85 148

Cited 2 times in

Prognostic Effect of Guideline-Directed Therapy Is More Noticeable Early in the Course of Heart Failure

Authors
 Min-Soo Ahn  ;  Byung-Su Yoo  ;  Junghan Yoon  ;  Seung-Hwan Lee  ;  Jang-Young Kim  ;  Sung Gyun Ahn  ;  Young Jin Youn  ;  Jun-Won Lee  ;  Jung-Woo Son  ;  Hye Sim Kim  ;  Dae Ryong Kang  ;  Sang Eun Lee  ;  Hyun-Jai Cho  ;  Hae-Young Lee  ;  Eun-Seok Jeon  ;  Seok-Min Kang  ;  Dong-Ju Choi  ;  Myeong-Chan Cho 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.34(17) : e133, 2019 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2019
Keywords
Acute Decompensated Heart Failure ; De Novo Acute Heart Failure ; Guideline-Directed Therapy
Abstract
BACKGROUND: There have been few studies to evaluate the prognostic implications of guideline-directed therapy according to the temporal course of heart failure. This study assessed the relationship between adherence to guideline-directed therapy at discharge and 60-day clinical outcomes in de novo acute heart failure (AHF) and acute decompensated chronic heart failure (ADCHF) separately. METHODS: Among 5,625 AHF patients who were recruited from a multicenter cohort registry of Korean Acute Heart Failure, 2,769 patients with reduced ejection fraction were analyzed. Guideline-directed therapies were defined as the use of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), β-blocker, and mineralocorticoid receptor antagonist. RESULTS: In de novo AHF, ACEI or ARB reduced re-hospitalization (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.34-0.95), mortality (HR, 0.41; 95% CI, 0.24-0.69) and composite endpoint (HR, 0.52; 95% CI, 0.36-0.77) rates. Beta-blockers reduced re-hospitalization (HR, 0.62; 95% CI, 0.41-0.95) and composite endpoint (HR, 0.65; 95% CI, 0.47-0.90) rates. In ADCHF, adherence to ACEI or ARB was associated with only mortality and β-blockers with composite endpoint. CONCLUSION: The prognostic implications of adherence to guideline-directed therapy at discharge were more pronounced in de novo heart failure. We recommend that guideline-directed therapy be started as early as possible in the course of heart failure with reduced ejection fraction.
Files in This Item:
T201901382.pdf Download
DOI
10.3346/jkms.2019.34.e133
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169860
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links