Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers in Heart Failure With Chronic Kidney Disease ― Propensity Score Matching Analysis ―
Year: 2019
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Whether angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) exert beneficial effects in patients with concomitant heart failure (HF) and chronic kidney disease (CKD) remains uncertain. In this study, the effects of ACEI and ARB on long-term clinical outcomes in such patients were investigated. METHODS AND RESULTS: Study data were obtained from a multicenter cohort that included patients hospitalized for HF. A total of 1,601 patients with both HF and CKD were classified according to prescription of ACEI or ARB at discharge. The mortality rate was 19.0% in the ACEI/ARB treatment group (n=943) and 33.6% in the no ACEI/ARB treatment group (n=658) during follow-up. The ACEI/ARB treatment group had a significantly higher cumulative death-free survival rate than the no ACEI/ARB treatment group. Cox regression analysis showed that using ACEI or ARB was independently associated with reduced risk of all-cause death after adjusting for confounding factors. The beneficial effects of ACEI or ARB were retained after propensity score matching. CONCLUSIONS: Prescription of an ACEI or ARB at discharge was associated with reduction in all-cause mortality in patients with acute HF and CKD. Clinicians need to be aware of the prognostic value and consider prescribing ACEI or ARB to high-risk patients.
Source: Circulation Journal
Institutions: Hanyang University Guri Hospital, Soonchunhyang University, Soonchunhyang University Hospital Seoul, Hallym University Sacred Heart Hospital, Hallym University, Kangdong Sacred Heart Hospital, Ewha Womans University, Ewha Womans University Medical Center, Samsung Medical Center, Sungkyunkwan University, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Seoul National University, Seoul National University Bundang Hospital, Hallym University Dongtan Sacred Heart Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2990492011