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Prescription Pattern in Angiotensin Receptor Neprilysin Inhibitor is Associated with Heart Failure Events.
Wu, Wei-Tsung; Wang, Shih-Han; Wang, Ya-Lin; Lin, Tsung-Hsien; Lai, Wen-Ter; Sheu, Sheng-Hsiung.
Afiliación
  • Wu WT; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital.
  • Wang SH; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University.
  • Wang YL; Department of Pharmacy, Kaohsiung Medical University Hospital.
  • Lin TH; Department of Pharmacy, Kaohsiung Medical University Hospital.
  • Lai WT; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital.
  • Sheu SH; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University.
Acta Cardiol Sin ; 39(1): 144-150, 2023 Jan.
Article en En | MEDLINE | ID: mdl-36685156
Background: Angiotensin receptor neprilysin inhibition (ARNI) is superior to enalapril in reducing the risk of cardiovascular death and heart failure hospitalization (HFH). However, whether prescription pattern is associated with heart failure outcome is unknown. Methods: This is a retrospective study of 153 patients who received ARNI in a tertiary medical center in Taiwan. We analyzed the impact of dose up-titration and prescription timing including during initial admission, within 3 months after initial HFH discharge, and at outpatient clinics without prior HFH. The primary endpoint was the composite of cardiovascular death and HFH. Results: After a mean follow-up period of 287 ± 197 days, the primary endpoint occurred in 43 (28.1%) subjects. Patients without and with a primary endpoint significantly differed in terms of history of valvular heart disease (VHD, p = 0.006), ventricular tachyarrhythmia (VT, p = 0.043), percutaneous coronary intervention (p = 0.007), coronary artery bypass grafting (p = 0.002), chronic kidney disease (p = 0.002), age (p = 0.002), diastolic blood pressure (p = 0.025), and prescription timing (p = 0.002). Kaplan-Meier analysis showed ARNI up-titration and prescription timing had a significant association with primary endpoint-free survival (Breslow test; p = 0.032, and log-rank test; p = 0.001, respectively). Cox regression analysis showed that independent predictors for the primary endpoint were ARNI up-titration [hazard ratio (HR): 0.41, p = 0.024], non-hospital ARNI versus hospital ARNI (HR: 0.41, p = 0.009), VHD (HR: 2.71, p = 0.013), VT (HR: 3.09, p = 0.02), and age (HR: 1.03, p = 0.033). Conclusions: The prescription pattern of ARNI could be associated with heart failure events.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Acta Cardiol Sin Año: 2023 Tipo del documento: Article Pais de publicación: China
Texto completo
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Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Acta Cardiol Sin Año: 2023 Tipo del documento: Article Pais de publicación: China