Key result
Usage of ACE-I or ARB and beta-blockers at ≥50% of target dose at 3 months post-discharge showed a tendency to decrease mortality (HR 5.2999, p=0.0635).
Why the study?
Does optimization of evidence-based HF medications after discharge improve survival in patients with AHF and LVEF ≤ 40%?
Cohort (n=275)
Yes
Does optimization of evidence-based HF medications after discharge improve survival in patients with AHF and LVEF ≤ 40%?
Hazard Ratio: 5.2999 (95% CI 1.7369–16.1722)
p-value: p=0.0635
There is significant medical inertia in optimizing evidence-based heart failure medications early after discharge, which may negatively impact patient survival.
Should not yet change post-discharge HF optimization practices; leaves open survival benefit of target dosing in AHF with LVEF ≤40%.
Background: After discharge, patients with Acute Heart Failure (AHF) have a high risk of early re-admission and death. Many patients are discharged early before treatment has been optimized. By using a multicenter cohort of AHF patients, we analyzed changes in evidence-based HF medication between admission, discharge and early follow-up as well as their links to mortality.
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Berthelot et al. (2018) conducted a cohort in Acute Heart Failure with reduced LVEF (n=275). ACE-I/ARB and beta-blockers ≥ 50% of target dose vs. ACE-I/ARB and beta-blockers < 50% of target dose or not prescribed was evaluated on All-cause mortality at one year (HR 5.2999, 95% CI 1.7369-16.1722, p=0.0635). Usage of ACE-I or ARB and beta-blockers at ≥50% of target dose at 3 months post-discharge showed a tendency to decrease mortality (HR 5.2999, p=0.0635).
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