patients with incident HFpEF.
Methods
Retrospective study over 15 years on 3864 patients with HFpEF (GAMIC cohort). Main outcomes were mortality (all‐cause and cardiovascular) and hospitalisations for HF. The independent relationship between CT‐RASIs and the prognosis, stratifying patients for cardiovascular comorbidity after propensity score‐matching was analysed.
Results
During a median follow‐up of 7.94 years, 2960 died (76.6%) and 3138 were hospitalised (81.2%). Therapy with RASIs was associated with a lower mortality, all‐cause (RR [95% CI] for ACEIs: 0.76 [0.66‐0.86], and RR for ARBs: 0.88 [0.80‐0.96]; P < 0.001 in both cases), and cardiovascular (RR for ACEIs: 0.72 [0.66‐0.78], and RR for ARBs: 0.87 [0.80‐0.94]; P < 0.001), a lower hospitalisation rate (RR for ACEIs: 0.82 [0.74‐0.90], and RR for ARBs: 0.90 [0.82‐0.98]; P < 0.001), and a lower 30‐day readmission rate (RR for ACEIs: 0.66 [0.60‐0.73], and RR for ARBs: 0.86 [0.75‐0.97]; P < 0.001), after adjustment for the propensity to take RASIs or other medications, comorbidities and other potential confounders. Results on the effect of ARBs are compromised by the small number of patients. Analyses of recurrent hospitalisations gave larger treatment benefits than time‐to‐first‐event analyses.
Conclusion
In this propensity‐matched study, commencing treatment with ACEIs is associated with an improved prognosis of patients newly diagnosed with incident HFpEF.</description><subject>Angiotensin</subject><subject>angiotensin receptors blockers</subject><subject>angiotensin‐converting enzyme inhibitors</subject><subject>Cardiovascular diseases</subject><subject>Congestive heart failure</subject><subject>Ejection fraction</subject><subject>Enzyme inhibitors</subject><subject>Heart failure</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>preserved ejection fraction</subject><subject>Prognosis</subject><subject>Renin</subject><subject>renin‐angiotensin system inhibitors</subject><issn>1368-5031</issn><issn>1742-1241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kU9u1TAQhy1ERUthwwGQJTYIKcX_EtvsqqcCrSrBoqwjv2TS-Cmxg-20yo4j9A7cjJPg17QsumA2HsnffDPSD6E3lJzQXB_trplOKOdUPkNHVApWUCbo89zzShUl4fQQvYxxRwgrS0VeoENOKi1KqY_Q76sAJo3gEr61qccBnHV_ft0Zd219Ahetw3GJCUZsXW-3NvkQsXEtnoK_dj7aiH2HezAh4c7YYQ6wmqYAEcINtBh20CTrHe6CuW8-4dP9-LTXpyVvG01q-kzGNLdLXoRTD7jx4zi7DLxCB50ZIrx-eI_Rj89nV5uvxeW3L-eb08ui4ZrLQlEjWEMUVAR0RUsuBNNmq6lihAkAaDTVXVdSLiuhgAkOrQFVVmX-lobwY_R-9ebbfs4QUz3a2MAwGAd-jjWjUguhKikz-u4JuvNzcPm6mjGuhWJVyTL1YaWa4GMM0NVTsKMJS01JvY-u3kdX30eX4bcPynk7QvsPfcwqA3QFbu0Ay39U9fnF5vsq_QvLgaij</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Egido, Jose J.</creator><creator>Gomez, Rocio</creator><creator>Romero, Sotero P.</creator><creator>Andrey, Jose L.</creator><creator>Ramirez, Daniel</creator><creator>Rodriguez, Ana</creator><creator>Pedrosa, Maria J.</creator><creator>Gomez, Francisco</creator><general>Hindawi Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1326-0392</orcidid></search><sort><creationdate>201906</creationdate><title>Treatment with renin‐angiotensin system inhibitors and prognosis of heart failure with preserved ejection fraction: A propensity‐matched study in the community</title><author>Egido, Jose J. ; Gomez, Rocio ; Romero, Sotero P. ; Andrey, Jose L. ; Ramirez, Daniel ; Rodriguez, Ana ; Pedrosa, Maria J. ; Gomez, Francisco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3937-81a42c08e60e961534429ab9182024eeec919ff5137648e243edae85650247a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Angiotensin</topic><topic>angiotensin receptors blockers</topic><topic>angiotensin‐converting enzyme inhibitors</topic><topic>Cardiovascular diseases</topic><topic>Congestive heart failure</topic><topic>Ejection fraction</topic><topic>Enzyme inhibitors</topic><topic>Heart failure</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>preserved ejection fraction</topic><topic>Prognosis</topic><topic>Renin</topic><topic>renin‐angiotensin system inhibitors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egido, Jose J.