Previous heart failure hospitalization, spironolactone, and outcomes in heart failure with preserved ejection fraction - a secondary analysis of TOPCAT

被引:3
作者
Szabo, Barna [1 ]
Benson, Lina [1 ]
Savarese, Gianluigi [1 ,2 ]
Hage, Camilla [1 ,2 ]
Fudim, Marat [3 ,4 ]
Devore, Adam [3 ,4 ]
Pitt, Bertram [5 ]
Lund, Lars H. [1 ,2 ,6 ,7 ]
机构
[1] Karolinska Inst, Dept Med, Stockholm, Sweden
[2] Karolinska Univ Hosp, Heart Vasc & Neuro Theme, Stockholm, Sweden
[3] Duke Clin Res Inst, Durham, NC USA
[4] Duke Univ, Med Ctr, Dept Med, Durham, NC USA
[5] Univ Michigan, Sch Med, Dept Med, Ann Arbor, MI USA
[6] Karolinska Inst, Cardiol, Norrbacka S1 02, S-17176 Stockholm, Sweden
[7] Karolinska Univ Hosp, Norrbacka S1 02, S-17176 Stockholm, Sweden
基金
美国国家卫生研究院; 瑞典研究理事会;
关键词
IRBESARTAN;
D O I
10.1016/j.ahj.2024.02.021
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Hospitalization for heart failure (HHF) is associated with poor postdischarge outcomes but the role of time since most recent HHF and potential treatment interactions are unknown. We aimed to assess history of and time since previous HHF, associations with composite of cardiovascular (CV) death and total HHF, first HHF and interactions with randomization to spironolactone, in heart failure with preserved ejection fraction. Methods and results We assessed these objectives using uni- and multivariable regressions and spline analyses in TOPCAT-Americas. Among 1,765 patients, 66% had a previous HHF. Over a median of 2.9 years, 1,064 composite events of CV death or total HHFs occurred. Previous HHF was associated with more severe HF, and was independently associated with the composite outcome (HR 1.26, 95%CI 1.05-1.52, P = .014), and all secondary outcomes. A shorter time since most recent HHF appeared to be associated with subsequent first HHF, but not the composite of CV death or total HHF. Spironolactone had a significant interaction with previous HHF (interaction - P .046). Patients without a previous HHF had a larger effect of spironolactone on the composite outcome (HR 0.63, 95%CI 0.46-0.87, P = .005) than patients with a previous HHF (HR 0.91, 95%CI 0.78-1.06, P = .224). Conclusion In TOPCAT-Americas, previous HHF was associated with CV death and first and total HHF. Duration since most recent HHF seemed to be associated with time to first HHF only. Spironolactone was associated with better outcomes in patients without a previous HHF. This interaction is hypothesis -generating and requires validation in future trials. (Am Heart J 2024;271:136-147.)
引用
收藏
页码:136 / 147
页数:12
相关论文
共 26 条
[1]   Interaction Between Spironolactone and Natriuretic Peptides in Patients With Heart Failure and Preserved Ejection Fraction [J].
Anand, Inder S. ;
Claggett, Brian ;
Liu, Jiankang ;
Shah, Amil M. ;
Rector, Thomas S. ;
Shah, Sanjiv J. ;
Desai, Akshay S. ;
O'Meara, Eileen ;
Fleg, Jerome L. ;
Pfeffer, Marc A. ;
Pitt, Bertram ;
Solomon, Scott D. .
JACC-HEART FAILURE, 2017, 5 (04) :241-252
[2]   Prognostic Value of Baseline Plasma Amino-Terminal Pro-Brain Natriuretic Peptide and Its Interactions With Irbesartan Treatment Effects in Patients With Heart Failure and Preserved Ejection Fraction Findings From the I-PRESERVE Trial [J].
Anand, Inder S. ;
Rector, Thomas S. ;
Cleland, John G. ;
Kuskowski, Michael ;
McKelvie, Robert S. ;
Persson, Hans ;
McMurray, John J. ;
Zile, Michael R. ;
Komajda, Michel ;
Massie, Barry M. ;
Carson, Peter E. .
CIRCULATION-HEART FAILURE, 2011, 4 (05) :569-577
[3]   Empagliflozin in Heart Failure with a Preserved Ejection Fraction [J].
Anker, Stefan D. ;
Butler, Javed ;
Filippatos, Gerasimos ;
Ferreira, Joao P. ;
Bocchi, Edimar ;
Boehm, Michael ;
Brunner-La Rocca, Hans-Peter ;
Choi, Dong-Ju ;
Chopra, Vijay ;
Chuquiure-Valenzuela, Eduardo ;
Giannetti, Nadia ;
Gomez-Mesa, Juan Esteban ;
Janssens, Stefan ;
Januzzi, James L. ;
Gonzalez-Juanatey, Jose R. ;
Merkely, Bela ;
Nicholls, Stephen J. ;
Perrone, Sergio V. ;
Pina, Ileana L. ;
Ponikowski, Piotr ;
Senni, Michele ;
Sim, David ;
Spinar, Jindrich ;
Squire, Iain ;
Taddei, Stefano ;
Tsutsui, Hiroyuki ;
Verma, Subodh ;
Vinereanu, Dragos ;
Zhang, Jian ;
Carson, Peter ;
Lam, Carolyn Su Ping ;
Marx, Nikolaus ;
Zeller, Cordula ;
Sattar, Naveed ;
Jamal, Waheed ;
Schnaidt, Sven ;
Schnee, Janet M. ;
Brueckmann, Martina ;
Pocock, Stuart J. ;
Zannad, Faiez ;
Packer, Milton .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (16) :1451-1461
[4]   Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure [J].
Bhatt, Deepak L. ;
Szarek, Michael ;
Steg, P. Gabriel ;
Cannon, Christopher P. ;
Leiter, Lawrence A. ;
McGuire, Darren K. ;
Lewis, Julia B. ;
Riddle, Matthew C. ;
Voors, Adriaan A. ;
Metra, Marco ;
Lund, Lars H. ;
Komajda, Michel ;
Testani, Jeffrey M. ;
Wilcox, Christopher S. ;
Ponikowski, Piotr ;
Lopes, Renato D. ;
Verma, