Prognostic association of medication trajectories with 3-year mortality in heart failure and preserved ejection fraction: findings from the EPICAL2 cohort study.
Adrenergic beta-Antagonists
/ therapeutic use
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors
/ therapeutic use
Cardiovascular Agents
/ therapeutic use
Comorbidity
Female
Heart Failure
/ drug therapy
Humans
Male
Middle Aged
Mineralocorticoid Receptor Antagonists
/ therapeutic use
Prognosis
Prospective Studies
Renin-Angiotensin System
/ drug effects
Sociodemographic Factors
Stroke Volume
Heart failure
Long-term outcomes
Medication
Preserved ejection fraction
Trajectory
Journal
European journal of clinical pharmacology
ISSN: 1432-1041
Titre abrégé: Eur J Clin Pharmacol
Pays: Germany
ID NLM: 1256165
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
11
02
2021
accepted:
02
05
2021
pubmed:
11
5
2021
medline:
11
1
2022
entrez:
10
5
2021
Statut:
ppublish
Résumé
The aims of this study were to describe combinations of beta-blockers (BB), renin-angiotensin system (RAS) blockers, and mineralocorticoid receptor antagonist (MRA) prescriptions and their trajectories in heart failure with preserved ejection fraction (HFpEF) patients, and to assess their effect on the three-year all-cause and cardiovascular (CV)-mortality. We used data from the EPICAL2 cohort of 689 hospitalized HFpEF patients. Medication prescriptions were collected at hospital discharge and at 6, 12, and 24 months after discharge. A multi-trajectory approach was used to conjointly model groups of individuals following similar trajectories over medications prescriptions. We used Cox and Fine-Gray models, to evaluate respectively the associations between 3-year all-cause mortality and CV-mortality and the trajectory groups. Multi-trajectory modelling revealed five distinct trajectory groups: group1 (N = 232, 33.6%) stable ACEI/ARB and BB prescriptions, group 2 (N = 199, 28.8%) stable ACEI/ARB prescription, group 3 (N = 133, 19.3%) stable BB prescriptions, group 4 (N = 78, 11.3%) stable prescriptions of none of the medications, and group 5 (N = 47, 6.8%) stable ACEI/ARB, BB, and MRA prescriptions. As compared to the group 4 of patients receiving none of the three medications, patients receiving a stable prescription of one or a combination of two or the three medications over 2 years) had a lower overall mortality over 3-year follow-up, i.e., group 1 (HR = 0.5, 95% CI 0.4-0.8), group 2 (HR = 0.6, 95% CI:0.4-0.8), group 3 (HR = 0.5, 95% CI:0.4-0.7), and group 5 (HR = 0.5, 95% CI:0.3-0.9). However, none of these trajectory groups was associated with a lower CV-mortality over 3 years. In an unselected population-based sample of HFpEF patients, the long-term stable use of the combination ACEI/ARB and BB, BB exclusively, ACEI/ARB exclusively, or the combination ACEI/ARB and BB and MRAs was associated with reduced three-year all-cause mortality.
Identifiants
pubmed: 33970296
doi: 10.1007/s00228-021-03153-6
pii: 10.1007/s00228-021-03153-6
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Cardiovascular Agents
0
Mineralocorticoid Receptor Antagonists
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1569-1581Subventions
Organisme : national Hospital Program of Clinical Research
ID : ANR-15-RHUS-0004
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Sharma K, Kass D (2014) Heart failure with preserved ejection fraction. Circ Res 115(1):79–96
van Riet EES, Hoes AW, Wagenaar KP, Limburg A, Landman MAJ, Rutten FH (2016) Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail 18(3):242–252
doi: 10.1002/ejhf.483
Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355(3):251–259
doi: 10.1056/NEJMoa052256
Carson PE, Anand IS, Win S, Rector T, Haass M, Lopez-Sendon J et al (2015) The hospitalization burden and post-hospitalization mortality risk in heart failure with preserved ejection fraction: results from the I-PRESERVE trial (Irbesartan in Heart Failure and Preserved Ejection Fraction). JACC: Heart Failure 3(6):429–441
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail 18(8):891–975
doi: 10.1002/ejhf.592
van Veldhuisen DJ, Cohen-Solal A, Böhm M, Anker SD, Babalis D, Roughton M et al (2009) Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: Data From SENIORS (Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure). J Am Coll Cardiol 53(23):2150–2158
