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Effect of Oral Nitrates on All-Cause Mortality and Hospitalization in Heart Failure Patients with Reduced Ejection Fraction: A Propensity-Matched Analysis.
Ural, Dilek; Kandemir, Aysen Simsek; Karaüzüm, Kurtulus; Baydemir, Canan; Karaüzüm, Irem Yilmaz; Bozyel, Serdar; Kozdag, Güliz; Agir, Aysen Agaçdiken.
Afiliación
  • Ural D; Koç University, School of Medicine, Department of Cardiology, Istanbul, Turkey. Electronic address: dilekural@yandex.com.
  • Kandemir AS; Kocaeli University, Hereke Vocational School, Department of Biostatistics, Kocaeli, Turkey.
  • Karaüzüm K; Derince Education and Research Hospital, Department of Cardiology, Kocaeli, Turkey.
  • Baydemir C; Kocaeli University, School of Medicine, Department of Biostatistics, Kocaeli, Turkey.
  • Karaüzüm IY; Kocaeli University, School of Medicine, Department of Cardiology, Kocaeli, Turkey.
  • Bozyel S; Derince Education and Research Hospital, Department of Cardiology, Kocaeli, Turkey.
  • Kozdag G; Kocaeli University, School of Medicine, Department of Cardiology, Kocaeli, Turkey.
  • Agir AA; Kocaeli University, School of Medicine, Department of Cardiology, Kocaeli, Turkey.
J Card Fail ; 23(4): 286-292, 2017 Apr.
Article en En | MEDLINE | ID: mdl-28235568
BACKGROUND: Hydralazine-nitrate combination is recommended for patients with heart failure with reduced ejection fraction (HFrEF)/systolic heart failure who are symptomatic despite guideline-directed medical therapy (GDMT). Use of nitrates alone for this indication is not well-established. This study aims to evaluate the effect of oral nitrates on all-cause mortality and hospitalization in HFrEF patients using GDMT. METHODS AND RESULTS: Nitrate prescription at discharge and its association with all-cause mortality and heart failure hospitalization were examined in a propensity-matched analysis of 648 HFrEF patients followed for a median of 56 months. A total of 269 (42%) patients died during that period. In Cox regression analysis, nitrate usage was associated with a slightly increased mortality risk compared with not using nitrates (hazard ratio 1.29; 95% confidence interval 1.01-1.65; P = .040), which continued modestly after the propensity-matched analysis (hazard ratio 1.26; 95% confidence interval 0.95-1.68; P = .102). In both prematch and propensity-matched analyses, nitrate use was not associated with risk of rehospitalization. No significant effect was detected on subgroups stratified by coronary artery disease, age, gender, and background medical therapy. CONCLUSIONS: In this study, oral nitrate use alone in addition to GDMT did not affect all-cause mortality and hospitalization risk in HFrEF patients during a long-term follow-up. There was even a modest tendency for increased risk of mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Cardíaca / Hospitalización / Dinitrato de Isosorbide Tipo de estudio: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Card Fail Asunto de la revista: CARDIOLOGIA Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Cardíaca / Hospitalización / Dinitrato de Isosorbide Tipo de estudio: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Card Fail Asunto de la revista: CARDIOLOGIA Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos