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| 題名: | Real-World Experience of Angiotensin Receptor-Neprilysin Inhibition in Reduced Ejection Fraction Heart Failure Patients With Advanced Kidney Disease. |
| 作者: | 徐千彝
Hung-Yu Chang, Chun-Cheng Lin, Chieh-Ju Chao, Yi-Cheng Lin, Yao-Chang Wang, Chia-Te Liao, Jin-Long Huang, Ying-Hsiang Lee, Chun-Yao Huang, Li-Nien Chien, Chien-Yi Hsu |
| 貢獻者: | 醫學系內科學科心臟血管內科 |
| 日期: | 2023-01 |
| 上傳時間: | 2025-03-27 11:44:27 (UTC+8) |
| 摘要: | Abstract: Objective
To investigate the effectiveness and safety of angiotensin receptor-neprilysin inhibitors (ARNIs) in real-world patients with heart failure with reduced ejection fraction (HFrEF) and advanced chronic kidney disease (estimated glomerular filtration rate [eGFR] < 30 mL/min per 1.73 m2), which have been excluded from the landmark trials.
Patients and Methods
This study examined 3281 patients pooled from two multicenter HFrEF cohorts, and 661 patients with baseline eGFR less than 30 mL/min per 1.73 m2 were further analyzed (the Taiwan Society of Cardiology – Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry: May 1, 2013 to October 31, 2014, and the Treatment with Angiotensin Receptor neprilysin inhibitor fOr Taiwan Heart Failure patients (TAROT-HF) study: March 1, 2017, to December 31, 2018). Propensity score matching was performed to adjust for confounders. At 1-year follow-up, all-cause mortality, total heart failure hospitalizations, renal function, and left ventricular ejection fraction (LVEF) were used as the endpoints.
Results
After propensity score matching, 510 patients (age, 69.8±13.9 years; male, 61.0%; mean LVEF, 29.8±7.3%; mean eGFR, 19.8±9.0 mL/min per 1.73 m2) were included in the final analysis, including 278 patients receiving ARNI treatment (ARNI group) and 232 patients not on ARNI treatment (non-ARNI group). Baseline characteristics were comparable between the two groups. At 1 year, eGFR and LVEF measurements were significantly higher in the ARNI group than in the non-ARNI group (25.0±17.1 mL/min per 1.73 m2 vs 21.4±17.5 mL/min per 1.73 m2; P=.04; and 40.1±12.9% vs. 33.1±10.8%, P<.001, respectively). The ARNI group had significantly lower risks of 1-year all-cause mortality (19.4 vs 30.9 per 100-person year; P=.02), and total HF rehospitalizations (70.0 vs 110.4 per 100-person year; P=.01) than non-ARNI users.
Conclusion
Our results show the effectiveness of ARNIs in HFrEF patients with advanced chronic kidney disease in a real-world setting. |
| 關聯: | Mayo Clinic Proceedings, Volume 98, Issue 1, 2023, Pages 88-99 |
| 描述: | 【112-1 升等】臺北醫學大學教師升等專門著作
職別：專任
送審等級：副教授
著作送審 |
| 資料類型: | article |
| 顯示於類別: | [教師升等送審著作] 112
[內科學科] 期刊論文
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