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Clinical benefit of spironolactone in patients with acute decompensated heart failure and severe renal dysfunction: Data from the Korean Heart Failure Registry

DC FieldValueLanguage
dc.contributor.author송미경-
dc.contributor.author오재원-
dc.contributor.author윤종찬-
dc.contributor.author홍남기-
dc.contributor.author강석민-
dc.date.accessioned2016-02-04T11:20:17Z-
dc.date.available2016-02-04T11:20:17Z-
dc.date.issued2015-
dc.identifier.issn0002-8703-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/140201-
dc.description.abstractBACKGROUNDS: We investigated the relationship between spironolactone use and all-cause mortality in acute decompensated heart failure (ADHF) patients with severe renal dysfunction. The clinical benefit of spironolactone in the treatment of heart failure (HF) has been described in several large randomized clinical trials. However, its clinical benefits have not been studied in hospitalized ADHF patients with severe renal dysfunction (estimated glomerular filtration rate [eGFR] <45 mL/min per 1.73 m(2)). METHODS AND RESULTS: We retrospectively analyzed data from the Korean Heart Failure Registry. We included 1,035 ADHF patients with severe renal dysfunction. In Kaplan-Meier survival analysis, all-cause mortality in the spironolactone-treated group was significantly lower than that in the nonspironolactone group (18.1% vs 24.9%, respectively, log rank P = .028). However, spironolactone use was not an independent predictor after adjusting other HF risk factors (hazard ratio 0.974, 95% CI 0.681-1.392, P = .884) and after propensity score matching (P = .115). In subgroup analysis, the clinical benefit of spironolactone use was preserved in women, prehospital spironolactone use, the chronic kidney disease stage 3b (eGFR 30-44 mL/min per 1.73 m(2)), and the appropriate spironolactone use (eGFR ≥30 mL/min per 1.73 m(2) and K ≤5.0 mmol/L). CONCLUSION: The spironolactone therapy was not beneficial in ADHF patients with severe renal dysfunction after multivariable adjusting and propensity score matching. However, we reassured the current HF guidelines for spironolactone use and the clinical benefit in chronic kidney disease stage 3b should be assessed in future clinical trial.-
dc.description.statementOfResponsibilityopen-
dc.format.extent713~720-
dc.relation.isPartOfAMERICAN HEART JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAcute Disease-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHFemale-
dc.subject.MESHGlomerular Filtration Rate-
dc.subject.MESHHeart Failure/complications-
dc.subject.MESHHeart Failure/drug therapy*-
dc.subject.MESHHeart Failure/mortality-
dc.subject.MESHHeart Failure/physiopathology-
dc.subject.MESHHospitalization-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHLogistic Models-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMineralocorticoid Receptor Antagonists/pharmacology-
dc.subject.MESHMineralocorticoid Receptor Antagonists/therapeutic use*-
dc.subject.MESHRegistries-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Factors-
dc.subject.MESHSex Factors-
dc.subject.MESHSpironolactone/pharmacology-
dc.subject.MESHSpironolactone/therapeutic use*-
dc.titleClinical benefit of spironolactone in patients with acute decompensated heart failure and severe renal dysfunction: Data from the Korean Heart Failure Registry-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorJaewon Oh-
dc.contributor.googleauthorSeok-Min Kang-
dc.contributor.googleauthorMi Kyung Song-
dc.contributor.googleauthorNamki Hong-
dc.contributor.googleauthorJong-Chan Youn-
dc.contributor.googleauthorSeongwoo Han-
dc.contributor.googleauthorEun-Seok Jeon-
dc.contributor.googleauthorMyeong-Chan Cho-
dc.contributor.googleauthorJae-Joong Kim-
dc.contributor.googleauthorByung-Su Yoo-
dc.contributor.googleauthorShung Chull Chae-
dc.contributor.googleauthorByung-Hee Oh-
dc.contributor.googleauthorDong-Ju Choi-
dc.contributor.googleauthorMyung-Mook Lee-
dc.contributor.googleauthorKyu-Hyung Ryu-
dc.identifier.doi10.1016/j.ahj.2015.01.014-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA02020-
dc.contributor.localIdA02600-
dc.contributor.localIdA04388-
dc.contributor.localIdA00037-
dc.contributor.localIdA02395-
dc.relation.journalcodeJ00069-
dc.identifier.eissn1097-6744-
dc.identifier.pmid25965719-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0002870315001106-
dc.contributor.alternativeNameSong, Mi Kyung-
dc.contributor.alternativeNameOh, Jae Won-
dc.contributor.alternativeNameYoun, Jong Chan-
dc.contributor.alternativeNameHong, Nam Ki-
dc.contributor.alternativeNameKang, Seok Min-
dc.contributor.affiliatedAuthorSong, Mi Kyung-
dc.contributor.affiliatedAuthorYoun, Jong Chan-
dc.contributor.affiliatedAuthorHong, Namki-
dc.contributor.affiliatedAuthorKang, Seok Min-
dc.contributor.affiliatedAuthorOh, Jae Won-
dc.rights.accessRightsnot free-
dc.citation.volume169-
dc.citation.number5-
dc.citation.startPage713-
dc.citation.endPage720-
dc.identifier.bibliographicCitationAMERICAN HEART JOURNAL, Vol.169(5) : 713-720, 2015-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers

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