doi: 10.1016/j.jacc.2009.02.046
Cleland JGF, Tendera M, Adamus J, Freemantle N, Polonski L, Taylor J et al (2006) The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J 27(19):2338–2345
doi: 10.1093/eurheartj/ehl250
Massie BM, Carson PE, McMurray JJ, Komajda M, McKelvie R, Zile MR et al (2008) Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med 359(23):2456–2467
doi: 10.1056/NEJMoa0805450
Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJV et al (2003) Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet 362(9386):777–781
doi: 10.1016/S0140-6736(03)14285-7
Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B et al (2014) Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 370(15):1383–1392
doi: 10.1056/NEJMoa1313731
Steinberg BA, Zhao X, Heidenreich PA, Peterson ED, Bhatt DL, Cannon CP et al (2012) Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation 126(1):65–75
doi: 10.1161/CIRCULATIONAHA.111.080770
Cohen Solal A, Leurs I, Assyag P, Beauvais F, Clerson P, Contre C et al (2012) Optimization of heart FailUre medical Treatment after hospital discharge according to left ventricUlaR Ejection fraction: The FUTURE survey. Arch Cardiovasc Dis 105(6):355–365
doi: 10.1016/j.acvd.2012.04.003
Goldberg RJ, Gurwitz JH, Saczynski JS, Hsu G, McManus DD, Magid DJ et al (2013) Comparison of medication practices in patients with heart failure and preserved versus those with reduced ejection fraction (from the Cardiovascular Research Network [CVRN]). Am J Cardiol 111(9):1324–1329
doi: 10.1016/j.amjcard.2013.01.276
Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC (2006) Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J Am Coll Cardiol 47(1):76–84
doi: 10.1016/j.jacc.2005.09.022
Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo-Leiro MG, Harjola V-P et al (2017) Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail 19(12):1574–1585
doi: 10.1002/ejhf.813
Maggioni AP, Anker SD, Dahlström U, Filippatos G, Ponikowski P, Zannad F et al (2013) Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail 15(10):1173–1184
doi: 10.1093/eurjhf/hft134
Lund LH, Benson L, Dahlström U, Edner M (2012) Association between use of renin-angiotensin system antagonists and mortality in patients with heart failure and preserved ejection fraction. JAMA 308(20):2108–2117
doi: 10.1001/jama.2012.14785
Agarwal V, Briasoulis A, Messerli FH (2013) Effects of renin-angiotensin system blockade on mortality and hospitalization in heart failure with preserved ejection fraction. Heart Fail Rev 18(4):429–437
doi: 10.1007/s10741-012-9329-8
Fukuta H, Goto T, Wakami K, Ohte N (2017) The effect of beta-blockers on mortality in heart failure with preserved ejection fraction: a meta-analysis of observational cohort and randomized controlled studies. Int J Cardiol 1(228):4–10
doi: 10.1016/j.ijcard.2016.11.239
Bitar S, Agrinier N, Alla F, Rossignol P, Mebazaa A, Thilly N (2019) Adherence to ESC guideline-recommended medications over a 36-month follow-up period after hospitalization for heart failure: results from the EPICAL2 cohort study. Pharmacoepidemiol Drug Saf 28(11):1489–1500
Busson A, Thilly N, Laborde-Castérot H, Alla F, Messikh Z, Clerc-Urmes I et al (2018) Effectiveness of guideline-consistent heart failure drug prescriptions at hospital discharge on 1-year mortality: results from the EPICAL2 cohort study. Eur J Intern Med 1(51):53–60
doi: 10.1016/j.ejim.2017.12.005
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383
doi: 10.1016/0021-9681(87)90171-8
Jones BL, Nagin DS, Roeder K (2001) A SAS procedure based on mixture models for estimating developmental trajectories. Sociol Methods Res 29(3):374–393
doi: 10.1177/0049124101029003005
Nagin DS, Jones BL, Passos VL, Tremblay RE (2018) Group-based multi-trajectory modeling. Stat Methods Med Res 27(7):2015–2023
doi: 10.1177/0962280216673085
Nagin DS, Odgers CL (2010) Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol 6:109–138
doi: 10.1146/annurev.clinpsy.121208.131413
Schwartz T, Chen Q, Duan N (2011) Studying missing data patterns using a SAS® Macro. 4:339
Suissa S (2008) Immortal time bias in pharmaco-epidemiology. Am J Epidemiol 167(4):492–499
doi: 10.1093/aje/kwm324
