TY - JOUR
T1 - Association between class of foundational medication for heart failure and prognosis in heart failure with reduced/mildly reduced ejection fraction
AU - Ito, Miyuki
AU - Maeda, Daichi
AU - Matsue, Yuya
AU - Shiraishi, Yasuyuki
AU - Dotare, Taishi
AU - Sunayama, Tsutomu
AU - Nogi, Kazutaka
AU - Takei, Makoto
AU - Ueda, Tomoya
AU - Nogi, Maki
AU - Ishihara, Satomi
AU - Nakada, Yasuki
AU - Kawakami, Rika
AU - Kagiyama, Nobuyuki
AU - Kitai, Takeshi
AU - Oishi, Shogo
AU - Akiyama, Eiichi
AU - Suzuki, Satoshi
AU - Yamamoto, Masayoshi
AU - Kida, Keisuke
AU - Okumura, Takahiro
AU - Nagatomo, Yuji
AU - Kohno, Takashi
AU - Nakano, Shintaro
AU - Kohsaka, Shun
AU - Yoshikawa, Tsutomu
AU - Saito, Yoshihiko
AU - Minamino, Tohru
N1 - Funding Information:
Y.M. received an honorarium from Otsuka Pharmaceutical Co, Novartis Japan, and Bayer Japan, and a collaborative research grant from Pfizer Inc. Y.Sh. received honoraria from Otsuka, Ono, and personal fees from Nippon Shinyaku, Medtronic Japan, and Biotronik outside the submitted work. K.K. received honoraria from Daiichi-Sankyo, Ono, AstraZeneca, Otsuka, and Novartis outside the submitted work. T.O. received honoraria from Ono, Otsuka, Novartis, and AstraZeneca and research grants from Ono, Amgen, Pfizer, Alnylam, and Alexion outside the submitted work. S.K. received honoraria from Bayer and research grants from Novartis outside the submitted work. Other authors declare no competing interests.
Funding Information:
This work was partially supported by JSPS KAKENHI (Y.M., 21H03309; D.M., 22K16152). REALITY registry was funded by the Cardiovascular Research Fund of Japan. WET-HF registry was supported by a Grant-in-Aid for Young Scientists (Y.Sh. JSPS KAKENHI, 18K15860), Grants-in-Aid for Scientific Research (T.Y. JSPS KAKENHI, 23591062 and 26461088; T.Ko. 17K09526), a grant from the Japan Agency for Medical Research and Development (S.K. 201439013C), and Sakakibara Clinical Research Grants for the Promotion of Science (T.Y. 2012–2018).
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - We clarified the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure (HF) and post-discharge prognosis. We retrospectively analyzed a combined dataset from three large-scale registries of hospitalized patients with HF in Japan (NARA-HF, WET-HF, and REALITY-AHF) and patients diagnosed with HF with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes from admission to discharge: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and mineralocorticoid receptor blockers. Primary endpoint was the combined endpoint of HF rehospitalization and all-cause death within 1 year of discharge. The cohort comprised 1113 patients, and 482 combined endpoints were observed. Overall, FMHF prescriptions increased in 413 (37.1%) patients (increased group), remained unchanged in 607 (54.5%) (unchanged group), and decreased in 93 (8.4%) (decreased group) at discharge compared with that during admission. In the multivariable analysis, the increased group had a significantly lower incidence of the primary endpoint than the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P < 0.001). In conclusion, increase in FMHF classes during HF hospitalization is associated with a better prognosis in patients with HFr/mrEF.
AB - We clarified the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure (HF) and post-discharge prognosis. We retrospectively analyzed a combined dataset from three large-scale registries of hospitalized patients with HF in Japan (NARA-HF, WET-HF, and REALITY-AHF) and patients diagnosed with HF with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes from admission to discharge: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and mineralocorticoid receptor blockers. Primary endpoint was the combined endpoint of HF rehospitalization and all-cause death within 1 year of discharge. The cohort comprised 1113 patients, and 482 combined endpoints were observed. Overall, FMHF prescriptions increased in 413 (37.1%) patients (increased group), remained unchanged in 607 (54.5%) (unchanged group), and decreased in 93 (8.4%) (decreased group) at discharge compared with that during admission. In the multivariable analysis, the increased group had a significantly lower incidence of the primary endpoint than the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P < 0.001). In conclusion, increase in FMHF classes during HF hospitalization is associated with a better prognosis in patients with HFr/mrEF.
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U2 - 10.1038/s41598-022-20892-3
DO - 10.1038/s41598-022-20892-3
M3 - Article
C2 - 36198895
AN - SCOPUS:85139294850
SN - 2045-2322
VL - 12
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 16611
ER -