Guideline-directed medical therapy in real-world heart failure patients with low blood pressure and renal dysfunction
Background Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognos...
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| Published in | Clinical research in cardiology Vol. 110; no. 7; pp. 1051 - 1062 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.07.2021
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction.
Methods
This study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP ≦ 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) ≦ 60 ml/min/1.73m
2
) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1–4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality.
Results
Among the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1–4. Patients in group 1 were younger, had highest hemoglobin, and most with EF < 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89–1.21) (
p
= 0.62), group 3 1.40 (1.09–1.79) (
p
= 0.009), and group 4 1.71 (1.39–2.09) (
p
< 0.001).
Conclusions
In real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time.
Graphic abstract |
|---|---|
| AbstractList | BackgroundAmong patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction.MethodsThis study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP ≦ 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) ≦ 60 ml/min/1.73m2) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1–4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality.ResultsAmong the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1–4. Patients in group 1 were younger, had highest hemoglobin, and most with EF < 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89–1.21) (p = 0.62), group 3 1.40 (1.09–1.79) (p = 0.009), and group 4 1.71 (1.39–2.09) (p < 0.001).ConclusionsIn real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time.Graphic abstract Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction.BACKGROUNDAmong patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction.This study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP ≦ 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) ≦ 60 ml/min/1.73m2) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1-4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality.METHODSThis study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP ≦ 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) ≦ 60 ml/min/1.73m2) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1-4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality.Among the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1-4. Patients in group 1 were younger, had highest hemoglobin, and most with EF < 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89-1.21) (p = 0.62), group 3 1.40 (1.09-1.79) (p = 0.009), and group 4 1.71 (1.39-2.09) (p < 0.001).RESULTSAmong the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1-4. Patients in group 1 were younger, had highest hemoglobin, and most with EF < 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89-1.21) (p = 0.62), group 3 1.40 (1.09-1.79) (p = 0.009), and group 4 1.71 (1.39-2.09) (p < 0.001).In real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time.CONCLUSIONSIn real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time. Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction. This study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP ≦ 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) ≦ 60 ml/min/1.73m ) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1-4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality. Among the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1-4. Patients in group 1 were younger, had highest hemoglobin, and most with EF < 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89-1.21) (p = 0.62), group 3 1.40 (1.09-1.79) (p = 0.009), and group 4 1.71 (1.39-2.09) (p < 0.001). In real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time. Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction.This study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP≦100mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR)≦60ml/min/1.73m2) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1-4: ACEI/ARB+BB+MRA, ACEI/ARB+BB, ACEI/ARB+MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality.Among the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1-4. Patients in group 1 were younger, had highest hemoglobin, and most with EF<30%. During a median of 1.33years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89-1.21) (p=0.62), group 3 1.40 (1.09-1.79) (p=0.009), and group 4 1.71 (1.39-2.09) (p<0.001).In real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time. Background Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), β-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction. Methods This study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP ≦ 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) ≦ 60 ml/min/1.73m 2 ) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1–4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality. Results Among the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1–4. Patients in group 1 were younger, had highest hemoglobin, and most with EF < 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89–1.21) ( p = 0.62), group 3 1.40 (1.09–1.79) ( p = 0.009), and group 4 1.71 (1.39–2.09) ( p < 0.001). Conclusions In real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time. Graphic abstract Background Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), beta-blockers (BB) and mineralocorticoid receptor antagonist (MRA) are known as guideline-directed medical therapy to improve prognosis. However, low blood pressure (BP) and renal dysfunction are often challenges prevent clinical implementation, so we investigated the association of different combinations of GDMT treatments with all-cause mortality in HFrEF population with low BP and renal dysfunction. Methods This study initially included 51, 060 HF patients from the Swedish Heart Failure Registry, and finally 1464 HFrEF patients with low BP (systolic BP &lt;= 100 mmHg) and renal dysfunction (estimated glomerular filtration rate (eGFR) &lt;= 60 ml/min/1.73m(2)) were ultimately enrolled. Patients were receiving oral medication for HF at study enrollment, and divided into four groups (group 1-4: ACEI/ARB + BB + MRA, ACEI/ARB + BB, ACEI/ARB + MRA or ACEI/ARB only, and other). The outcome is time to all-cause mortality. Results Among the study patients, 485 (33.1%), 672 (45.9%), 109 (7.4%) and 198 (13.5%) patients were in group 1-4. Patients in group 1 were younger, had highest hemoglobin, and most with EF &lt; 30%. During a median of 1.33 years follow-up, 937 (64%) patients died. After adjustment for age, gender, LVEF, eGFR, hemoglobin when compared with the group 1, the hazard ratio for all-cause mortality in group 2 was 1.04 (0.89-1.21) (p = 0.62), group 3 1.40 (1.09-1.79) (p = 0.009), and group 4 1.71 (1.39-2.09) (p &lt; 0.001). Conclusions In real-world HFrEF patients with low BP and renal dysfunction, full medication of guideline-directed medical therapy is associated with improved survival. The benefit was larger close to the index date and decreased with follow-up time. |
| Author | Thunström, Erik Dahlström, Ulf Chen, Xiaojing Cui, Xiaotong Pivodic, Aldina Fu, Michael |
| Author_xml | – sequence: 1 givenname: Xiaojing orcidid: 0000-0003-1354-5053 surname: Chen fullname: Chen, Xiaojing email: chenxiaojing_058@163.com organization: Department of Cardiology, West China Hospital, Sichuan University, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg – sequence: 2 givenname: Xiaotong surname: Cui fullname: Cui, Xiaotong organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Department of Cardiology, Zhongshan Hospital, Fudan University – sequence: 3 givenname: Erik surname: Thunström fullname: Thunström, Erik organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg – sequence: 4 givenname: Aldina surname: Pivodic fullname: Pivodic, Aldina organization: Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Statistiska Konsultgruppen – sequence: 5 givenname: Ulf surname: Dahlström fullname: Dahlström, Ulf organization: Department of Cardiology and Department of Medical and Health Sciences, Linköping University – sequence: 6 givenname: Michael surname: Fu fullname: Fu, Michael organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33394127$$D View this record in MEDLINE/PubMed https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-172988$$DView record from Swedish Publication Index https://gup.ub.gu.se/publication/300493$$DView record from Swedish Publication Index |
