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Guideline-Directed Medical Therapy for Patients With Heart Failure With Midrange Ejection Fraction: A Patient-Pooled Analysis From the Kor HF and Kor AHF Registries

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dc.contributor.author강석민-
dc.date.accessioned2019-05-29T05:17:48Z-
dc.date.available2019-05-29T05:17:48Z-
dc.date.issued2018-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/169512-
dc.description.abstractBackground Although current guidelines now define heart failure with midrange ejection fraction ( HF mr EF ) as HF with a left ventricular EF of 40% to 49%, there are limited data on response to guideline-directed medical therapy in patients with HF mr EF . The current study aimed to evaluate the association between β-blocker, renin-angiotensin system blocker ( RASB ), or aldosterone antagonist ( AA ) treatment with clinical outcome in patients with HF mr EF . Methods and Results We performed a patient-level pooled analysis on 1144 patients with HF mr EF who were hospitalized for acute HF from the Kor HF (Korean Heart Failure) and Kor AHF (Korean Acute Heart Failure) registries. The study population was divided between use of β-blocker, RASB , or AA to evaluate the guideline-directed medical therapy in patients with HF mr EF . Sensitivity analyses, including propensity score matching and inverse-probability-weighted methods, were performed. The use of β-blocker in the discharge group showed significantly lower rates of all-cause mortality compared with those who did not use a β-blocker (β-blocker versus no β-blocker, 30.7% versus 38.2%; hazard ratio, 0.758; 95% confidence interval, 0.615-0.934; P=0.009). Similarly, the RASB use in the discharge group was associated with the lower risk of mortality compared with no use of RASB ( RASB versus no RASB , 31.9% versus 38.1%; hazard ratio, 0.76; 95% confidence interval, 0.618-0.946; P=0.013). However, there was no significant difference in all-cause mortality between AA and no AA in the discharge group ( AA versus no AA , 34.2% versus 34.0%; hazard ratio, 1.063; 95% confidence interval, 0.858-1.317; P=0.578). Multiple sensitivity analyses showed similar trends. Conclusions For treatment of acute HFmrEF after hospitalization, β-blocker and RASB therapies on discharge were associated with reduced risk of all-cause mortality. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01389843.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherWiley-Blackwell-
dc.relation.isPartOfJOURNAL OF THE AMERICAN HEART ASSOCIATION-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleGuideline-Directed Medical Therapy for Patients With Heart Failure With Midrange Ejection Fraction: A Patient-Pooled Analysis From the Kor HF and Kor AHF Registries-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorKi Hong Choi-
dc.contributor.googleauthorJin-Oh Choi-
dc.contributor.googleauthorEun-Seok Jeon-
dc.contributor.googleauthorGa Yeon Lee-
dc.contributor.googleauthorDong-Ju Choi-
dc.contributor.googleauthorHae-Young Lee-
dc.contributor.googleauthorJae-Joong Kim-
dc.contributor.googleauthorShung Chull Chae-
dc.contributor.googleauthorSang Hong Baek-
dc.contributor.googleauthorSeok-Min Kang-
dc.contributor.googleauthorByung-Su Yoo-
dc.contributor.googleauthorKye Hun Kim-
dc.contributor.googleauthorMyeong-Chan Cho-
dc.contributor.googleauthorHyun-Young Park-
dc.contributor.googleauthorByung-Hee Oh-
dc.identifier.doi10.1161/JAHA.118.009806-
dc.contributor.localIdA00037-
dc.relation.journalcodeJ01774-
dc.identifier.eissn2047-9980-
dc.identifier.pmid30608208-
dc.subject.keywordaldosterone antagonist-
dc.subject.keywordheart failure with midrange ejection fraction-
dc.subject.keywordmedical therapy-
dc.subject.keywordrenin‐angiotensin system blocker-
dc.subject.keywordβ‐blocker-
dc.contributor.alternativeNameKang, Seok Min-
dc.contributor.affiliatedAuthor강석민-
dc.citation.volume7-
dc.citation.number21-
dc.citation.startPagee009806-
dc.identifier.bibliographicCitationJOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol.7(21) : e009806, 2018-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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