著者

Kanae Su Takao Kato Mamoru Toyofuku Takeshi Morimoto Hidenori Yaku Yasutaka Inuzuka Yodo Tamaki Neiko Ozasa Erika Yamamoto Yusuke Yoshikawa Yasuyo Motohashi Hiroki Watanabe Takeshi Kitai Ryoji Taniguchi Moritake Iguchi Masashi Kato Kazuya Nagao Takafumi Kawai Akihiro Komasa Ryusuke Nishikawa Yuichi Kawase Takashi Morinaga Toshikazu Jinnai Mitsunori Kawato Yukihito Sato Koichiro Kuwahara Takashi Tamura Takeshi Kimura KCHF Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.11, pp.517-524, 2019-11-08 (Released:2019-11-08)

参考文献数

30

被引用文献数

17

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Background:We sought to explore the effects of previous heart failure (HF) hospitalization on mortality in patients hospitalized for acute decompensated HF (ADHF) in a large Japanese contemporary observational database.Methods and Results:We prospectively enrolled consecutive patients with ADHF in 19 participating hospitals between October 2014 and March 2016. Of 4,056 patients, 1,442 patients (35.4%) had at least 1 previous HF hospitalization (previous hospitalization group), while 2,614 patients (64.5%) did not have a history of HF hospitalization (de novo hospitalization group). Patients with previous hospitalization were older and more often had comorbidities such as anemia, and renal failure than those without. The cumulative 1-year incidence of all-cause death was significantly higher in the previous hospitalization group than in the de novo hospitalization group (28% vs. 19%, P<0.001). After adjusting confounders, the excess risk of the previous hospitalization group relative to the de novo hospitalization group for all-cause death remained significant (HR, 1.28; 95% CI: 1.10–1.50, P=0.001). The excess risk was significant in patients without advanced age, anemia, or renal failure, but not significant in patients with these comorbidities, with significant interaction. Increase in the number of hospitalizations was associated with an increased risk for mortality.Conclusions:In a contemporary ADHF cohort in Japan, repeated hospitalization was associated with an increasing, higher risk for 1-year mortality.

著者

Yuta Seko Takao Kato Takeshi Morimoto Hidenori Yaku Yasutaka Inuzuka Yodo Tamaki Neiko Ozasa Masayuki Shiba Erika Yamamoto Yusuke Yoshikawa Yugo Yamashita Takeshi Kitai Ryoji Taniguchi Moritake Iguchi Kazuya Nagao Takafumi Kawai Akihiro Komasa Ryusuke Nishikawa Yuichi Kawase Takashi Morinaga Mamoru Toyofuku Yutaka Furukawa Kenji Ando Kazushige Kadota Yukihito Sato Koichiro Kuwahara Takeshi Kimura for the KCHF Study Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.10, pp.1547-1558, 2022-09-22 (Released:2022-09-22)

参考文献数

30

被引用文献数

3

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Background: The clinical benefits of neurohormonal antagonists for patients with heart failure (HF) with mid-range and preserved ejection fraction (HFmrEF and HFpEF) are uncertain.Methods and Results: This study analyzed 858 consecutive patients with HFmrEF (EF: 40–49%) or HFpEF (EF ≥50%), who were hospitalized for acute HF, and who were discharged alive, and were not taking angiotensin-converting enzyme inhibitors (ACE)-I/ angiotensin II receptor blockers (ARB) or β-blockers at admission. The study population was classified into 4 groups according to the status of prescription of ACE-I/ARB and β-blocker at discharge: no neurohormonal antagonist (n=342, 39.9%), ACE-I/ARB only (n=128, 14.9%), β-blocker only (n=189, 22.0%), and both ACE-I/ARB and β-blocker (n=199, 23.2%) groups. The primary outcome measure was a composite of all-cause death or HF hospitalization. The cumulative 1-year incidence of the primary outcome measure was 41.2% in the no neurohormonal antagonist group, 34.0% in the ACE-I/ARB only group, 28.6% in the β-blocker only group, and 16.4% in the both ACE-I/ARB and β-blocker group (P<0.001). Compared with the no neurohormonal antagonist group, both the ACE-I/ARB and β-blocker groups were associated with a significantly lower risk for a composite of all-cause death or HF hospitalization (HR: 0.46, 95% CI: 0.28–0.76, P=0.002).Conclusions: In hospitalized patients with HFmrEF and HFpEF, starting both ACE-I/ARB and a β-blocker was associated with a reduced risk of the composite of all-cause death or HF hospitalization compared with patients not starting on an ACE-I/ARB or β-blocker.