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

DC FieldValueLanguage
dc.contributor.author강석민-
dc.date.accessioned2019-07-11T03:09:27Z-
dc.date.available2019-07-11T03:09:27Z-
dc.date.issued2019-
dc.identifier.issn1011-8934-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/169860-
dc.description.abstractBACKGROUND: 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.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisher대한의학회(The Korean Academy of Medical Sciences)-
dc.relation.isPartOfJOURNAL OF KOREAN MEDICAL SCIENCE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titlePrognostic Effect of Guideline-Directed Therapy Is More Noticeable Early in the Course of Heart Failure-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorMin-Soo Ahn-
dc.contributor.googleauthorByung-Su Yoo-
dc.contributor.googleauthorJunghan Yoon-
dc.contributor.googleauthorSeung-Hwan Lee-
dc.contributor.googleauthorJang-Young Kim-
dc.contributor.googleauthorSung Gyun Ahn-
dc.contributor.googleauthorYoung Jin Youn-
dc.contributor.googleauthorJun-Won Lee-
dc.contributor.googleauthorJung-Woo Son-
dc.contributor.googleauthorHye Sim Kim-
dc.contributor.googleauthorDae Ryong Kang-
dc.contributor.googleauthorSang Eun Lee-
dc.contributor.googleauthorHyun-Jai Cho-
dc.contributor.googleauthorHae-Young Lee-
dc.contributor.googleauthorEun-Seok Jeon-
dc.contributor.googleauthorSeok-Min Kang-
dc.contributor.googleauthorDong-Ju Choi-
dc.contributor.googleauthorMyeong-Chan Cho-
dc.identifier.doi10.3346/jkms.2019.34.e133-
dc.contributor.localIdA00037-
dc.relation.journalcodeJ01517-
dc.identifier.eissn1598-6357-
dc.identifier.pmid31050223-
dc.subject.keywordAcute Decompensated Heart Failure-
dc.subject.keywordDe Novo Acute Heart Failure-
dc.subject.keywordGuideline-Directed Therapy-
dc.contributor.alternativeNameKang, Seok Min-
dc.contributor.affiliatedAuthor강석민-
dc.citation.volume34-
dc.citation.number17-
dc.citation.startPagee133-
dc.identifier.bibliographicCitationJOURNAL OF KOREAN MEDICAL SCIENCE, Vol.34(17) : e133, 2019-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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