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| Cites_doi | 10.1016/j.jacc.2018.04.070 10.1161/01.CIR.102.2.203 10.1046/j.1532-5415.2002.50457.x 10.1016/j.jacc.2005.11.084 10.1093/eurheartj/eht386 10.1016/j.ahj.2012.11.004 10.1161/CIRCHEARTFAILURE.109.869743 10.1093/eurheartj/ehi386 10.1093/eurheartj/ehw128 10.1161/CIRCULATIONAHA.105.577577 10.1002/sim.1203 10.1093/eurheartj/ehw570 10.1093/eurjhf/hfp175 10.1016/j.cardfail.2007.03.011 10.1093/eurheartj/ehi845 10.7326/0003-4819-158-11-201306040-00007 10.1161/CIRCHEARTFAILURE.112.970889 10.1161/01.CIR.0000116764.53225.A9 10.1186/s12916-016-0731-2 10.1001/jama.296.18.2217 10.1056/NEJMoa041031 10.1016/j.recesp.2013.03.014 10.1007/s10741-012-9315-1 10.1002/ejhf.114 |
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| References | Metra, Torp-Pedersen, Swedberg (CR25) 2005; 26 Ferreira, Girerd, Pellicori (CR2) 2016; 14 Gheorghiade, Vaduganathan, Ambrosy (CR22) 2013; 18 Komajda, Böhm, Borer (CR23) 2014; 16 Böhm, Young, Jhund (CR24) 2017; 38 Royston, Parmar (CR11) 2002; 21 Go, Yang, Ackerson (CR16) 2006; 113 McAlister, Ezekowitz, Tonelli, Armstrong (CR13) 2004; 109 Ponikowski, Voors, Anker (CR5) 2016; 37 Heywood, Fonarow, Costanzo (CR14) 2007; 13 Lee, Ghosh, Floras (CR10) 2009; 2 Ahmed, Kiefe, Allman, Sims, DeLong (CR18) 2002; 50 Greene, Butler, Albert (CR6) 2018; 72 Smith, Lichtman, Bracken (CR15) 2006; 47 Stevens, Levin (CR9) 2013; 158 Parwani, Ryan (CR7) 2012; 5 Sayago-Silva, García-López, Segovia-Cubero (CR1) 2013; 66 Go, Chertow, Fan, McCulloch, Hsu (CR17) 2004; 351 Jonsson, Edner, Alehagen, Dahlstrom (CR8) 2010; 12 Ambrosy, Vaduganathan, Mentz (CR21) 2013; 165 Damman, Valente, Voors (CR4) 2014; 35 Tavazzi, Maggioni, Lucci (CR20) 2006; 27 Gheorghiade, Abraham, Albert (CR19) 2006; 296 Dewar, Khan (CR12) 2015; 1 Hillege, Girbes, de Kam (CR3) 2000; 102 JP Ferreira (1790_CR2) 2016; 14 HL Hillege (1790_CR3) 2000; 102 M Gheorghiade (1790_CR19) 2006; 296 AS Go (1790_CR17) 2004; 351 M Böhm (1790_CR24) 2017; 38 P Parwani (1790_CR7) 2012; 5 FA McAlister (1790_CR13) 2004; 109 M Komajda (1790_CR23) 2014; 16 L Tavazzi (1790_CR20) 2006; 27 DS Lee (1790_CR10) 2009; 2 A Jonsson (1790_CR8) 2010; 12 AP Ambrosy (1790_CR21) 2013; 165 K Damman (1790_CR4) 2014; 35 GL Smith (1790_CR15) 2006; 47 PE Stevens (1790_CR9) 2013; 158 I Sayago-Silva (1790_CR1) 2013; 66 P Royston (1790_CR11) 2002; 21 JT Heywood (1790_CR14) 2007; 13 M Gheorghiade (1790_CR22) 2013; 18 AS Go (1790_CR16) 2006; 113 P Ponikowski (1790_CR5) 2016; 37 R Dewar (1790_CR12) 2015; 1 SJ Greene (1790_CR6) 2018; 72 A Ahmed (1790_CR18) 2002; 50 M Metra (1790_CR25) 2005; 26 |
| References_xml | – volume: 72 start-page: 351 year: 2018 end-page: 366 ident: CR6 article-title: Medical Therapy for heart failure with reduced ejection fraction. the CHAMP-Hf Registry publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2018.04.070 – volume: 102 start-page: 203 year: 2000 end-page: 210 ident: CR3 article-title: Renal function, neurohormonal activation, and survival in patients with chronic heart failure publication-title: Circulation doi: 10.1161/01.CIR.102.2.203 – volume: 50 start-page: 1659 year: 2002 end-page: 1666 ident: CR18 article-title: Survival benefits of angiotensin-converting enzyme inhibitors in older heart failure patients with perceived contraindications publication-title: J Am Geriatr Soc doi: 10.1046/j.1532-5415.2002.50457.x – volume: 47 start-page: 1987 year: 2006 end-page: 1996 ident: CR15 article-title: Renal impairment and outcomes in heart failure: systematic review and meta-analysis publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2005.11.084 – volume: 35 start-page: 455 year: 2014 end-page: 469 ident: CR4 article-title: Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis publication-title: Eur Heart J doi: 10.1093/eurheartj/eht386 – volume: 165 start-page: 216 year: 2013 end-page: 225 ident: CR21 article-title: Clinical profile and prognostic value of low systolic blood pressure in patients hospitalized for heart failure with reduced ejection fraction: insights from the efficacy of vasopressin antagonism in heart failure: outcome study with tolvaptan (EVEREST) trial publication-title: Am Heart J doi: 10.1016/j.ahj.2012.11.004 – volume: 2 start-page: 616 year: 2009 end-page: 623 ident: CR10 article-title: Association of blood pressure at hospital discharge with mortality in patients diagnosed with heart failure publication-title: Circ Heart Fail doi: 10.1161/CIRCHEARTFAILURE.109.869743 – volume: 26 start-page: 2259 year: 2005 end-page: 