1. Mineralocorticoid receptor antagonist use after hospitalization of patients with heart failure and post-discharge outcomes: a single-center retrospective cohort study
- Author
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Durstenfeld, Matthew S, Katz, Stuart D, Park, Hannah, and Blecker, Saul
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease ,Cardiovascular ,Clinical Research ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Drug Prescriptions ,Drug Utilization ,Female ,Heart Failure ,Humans ,Male ,Middle Aged ,Mineralocorticoid Receptor Antagonists ,New York City ,Patient Admission ,Patient Discharge ,Patient Readmission ,Practice Patterns ,Physicians' ,Retrospective Studies ,Risk Factors ,Time Factors ,Treatment Outcome ,Mineralocorticoid ,Aldosterone ,Hospitalization ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundMineralocorticoid receptor antagonists (MRA) are an underutilized therapy for heart failure with a reduced ejection fraction (HFrEF), but the current impact of hospitalization on MRA use is not well characterized. The objective of this study was to describe contemporary MRA prescription for heart failure patients before and after the full scope of hospitalizations and the association between MRA discharge prescription and post-hospitalization outcomes.MethodsWe conducted a retrospective cohort study at an academic hospital system in 2013-2016. Among 1500 included hospitalizations of 1009 unique patients with HFrEF and without MRA contraindication, the mean age was 71.9 ± 13.6 years and 443 (29.5%) were female. We compared MRA prescription before and after hospitalizations with McNemar's test and between patients with principal and secondary diagnoses of HFrEF with the chi-square test, and association of MRA discharge prescription with 30-day and 180-day mortality and readmissions using generalized estimating equations.ResultsMRA prescriptions increased from 303 (20.2%) to 375 (25.0%) at discharge (+4.8%, p
- Published
- 2019