Association between class of foundational medication for heart failure and prognosis in heart failure with reduced/mildly reduced ejection fraction

Miyuki Ito, Daichi Maeda, Yuya Matsue, Yasuyuki Shiraishi, Taishi Dotare, Tsutomu Sunayama, Kazutaka Nogi, Makoto Takei, Tomoya Ueda, Maki Nogi, Satomi Ishihara, Yasuki Nakada, Rika Kawakami, Nobuyuki Kagiyama, Takeshi Kitai, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke KidaTakahiro Okumura, Yuji Nagatomo, Takashi Kono, Shintaro Nakano, Shun Kohsaka, Tsutomu Yoshikawa, Yoshihiko Saito, Tohru Minamino

Research output: Contribution to journalArticlepeer-review

Abstract

We clarified the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure (HF) and post-discharge prognosis. We retrospectively analyzed a combined dataset from three large-scale registries of hospitalized patients with HF in Japan (NARA-HF, WET-HF, and REALITY-AHF) and patients diagnosed with HF with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes from admission to discharge: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and mineralocorticoid receptor blockers. Primary endpoint was the combined endpoint of HF rehospitalization and all-cause death within 1 year of discharge. The cohort comprised 1113 patients, and 482 combined endpoints were observed. Overall, FMHF prescriptions increased in 413 (37.1%) patients (increased group), remained unchanged in 607 (54.5%) (unchanged group), and decreased in 93 (8.4%) (decreased group) at discharge compared with that during admission. In the multivariable analysis, the increased group had a significantly lower incidence of the primary endpoint than the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P < 0.001). In conclusion, increase in FMHF classes during HF hospitalization is associated with a better prognosis in patients with HFr/mrEF.

Original languageEnglish
Article number16611
JournalScientific reports
Volume12
Issue number1
DOIs
Publication statusPublished - 2022 Dec

ASJC Scopus subject areas

  • General

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