2268 ident: CR25 article-title: Influence of heart rate, blood pressure, and beta-blocker dose on outcome and the differences in outcome between carvedilol and metoprolol tartrate in patients with chronic heart failure: results from the COMET trial publication-title: Eur Heart J doi: 10.1093/eurheartj/ehi386 – volume: 37 start-page: 2129 year: 2016 end-page: 2200 ident: CR5 article-title: 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure publication-title: Eur Heart J doi: 10.1093/eurheartj/ehw128 – volume: 113 start-page: 2713 year: 2006 end-page: 2723 ident: CR16 article-title: Hemoglobin level, chronic kidney disease, and the risks of death and hospitalization in adults with chronic heart failure: the anemia in chronic heart failure: outcomes and resource utilization (ANCHOR) study publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.105.577577 – volume: 21 start-page: 2175 year: 2002 end-page: 2197 ident: CR11 article-title: Flexible parametric proportional-hazards and proportional-odds models for censored survival data, with application to prognostic modelling and estimation of treatment effects publication-title: Stat Med doi: 10.1002/sim.1203 – volume: 38 start-page: 1132 year: 2017 end-page: 1143 ident: CR24 article-title: Systolic blood pressure, cardiovascular outcomes and efficacy and safety of sacubitril/valsartan (LCZ696) in patients with chronic heart failure and reduced ejection fraction: results from PARADIGM-HF publication-title: Eur Heart J doi: 10.1093/eurheartj/ehw570 – volume: 12 start-page: 25 year: 2010 end-page: 31 ident: CR8 article-title: Heart failure registry: a valuable tool for improving the management of patients with heart failure publication-title: Eur J Heart Fail doi: 10.1093/eurjhf/hfp175 – volume: 13 start-page: 422 year: 2007 end-page: 430 ident: CR14 article-title: High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database publication-title: J Card Fail doi: 10.1016/j.cardfail.2007.03.011 – volume: 27 start-page: 1207 year: 2006 end-page: 1215 ident: CR20 article-title: Nationwide survey on acute heart failure in cardiology ward services in Italy publication-title: Eur Heart J doi: 10.1093/eurheartj/ehi845 – volume: 158 start-page: 825 year: 2013 end-page: 830 ident: CR9 article-title: Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline publication-title: Ann Intern Med doi: 10.7326/0003-4819-158-11-201306040-00007 – volume: 5 start-page: 819 issue: 6 year: 2012 ident: CR7 article-title: Heart failure patients with low blood pressure: how should we manage neurohormonal blocking drugs? publication-title: Circ Heart Fail doi: 10.1161/CIRCHEARTFAILURE.112.970889 – volume: 109 start-page: 1004 year: 2004 end-page: 1009 ident: CR13 article-title: Renal insufficiency and heart failure: prognostic and therapeutic implications from a prospective cohort study publication-title: Circulation doi: 10.1161/01.CIR.0000116764.53225.A9 – volume: 14 start-page: 181 issue: 1 year: 2016 ident: CR2 article-title: Gault formulas for predicting cardiovascular mortality in population-based, cardiovascular risk, heart failure and post-myocardial infarction cohorts: the heart 'OMics' in AGEing (HOMAGE) and the high-risk myocardial infarction database initiatives publication-title: BMC Med doi: 10.1186/s12916-016-0731-2 – volume: 296 start-page: 2217 year: 2006 end-page: 2226 ident: CR19 article-title: Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure publication-title: JAMA doi: 10.1001/jama.296.18.2217 – volume: 351 start-page: 1296 issue: 13 year: 2004 end-page: 1305 ident: CR17 article-title: Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization publication-title: N Engl J Med doi: 10.1056/NEJMoa041031 – volume: 66 start-page: 649 year: 2013 end-page: 656 ident: CR1 article-title: Epidemiology of heart failure in Spain over the last 20 years publication-title: Rev Esp Cardiol doi: 10.1016/j.recesp.2013.03.014 – volume: 18 start-page: 107 year: 2013 end-page: 122 ident: CR22 article-title: Current management and future directions for the treatment of patients hospitalized for heart failure with low blood pressure publication-title: Heart Fail Rev doi: 10.1007/s10741-012-9315-1 – volume: 16 start-page: 810 year: 2014 end-page: 816 ident: CR23 article-title: Efficacy and safety of ivabradine in patients with chronic systolic heart failure according to blood pressure level in SHIFT