| Autor: |
Katherine E. Kurgansky, Rachel Parker, Luc Djousse, David R. Gagnon, Jacob Joseph |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 14 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2047-9980 |
| DOI: |
10.1161/JAHA.123.032231 |
| Popis: |
Background Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome increasing in prevalence and affecting millions worldwide but with limited evidence‐based therapies. Results from explanatory clinical trials suggest that spironolactone may help to improve outcomes in patients with HFpEF. We sought to investigate the effectiveness of spironolactone in reducing death and hospitalization outcomes for patients with HFpEF in a real‐world setting. Methods and Results We used electronic health records from the US Veterans Affairs (VA) health care system between 2002 and 2012 to identify patients with HFpEF who were followed longitudinally through 2014 using a validated algorithm. Among our HFpEF cohort that is 96% men, 85% White individuals, and aged 74±11 years, 3690 spironolactone users and 49 191 nonusers were identified and followed for a median of 2.9 (interquartile range [IQR], 1.5–2.4) and 3.3 (IQR, 1.6–5.9) years, respectively. We evaluated the effect of spironolactone use on all‐cause death and number of days hospitalized per year for heart failure or for any cause by fitting generalized estimating equation–based Poisson and negative binomial models. Crude rates of 10.3 versus 13.5 deaths and 394.0 versus 485.9 days hospitalized were observed per 100 person‐years for spironolactone users versus nonusers, respectively. After multivariable adjustment, there was a 21% reduction (95% CI, 13–29; P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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