Tags

Type your tag names separated by a space and hit enter

Effect of statins, angiotensin-converting enzyme inhibitors, and beta blockers on survival in patients >or=65 years of age with heart failure and preserved left ventricular systolic function.
Am J Cardiol. 2008 Jan 15; 101(2):217-22.AJ

Abstract

About half of all patients with heart failure (HF) have preserved left ventricular systolic function. Statins, angiotensin-converting enzyme inhibitors, and beta blockers have been shown to improve survival in patients with HF and low ejection fraction. However, no large national study has investigated these agents in patients with HF and preserved left ventricular ejection fraction. We evaluated a nationwide sample of 13,533 eligible Medicare beneficiaries aged >or=65 years who were hospitalized with a primary discharge diagnosis of HF and had chart documentation of preserved left ventricular ejection fraction between April 1998 and March 1999 or between July 2000 and June 2001. In Cox proportional hazard model accounting for demographic profile, clinical characteristics, treatments, physician specialty, and hospital characteristics, discharge statin therapy was associated with significant improvements in 1- and 3-year mortality (RR 0.69, 95% confidence interval [CI] 0.61 to 0.78; RR 0.73, 95% CI 0.68 to 0.79, respectively). Irrespective of total cholesterol level or coronary artery disease status, diabetes, hypertension, and age, statin therapy was associated with significant differences in mortality rates. Similarly, angiotensin-converting enzyme inhibitors were associated with better survival at 1 year (RR 0.88, 95% CI 0.82 to 0.95) and 3 years (RR 0.93, 95% CI 0.89 to 0.98). Beta-blocker therapy was associated with a nonsignificant trend at 1 year (RR 0.93, 95% CI 0.87 to 1.10) and significant survival benefits at 3 years (RR 0.92%, 95% CI 0.87 to 0.97). In conclusion, our data demonstrate that statins, angiotensin-converting enzyme inhibitors, and beta blockers are associated with better short- and long-term survival in patients >or=65 years with HF and preserved left ventricular ejection fraction.

Authors+Show Affiliations

Cardiovascular Division, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA. shahcardiology@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18178410

Citation

Shah, Rahman, et al. "Effect of Statins, Angiotensin-converting Enzyme Inhibitors, and Beta Blockers On Survival in Patients >or=65 Years of Age With Heart Failure and Preserved Left Ventricular Systolic Function." The American Journal of Cardiology, vol. 101, no. 2, 2008, pp. 217-22.
Shah R, Wang Y, Foody JM. Effect of statins, angiotensin-converting enzyme inhibitors, and beta blockers on survival in patients >or=65 years of age with heart failure and preserved left ventricular systolic function. Am J Cardiol. 2008;101(2):217-22.
Shah, R., Wang, Y., & Foody, J. M. (2008). Effect of statins, angiotensin-converting enzyme inhibitors, and beta blockers on survival in patients >or=65 years of age with heart failure and preserved left ventricular systolic function. The American Journal of Cardiology, 101(2), 217-22. https://doi.org/10.1016/j.amjcard.2007.08.050
Shah R, Wang Y, Foody JM. Effect of Statins, Angiotensin-converting Enzyme Inhibitors, and Beta Blockers On Survival in Patients >or=65 Years of Age With Heart Failure and Preserved Left Ventricular Systolic Function. Am J Cardiol. 2008 Jan 15;101(2):217-22. PubMed PMID: 18178410.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of statins, angiotensin-converting enzyme inhibitors, and beta blockers on survival in patients >or=65 years of age with heart failure and preserved left ventricular systolic function. AU - Shah,Rahman, AU - Wang,Yung, AU - Foody,JoAnne M, PY - 2007/05/08/received PY - 2007/08/07/revised PY - 2007/08/07/accepted PY - 2008/1/8/pubmed PY - 2008/2/20/medline PY - 2008/1/8/entrez SP - 217 EP - 22 JF - The American journal of cardiology JO - Am J Cardiol VL - 101 IS - 2 N2 - About half of all patients with heart failure (HF) have preserved left ventricular systolic function. Statins, angiotensin-converting enzyme inhibitors, and beta blockers have been shown to improve survival in patients with HF and low ejection fraction. However, no large national study has investigated these agents in patients with HF and preserved left ventricular ejection fraction. We evaluated a nationwide sample of 13,533 eligible Medicare beneficiaries aged >or=65 years who were hospitalized with a primary discharge diagnosis of HF and had chart documentation of preserved left ventricular ejection fraction between April 1998 and March 1999 or between July 2000 and June 2001. In Cox proportional hazard model accounting for demographic profile, clinical characteristics, treatments, physician specialty, and hospital characteristics, discharge statin therapy was associated with significant improvements in 1- and 3-year mortality (RR 0.69, 95% confidence interval [CI] 0.61 to 0.78; RR 0.73, 95% CI 0.68 to 0.79, respectively). Irrespective of total cholesterol level or coronary artery disease status, diabetes, hypertension, and age, statin therapy was associated with significant differences in mortality rates. Similarly, angiotensin-converting enzyme inhibitors were associated with better survival at 1 year (RR 0.88, 95% CI 0.82 to 0.95) and 3 years (RR 0.93, 95% CI 0.89 to 0.98). Beta-blocker therapy was associated with a nonsignificant trend at 1 year (RR 0.93, 95% CI 0.87 to 1.10) and significant survival benefits at 3 years (RR 0.92%, 95% CI 0.87 to 0.97). In conclusion, our data demonstrate that statins, angiotensin-converting enzyme inhibitors, and beta blockers are associated with better short- and long-term survival in patients >or=65 years with HF and preserved left ventricular ejection fraction. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18178410/Effect_of_statins_angiotensin_converting_enzyme_inhibitors_and_beta_blockers_on_survival_in_patients_>or=65_years_of_age_with_heart_failure_and_preserved_left_ventricular_systolic_function_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)01886-3 DB - PRIME DP - Unbound Medicine ER -