publication-title: Eur J Heart Fail doi: 10.1002/ejhf.114 – volume: 1 start-page: 855 year: 2015 end-page: 866 ident: CR12 article-title: A new SAS macro for flexible parametric survival modelling: applications to clinical trials and surveillance data publication-title: Comput Methods Programs Biomed – volume: 27 start-page: 1207 year: 2006 ident: 1790_CR20 publication-title: Eur Heart J doi: 10.1093/eurheartj/ehi845 – volume: 158 start-page: 825 year: 2013 ident: 1790_CR9 publication-title: Ann Intern Med doi: 10.7326/0003-4819-158-11-201306040-00007 – volume: 21 start-page: 2175 year: 2002 ident: 1790_CR11 publication-title: Stat Med doi: 10.1002/sim.1203 – volume: 66 start-page: 649 year: 2013 ident: 1790_CR1 publication-title: Rev Esp Cardiol doi: 10.1016/j.recesp.2013.03.014 – volume: 5 start-page: 819 issue: 6 year: 2012 ident: 1790_CR7 publication-title: Circ Heart Fail doi: 10.1161/CIRCHEARTFAILURE.112.970889 – volume: 47 start-page: 1987 year: 2006 ident: 1790_CR15 publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2005.11.084 – volume: 109 start-page: 1004 year: 2004 ident: 1790_CR13 publication-title: Circulation doi: 10.1161/01.CIR.0000116764.53225.A9 – volume: 16 start-page: 810 year: 2014 ident: 1790_CR23 publication-title: Eur J Heart Fail doi: 10.1002/ejhf.114 – volume: 35 start-page: 455 year: 2014 ident: 1790_CR4 publication-title: Eur Heart J doi: 10.1093/eurheartj/eht386 – volume: 50 start-page: 1659 year: 2002 ident: 1790_CR18 publication-title: J Am Geriatr Soc doi: 10.1046/j.1532-5415.2002.50457.x – volume: 1 start-page: 855 year: 2015 ident: 1790_CR12 publication-title: Comput Methods Programs Biomed – volume: 113 start-page: 2713 year: 2006 ident: 1790_CR16 publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.105.577577 – volume: 102 start-page: 203 year: 2000 ident: 1790_CR3 publication-title: Circulation doi: 10.1161/01.CIR.102.2.203 – volume: 296 start-page: 2217 year: 2006 ident: 1790_CR19 publication-title: JAMA doi: 10.1001/jama.296.18.2217 – volume: 37 start-page: 2129 year: 2016 ident: 1790_CR5 publication-title: Eur Heart J doi: 10.1093/eurheartj/ehw128 – volume: 12 start-page: 25 year: 2010 ident: 1790_CR8 publication-title: Eur J Heart Fail doi: 10.1093/eurjhf/hfp175 – volume: 72 start-page: 351 year: 2018 ident: 1790_CR6 publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2018.04.070 – volume: 351 start-page: 1296 issue: 13 year: 2004 ident: 1790_CR17 publication-title: N Engl J Med doi: 10.1056/NEJMoa041031 – volume: 165 start-page: 216 year: 2013 ident: 1790_CR21 publication-title: Am Heart J doi: 10.1016/j.ahj.2012.11.004 – volume: 38 start-page: 1132 year: 2017 ident: 1790_CR24 publication-title: Eur Heart J doi: 10.1093/eurheartj/ehw570 – volume: 2 start-page: 616 year: 2009 ident: 1790_CR10 publication-title: Circ Heart Fail doi: 10.1161/CIRCHEARTFAILURE.109.869743 – volume: 14 start-page: 181 issue: 1 year: 2016 ident: 1790_CR2 publication-title: BMC Med doi: 10.1186/s12916-016-0731-2 – volume: 13 start-page: 422 year: 2007 ident: 1790_CR14 publication-title: J Card Fail doi: 10.1016/j.cardfail.2007.03.011 – volume: 26 start-page: 2259 year: 2005 ident: 1790_CR25 publication-title: Eur Heart J doi: 10.1093/eurheartj/ehi386 – volume: 18 start-page: 107 year: 2013 ident: 1790_CR22 publication-title: Heart Fail Rev doi: 10.1007/s10741-012-9315-1 |
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Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers... Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB),... BackgroundAmong patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers... Background Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers... |
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| SubjectTerms | Angiotensin Angiotensin II Angiotensin-converting enzyme inhibitors Blood pressure Cardiology Cardiology and Cardiovascular Disease Congestive heart failure Epidermal growth factor receptors Glomerular filtration rate Heart failure Hemoglobin Kardiologi och kardiovaskulära sjukdomar Medical prognosis Medicine Medicine & Public Health Mortality Original Paper Patients Peptidyl-dipeptidase A Receptors Renal function Therapy |
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| Title | Guideline-directed medical therapy in real-world heart failure patients with low blood pressure and renal dysfunction |
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