</creatorcontrib><creatorcontrib>Gomez, Rocio</creatorcontrib><creatorcontrib>Romero, Sotero P.</creatorcontrib><creatorcontrib>Andrey, Jose L.</creatorcontrib><creatorcontrib>Ramirez, Daniel</creatorcontrib><creatorcontrib>Rodriguez, Ana</creatorcontrib><creatorcontrib>Pedrosa, Maria J.</creatorcontrib><creatorcontrib>Gomez, Francisco</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical practice (Esher)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egido, Jose J.</au><au>Gomez, Rocio</au><au>Romero, Sotero P.</au><au>Andrey, Jose L.</au><au>Ramirez, Daniel</au><au>Rodriguez, Ana</au><au>Pedrosa, Maria J.</au><au>Gomez, Francisco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment with renin‐angiotensin system inhibitors and prognosis of heart failure with preserved ejection fraction: A propensity‐matched study in the community</atitle><jtitle>International journal of clinical practice (Esher)</jtitle><addtitle>Int J Clin Pract</addtitle><date>2019-06</date><risdate>2019</risdate><volume>73</volume><issue>6</issue><spage>e13317</spage><epage>n/a</epage><pages>e13317-n/a</pages><issn>1368-5031</issn><eissn>1742-1241</eissn><abstract>Aims
There is currently no consensus on the effect of treatment with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analysed the relationship of commencing treatment with ACEIs or ARBs and the prognosis of patients with incident HFpEF.
Methods
Retrospective study over 15 years on 3864 patients with HFpEF (GAMIC cohort). Main outcomes were mortality (all‐cause and cardiovascular) and hospitalisations for HF. The independent relationship between CT‐RASIs and the prognosis, stratifying patients for cardiovascular comorbidity after propensity score‐matching was analysed.
Results
During a median follow‐up of 7.94 years, 2960 died (76.6%) and 3138 were hospitalised (81.2%). Therapy with RASIs was associated with a lower mortality, all‐cause (RR [95% CI] for ACEIs: 0.76 [0.66‐0.86], and RR for ARBs: 0.88 [0.80‐0.96]; P < 0.001 in both cases), and cardiovascular (RR for ACEIs: 0.72 [0.66‐0.78], and RR for ARBs: 0.87 [0.80‐0.94]; P < 0.001), a lower hospitalisation rate (RR for ACEIs: 0.82 [0.74‐0.90], and RR for ARBs: 0.90 [0.82‐0.98]; P < 0.001), and a lower 30‐day readmission rate (RR for ACEIs: 0.66 [0.60‐0.73], and RR for ARBs: 0.86 [0.75‐0.97]; P < 0.001), after adjustment for the propensity to take RASIs or other medications, comorbidities and other potential confounders. Results on the effect of ARBs are compromised by the small number of patients. Analyses of recurrent hospitalisations gave larger treatment benefits than time‐to‐first‐event analyses.
Conclusion
In this propensity‐matched study, commencing treatment with ACEIs is associated with an improved prognosis of patients newly diagnosed with incident HFpEF.</abstract><cop>England</cop><pub>Hindawi Limited</pub><pmid>30694579</pmid><doi>10.1111/ijcp.13317</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-1326-0392</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Angiotensin angiotensin receptors blockers angiotensin‐converting enzyme inhibitors Cardiovascular diseases Congestive heart failure Ejection fraction Enzyme inhibitors Heart failure Medical prognosis Mortality preserved ejection fraction Prognosis Renin renin‐angiotensin system inhibitors |
| title | Treatment with renin‐angiotensin system inhibitors and prognosis of heart failure with preserved ejection fraction: A propensity‐matched study in the community |
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