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Effect of renin-angiotensin system inhibitors in elderly patients with heart failure and reduced ejection fraction

Title: Effect of renin-angiotensin system inhibitors in elderly patients with heart failure and reduced ejection fraction
Authors: Tamaki, Y; Yaku, H; Yamamoto, E; Ozasa, N; Inuzuka, Y; Enomoto, S; Miyake, M; Kondo, H; Tamura, T; Morimoto, T; Nakagawa, Y; Kato, T; Kimura, T
Source: European Heart Journal ; volume 45, issue Supplement_1 ; ISSN 0195-668X 1522-9645
Publisher Information: Oxford University Press (OUP)
Publication Year: 2024
Description: Background More than half of the patients admitted for acute decompensated heart failure (ADHF) in Japan are over 80 years of age. Both Japanese and European heart failure guidelines recommend the use of renin-angiotensin system inhibitors (RASIs) in patients with heart failure with reduced ejection fraction (HFrEF). However, there is a paucity of data on the effect of RASIs in elderly patients with HFrEF, because elderly patients have been excluded from large clinical trials. Purpose The purpose of the current study was to clarify the effect of RASIs in elderly patients with HFrEF. Methods This was a post-hoc analysis of a prospective, observational, multicentre cohort study that enrolled consecutive patients admitted with ADHF to 19 secondary and tertiary hospitals in Japan between October 2014 and March 2016. Patients who were ≥ 80 years old, with left ventricular ejection fraction (LVEF) < 40% and discharged alive were included in the present study. RASIs were defined as either ACE inhibitors or angiotensin II receptor blockers. The primary endpoint was a composite of all-cause death and heart failure (HF) hospitalisation. Results Among 518 patients enrolled, 288 patients received RASIs at discharge and 230 patients did not. The median follow-up period was 335 days (interquartile range; 124 – 499 days). Patients receiving RASIs were younger (85.7 ± 4.4 vs. 86.5 ± 4.4 years of age, p=0.03), had a higher body mass index (BMI; 21.4 ± 3.3 vs. 20.6 ± 3.7 kg/m², p=0.01) and better renal function (eGFR; 45.4 ± 21.5 vs. 38.2 ± 19.2 ml/min/1.73m², p
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurheartj/ehae666.1223
Availability: https://doi.org/10.1093/eurheartj/ehae666.1223; https://academic.oup.com/eurheartj/article-pdf/45/Supplement_1/ehae666.1223/60053135/ehae666.1223.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.735C2F80
Database: BASE