Impact of alpha-adrenergic receptor antagonists use on outcomes in patients with heart failure. A post-hoc analysis using Polish National Health Fund database

IF 0.4 Q4 PERIPHERAL VASCULAR DISEASE

Arterial Hypertension Pub Date : 2023-09-30 DOI:10.5603/ah.97054

B. Symonides, Jacek Lewandowski, Andrzej Śliwczyński

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Abstract

hyper-Abstract Background: The alpha-adrenolytics (AA) are not recommended in patients with ejection fraction (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. Material and methods: Data collected by the National Health Fund tracking all patient admissions and taking of the drug prescriptions throughout the entire country was used. Patients hospitalized due to HF exacerbation were included. The primary outcome variable 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. Results: Of 140 668 patients hospitalized in the year 2013, 53 317 were included and followed for a median of 56.3 months. AA patients had lower long-term all-cause mortality (52.8% vs . 54.9%, unadjusted p = 0.038). The treat-ment with AA positively and independently affected long-term survival [adjusted hazard ratio (adjHR): 0.82, 95% confidence interval (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). Conclusion: In compliant patients hospitalized due to HF exacerbation post discharge treatment with AA was safe and beneficial.

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使用α-肾上腺素能受体拮抗剂对心力衰竭患者预后的影响。利用波兰国家卫生基金数据库进行的事后分析

超摘要背景：由于安全性问题，射血分数（EF）降低的心衰患者不推荐使用α-肾上腺素类药物（AA）。我们的研究旨在评估因心衰加重而住院的患者使用 AA 的安全性，以及这些药物对长期终点的影响。材料和方法：使用国家卫生基金收集的数据，这些数据追踪了全国所有患者的入院情况和药物处方的服用情况。其中包括因高血压恶化而住院的患者。主要结果变量为全因死亡率，次要结果变量为出院后 30 天内首次因高血压再次入院或全因死亡。研究结果在 2013 年住院的 140 668 名患者中，有 53 317 人接受了中位数为 56.3 个月的随访。AA患者的长期全因死亡率较低（52.8% 对 54.9%，未调整 p = 0.038）。AA治疗对长期生存期[调整后危险比（adjHR）：0.82，95% 置信区间（CI）：0.78-0.87，p < 0.001]和次要终点（adjHR：0.85，95% CI：0.81-0.90，p < 0.001）均有独立的积极影响。对使用β-受体阻滞剂治疗的亚组进行的Cox分析显示，使用AA治疗与较低的死亡率（adjHR：0.82，95% CI：0.75-0.90，p＜0.001）和较低的次要终点发生率（adjHR：0.85，95% CI：0.78-0.92，p＜0.001）相关。结论对于因心房颤动加重而住院的合规患者，出院后使用 AA 治疗是安全有益的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arterial Hypertension PERIPHERAL VASCULAR DISEASE-

CiteScore

0.70

自引率

14.30%

发文量

审稿时长

10 weeks

期刊介绍： Arterial Hypertension hereinafter referred to as ‘AH’ or ′the Journal′, is a peer-reviewed, open access journal covering broad spectrum of topics in hypertension and aiming to advance the knowledge and science of this constantly evolving field. The Journal is the official quarterly of the Polish Society of Hypertension and publishes review articles, original clinical and experimental investigations in the field of arterial hypertension, case reports, letters and editorial comments. The Journal''s content has been published predominantly in full text English since 2015.