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Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure
Title: | Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure |
Authors: | Tsuchihashi-Makaya, Miyuki Browse this author | Furumoto, Tomoo Browse this author | Kinugawa, Shintaro Browse this author →KAKEN DB | Hamaguchi, Sanae Browse this author | Goto, Kazutomo Browse this author | Goto, Daisuke Browse this author | Yamada, Satoshi Browse this author →KAKEN DB | Yokoshiki, Hisashi Browse this author | Takeshita, Akira Browse this author | Tsutsui, Hiroyuki Browse this author →KAKEN DB |
Keywords: | ACE inhibitor | ARB | heart failure | outcome | survival |
Issue Date: | Mar-2010 |
Publisher: | Nature Publishing Group |
Journal Title: | Hypertension Research |
Volume: | 33 |
Issue: | 3 |
Start Page: | 197 |
End Page: | 202 |
Publisher DOI: | 10.1038/hr.2009.199 |
PMID: | 19960016 |
Abstract: | Large-scale, placebo-controlled, randomized clinical trials have demonstrated that angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) reduce mortality and hospitalization in patients with heart failure (HF) caused by left ventricular systolic dysfunction (LVSD). However, it is unknown whether ACE inhibitors and ARBs have similar effects on the long-term outcomes in HF patients encountered in routine clinical practice. The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) enrolled HF patients hospitalized with worsening symptoms and they were followed during an average of 2.2 years. The outcome data were compared in patients with LVSD by echocardiography (ejection fraction <40%) according to the predischarge use of ACE inhibitors (n=356) or ARBs (n=372). The clinical characteristics were similar between patients with ACE inhibitor and ARB use except for higher prevalence of hypertensive etiology and diabetes mellitus. There was no significant difference between ACE inhibitor and ARB use in all cause death (adjusted hazard ratio [HR] 0.958, 95% CI 0.601-1.527, P=0.858) and rehospitalization (adjusted HR 0.964, 95% CI 0.683-1.362, P=0.836). The effects of ACE inhibitor and ARB use on the outcomes were generally consistent across all clinically relevant subgroups examined, including age, sex, etiology, EF, hypertension, diabetes mellitus, and β-blocker use. Discharge use of ARBs provided comparable effects with ACE inhibitors on outcomes in patients hospitalized for HF. These findings provide further support for guideline recommendations that ARBs can be used in patients with HF and LVSD as an alternative of ACE inhibitors. |
Type: | article (author version) |
URI: | http://hdl.handle.net/2115/43817 |
Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 筒井 裕之
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