TY - JOUR 
A1 - Vicent, Lourdes
AU - Cinca, Juan
AU - Vázquez García, Rafael
AU - González Juanatey, José Ramón
AU - Rivera, Miguel
AU - Segovia Cubero, Javier
AU - Pascual Figal, Domingo
AU - Bover Freire, Ramón
AU - Fernández Avilés, Francisco
AU - Martínez Sellés Oliveria Soares, Manuel
AU - Et al.
T1 - Discharge treatment with angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker after a heart failure hospitalisation is associated with a better prognosis irrespective of left ventricular ejection fraction
Y1 - 2019
SN - 1444-0903

UR - http://hdl.handle.net/11268/8845
AB - Background
Medical therapy could improve the prognosis of real‐life patients discharged after a heart failure (HF) hospitalisation.

Aim
To determine the impact of discharge HF treatment on mortality and readmissions in different left ventricular ejection fraction (LVEF) groups.

Methods
Multicentre prospective registry in 20 Spanish hospitals. Patients were enrolled after a HF hospitalisation.

Results
A total of 1831 patients was included (583 (31.8%) HF with reduced ejection fraction (HFrEF); 227 (12.4%) HF with midrange ejection fraction (HFmrEF); 610 (33.3%) HF with preserved ejection fraction (HFpEF), and 411 (22.4%) with unknown LVEF). Angiotensin‐converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB) at discharge were independently associated with a reduction in: (i) all‐cause mortality: hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.41–0.74, P < 0.001, with a similar effect in the four groups; (ii) mortality due to refractory HF HR 0.45, 95% CI 0.29–0.64, P < 0.001, with a similar effect in the three groups with known LVEF; (iii) mortality/HF admissions (HR 0.61; 95% CI: 0.50–0.74), more evident in HFrEF (HR 0.54; 95% CI: 0.38–0.78) compared with HRmEF (HR 0.64; 95% CI 0.40–1.02), or HFpEF (HR 0.70; 95% CI 0.53–0.92). In patients with HFrEF triple therapy (ACE inhibitor/ARB + beta blocker + mineralocorticoid receptor antagonist) was associated with the lowest mortality risk (HR 0.21; 95% CI: 0.08–0.57, P = 0.002) compared with patients that received none of these drugs.

Conclusions
Discharge treatment with ACE inhibitor/ARB after a HF hospitalisation is associated with a reduction in all‐cause and refractory HF mortality, irrespective of LVEF.
KW - Enfermos cardíacos
KW - Hospitalizados
KW - Medicamentos cardiovasculares
KW - Enfermedad cardiovascular
KW - Paciente
KW - Tratamiento médico
LA - eng
ER -