- 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
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.