Key result
In patients hospitalized for heart failure exacerbation, post-discharge treatment with alpha-adrenergic receptor antagonists was associated with an 18% lower risk of long-term all-cause mortality (adjHR 0.82).
Why the study?
Alpha-adrenolytics are not recommended in patients with reduced ejection fraction heart failure due to safety concerns, leaving their safety and impact on long-term endpoints unclear after HF exacerbation.
Does treatment with alpha-adrenolytics reduce mortality and readmissions in patients hospitalized for heart failure exacerbation?
Cohort (n=53,317)
Yes
Does treatment with alpha-adrenolytics reduce mortality and readmissions in patients hospitalized for heart failure exacerbation?
Hazard Ratio: 0.82 (95% CI 0.78–0.87)
Absolute Event Rate: 52.8% vs 54.9%
p-value: p=<0.001
In a large national cohort of patients hospitalized for heart failure exacerbation, post-discharge treatment with alpha-adrenolytics was associated with significantly lower long-term all-cause mortality and readmissions.
BackgroundThe alpha-adrenolytics (AA) are not recommended in patients with EF reduced heart failure due to safety concerns. The aim of our study was to assess the safety of AA in patients hospitalized due to exacerbation of HF and the influence of these drugs on long-term endpoints.MethodsData collected by the National Health Fund was used. Patients hospitalized due to HF exacerbation were included. The primary outcome was all-cause mortality and the secondary was the first readmission due to HF or all-cause death occurring more than 30 days after discharge.ResultsOf 140 668 patients hospitalized in the year 2013 n=53317 were included and followed for a median of 56.3 months. AA patients had lower long-term mortality (52.8% vs. 54.9%, unadjusted P=0.038). The treatment with AA positively and affected long-term survival (adjHR 0.82, 95%CI 0.78-0.87, P<0.001), as well as secondary endpoint (adjHR 0.85, 95%CI 0.81-0.90, P<0.001).Cox analysis in the subgroup treated with beta-blockers revealed that treatment with AA was associated with lower mortality (adjHR 0.82, 95%CI 0.75-0.90, P<0.001) and lower incidence of secondary endpoint (adjHR 0.85, 95%CI 0.78-0.92, P<0.001). ConclusionsIn compliant patients hospitalized due to HF exacerbation post discharge treatment with AA was safe and beneficial.
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Symonides et al. (2021) conducted a cohort in Heart failure exacerbation (n=53,317). Alpha-adrenergic receptor antagonists vs. No alpha-adrenergic receptor antagonists was evaluated on Long-term all-cause mortality (adjHR 0.82, 95% CI 0.78-0.87, p=<0.001). In patients hospitalized for heart failure exacerbation, post-discharge treatment with alpha-adrenergic receptor antagonists was associated with an 18% lower risk of long-term all-cause mortality (adjHR 0.82).
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