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Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers in Heart Failure With Chronic Kidney Disease - Propensity Score Matching Analysis -

Title
Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers in Heart Failure With Chronic Kidney Disease - Propensity Score Matching Analysis -
Authors
Kim, Hyun-JinLee, Min-HoJo, Sang-HoSeo, Won-WooKim, Sung EunKim, Kyung-JinChoi, Jin-OhAhn, Hyo-SukChoi, Dong-JuRyu, Kyu-Hyung
Ewha Authors
김경진
Issue Date
2020
Journal Title
CIRCULATION JOURNAL
ISSN
1346-9843JCR Link

1347-4820JCR Link
Citation
CIRCULATION JOURNAL vol. 84, no. 1, pp. 83 - +
Keywords
Angiotensin-converting enzyme inhibitorsAngiotensin-receptor blockersChronic kidney diseaseHeart failure
Publisher
JAPANESE CIRCULATION SOC
Indexed
SCI; SCIE; SCOPUS WOS
Document Type
Article
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.
DOI
10.1253/circj.CJ-19-0782
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의료원 > 의료원 > Journal papers
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