scholarly journals Angiotensin-converting enzyme inhibitors, beta-blockers, and mortality in systolic heart failure

2004 ◽  
Vol 43 (7) ◽  
pp. 1333 ◽  
Author(s):  
Phillip L Thornton ◽  
Ali Ahmed
Keyword(s):  
Heart Failure ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Systolic Heart Failure ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

Abstract 19588: Angiotensin Converting Enzyme Inhibitors and Mortality Benefit in Systolic Heart Failure Patients With Glomerular Filtration Rate <30 ml/min/1.73 m2

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Chakradhari Inampudi ◽  
Vladimir Cotarlan
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Angiotensin Converting Enzyme ◽  
Filtration Rate ◽  
Index Date ◽  
Enzyme Inhibitors ◽  
Systolic Heart Failure ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

Introduction: Randomized controlled trials have shown beneficial effect of Angiotensin converting enzyme inhibitors (ACEI) in reducing mortality in patients with systolic heart failure (HF) and chronic kidney disease (CKD) with glomerular filtration rate (GFR) between 30-59 ml/min/1.73m2 but weak evidence exists in patients with GFR < 30 Hypothesis: We hypothesize that ACEI use is associated with lower mortality in CKD patients with GFR < 30. Methods: Using electronic medical records, we identified 2578 patients with advanced CKD defined as GFR < 30 but not on dialysis. We required a GFR < 30 on two occasions over a 60 day period to insure stability of CKD. Clinical outcomes were reviewed following the index date which was the date of first GFR < 30. Results: Of 2,578 patients (mean age 66+/-15, 61% males) with advanced CKD (GFR<30), 1,064 (41%) have been treated with an ACEI while 1,514 (59%) never received an ACEI. Kaplan Meyer Survival showed reduced mortality in the group of patients treated with an ACEI compared to those never treated with an ACEI despite more comorbidities present in the former group (mean survival 3.9 vs 4.8 years, p<0.001, Fig 1). Of the patients treated with an ACEI, 232 (22%) continued the ACEI till the end of follow up while 832 (78%) patients discontinued the drug: 93 (9%) prior to index date and 739 (69%) after index date. Survival was significantly better in patients who continued the ACEI than those who discontinued the drug late (after the index date) and those who discontinued early (prior to index date) than in those never treated with an ACEI (Fig 2). Conclusion: Treatment with ACEIs is associated with improved survival in CKD patients with GFR < 30ml/min/1.73m2

Sign in / Sign up

Export Citation Format

Share Document