Agarwal P, Moshier E, Ru M, Ohri N, Ennis R, Rosenzweig K, et al (2018) Immortal time bias in observational studies of time-to-event outcomes. Cancer Control [Internet]. [cited 2019 Nov 8];25(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053873/
Neefs J, van den Berg NWE, Limpens J, Berger WR, Boekholdt SM, Sanders P et al (2017) Aldosterone pathway blockade to prevent atrial fibrillation: a systematic review and meta-analysis. Int J Cardiol 15(231):155–161
doi: 10.1016/j.ijcard.2016.12.029
Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJV, Ponikowski P, Poole-Wilson PA et al (2008) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail 10(10):933–989
Hernandez AF, Hammill BG, O’Connor CM, Schulman KA, Curtis LH, Fonarow GC (2009) Clinical effectiveness of beta-blockers in heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) Registry. J Am Coll Cardiol 53(2):184–192
doi: 10.1016/j.jacc.2008.09.031
Peltier M, Houpe D, Cohen-Solal A, Béguin M, Levy F, Tribouilloy C (2007) Treatment practices in heart failure with preserved left ventricular ejection fraction: a prospective observational study. Int J Cardiol 118(3):363–369
doi: 10.1016/j.ijcard.2006.07.033
Bavishi C, Chatterjee S, Ather S, Patel D, Messerli FH (2015) Beta-blockers in heart failure with preserved ejection fraction: a meta-analysis. Heart Fail Rev 20(2):193–201
doi: 10.1007/s10741-014-9453-8
Khan MS, Fonarow GC, Khan H, Greene SJ, Anker SD, Gheorghiade M et al (2017) Renin-angiotensin blockade in heart failure with preserved ejection fraction: a systematic review and meta-analysis. ESC Heart Fail 4(4):402–408
doi: 10.1002/ehf2.12204
Martin N, Manoharan K, Thomas J, Davies C, Lumbers RT (2018) Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction. Cochrane Database Syst Rev 28(6):CD012721
Zheng SL, Chan FT, Nabeebaccus AA, Shah AM, McDonagh T, Okonko DO et al (2018) Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis. Heart 104(5):407–415
doi: 10.1136/heartjnl-2017-311652
Tsujimoto T, Kajio H (2018) Beta-blocker use and cardiovascular event risk in patients with heart failure with preserved ejection fraction. Sci Rep [Internet]. [cited 2020 Apr 23];8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015007/
Triposkiadis F, Karayannis G, Giamouzis G, Skoularigis J, Louridas G, Butler J (2009) The sympathetic nervous system in heart failure physiology, pathophysiology, and clinical implications. J Am Coll Cardiol 54(19):1747–1762
doi: 10.1016/j.jacc.2009.05.015
Tschöpe C, Birner C, Böhm M, Bruder O, Frantz S, Luchner A et al (2018) Heart failure with preserved ejection fraction: current management and future strategies: expert opinion on the behalf of the Nucleus of the “Heart Failure Working Group” of the German Society of Cardiology (DKG). Clin Res Cardiol 107(1):1–19
doi: 10.1007/s00392-017-1170-6
Senni M, Paulus WJ, Gavazzi A, Fraser AG, Díez J, Solomon SD et al (2014) New strategies for heart failure with preserved ejection fraction: the importance of targeted therapies for heart failure phenotypes. Eur Heart J 35(40):2797–2815
doi: 10.1093/eurheartj/ehu204
Nanayakkara S, Kaye DM (2015) Management of heart failure with preserved ejection fraction: a review. Clin Ther 37(10):2186–2198
doi: 10.1016/j.clinthera.2015.08.005
Costantino G, Rusconi AM, Duca PG, Guzzetti S, Bossi I, Del Medico M et al (2009) Eligibility criteria in heart failure randomized controlled trials: a gap between evidence and clinical practice. Intern Emerg Med 4(2):117–122
doi: 10.1007/s11739-008-0180-9
Patel HC, Hayward C, Dungu JN, Papadopoulou S, Saidmeerasah A, Ray R et al (2017) Assessing the eligibility criteria in phase III randomized controlled trials of drug therapy in heart failure with preserved ejection fraction: the critical play-off between a “pure” patient phenotype and the generalizability of trial findings. J Card Fail 23(7):517–524
doi: 10.1016/j.cardfail.2017.04.006
Girerd N, Seronde M-F, Coiro S, Chouihed T, Bilbault P, Braun F et al (2018) Integrative assessment of congestion in heart failure throughout the patient journey. JACC: Heart Failure 6(4):273–285
Massari F, Scicchitano P, Iacoviello M, Passantino A, Guida P, Sanasi M et al (2020) Multiparametric approach to congestion for predicting long-term survival in heart failure. J Cardiol 75(1):47–52
doi: 10.1016/j.jjcc.2019.05.017