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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

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/43817

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)

Submitter: 筒井 裕之

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