Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure

Tsuchihashi-Makaya, Miyuki; Furumoto, Tomoo; Kinugawa, Shintaro; Hamaguchi, Sanae; Goto, Kazutomo; Goto, Daisuke; Yamada, Satoshi; Yokoshiki, Hisashi; Takeshita, Akira; Tsutsui, Hiroyuki

Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure

Tsuchihashi-Makaya, Miyuki; Furumoto, Tomoo; Kinugawa, Shintaro et al.

Hypertension Research, 2010, 33(3), 197-202

Permalink : https://hdl.handle.net/2115/43817

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アクセス権	open access
URI	https://hdl.handle.net/2115/43817
タイトル	Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure
著者	Tsuchihashi-Makaya, Miyuki ; Furumoto, Tomoo ; Kinugawa, Shintaro ; Hamaguchi, Sanae ; Goto, Kazutomo ; Goto, Daisuke ; Yamada, Satoshi ; Yokoshiki, Hisashi ; Takeshita, Akira ; Tsutsui, Hiroyuki
著者名 Tsuchihashi-Makaya, Miyuki
著者名 Furumoto, Tomoo
e-Rad_Researcher 60399871 著者名 Kinugawa, Shintaro
著者名 Hamaguchi, Sanae
著者名 Goto, Kazutomo
著者名 Goto, Daisuke
e-Rad_Researcher 80374320 著者名 Yamada, Satoshi
著者名 Yokoshiki, Hisashi
著者名 Takeshita, Akira
e-Rad_Researcher 70264017 著者名 Tsutsui, Hiroyuki
言語	英語
キーワード	ACE inhibitor
	ARB
	heart failure
	outcome
	survival
発行日	2010-03
出版者	Nature Publishing Group
収録物名	Hypertension Research
巻(号)	33(3)
ページ	197-202
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	0916-9636
関連情報	PMID 19960016
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1038/hr.2009.199