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ESC guidelines adherence is associated with improved survival in patients from the Norwegian Heart Failure Registry
- Source :
- European heart journal. Cardiovascular pharmacotherapy. 1(1)
- Publication Year :
- 2014
-
Abstract
- Aims To assess the adherence to heart failure (HF) guidelines for angiotensin-converting enzyme-I (ACE-I), angiotensin II receptor blockers (ARB), and β-blockers and the possible association of ACE-I or ARB, β-blockers, and statins with survival in the large contemporary Norwegian Heart Failure Registry . Methods and results The study included 5761 outpatients who were diagnosed with HF of any aetiology (mean left ventricular ejection fraction 32% ± 11%) from January 2000 to January 2010 and followed up until death or February 2010. Adherence to treatment according to the guidelines was high. Cox regression analysis to identify risk factors for all-cause mortality, after adjustment for many factors, showed that ACE-I ≥ 50% of target dose, use of beta-blockers, and statins were significantly related to improved survival ( P = 0.003, P < 0.001, and P < 0.001, respectively). Propensity scoring showed the same benefit for these variables. Conclusions Both multivariable and propensity scoring analyses showed survival benefits with β-blockers, statins, and adequate doses of ACE-I in this contemporary HF cohort. This study stresses the importance of guidelines adherence, even in the context of high levels of adherence to guidelines. Moreover, respecting the recommended target doses of ACE-I appears to have a crucial role in survival improvement and, in the multivariate Cox regression analysis, ARB treatment was not significantly associated with a lower all-cause mortality. [10.1093/ehjcvp/pvu015][1] [1]: /lookup/doi/10.1093/ehjcvp/pvu015
- Subjects :
- Male
medicine.medical_specialty
Adrenergic beta-Antagonists
Context (language use)
Angiotensin-Converting Enzyme Inhibitors
Ventricular Function, Left
Angiotensin Receptor Antagonists
Internal medicine
medicine
Humans
Pharmacology (medical)
Registries
Intensive care medicine
Propensity Score
Survival rate
Aged
Heart Failure
Ejection fraction
Proportional hazards model
business.industry
Norway
Incidence (epidemiology)
Incidence
Stroke Volume
medicine.disease
Survival Rate
Heart failure
Cohort
Propensity score matching
Female
Guideline Adherence
Cardiology and Cardiovascular Medicine
business
Angiotensin II Type 1 Receptor Blockers
Subjects
Details
- ISSN :
- 20556845
- Volume :
- 1
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- European heart journal. Cardiovascular pharmacotherapy
- Accession number :
- edsair.doi.dedup.....8d91291cf1eb3c853eda9985ab6d0170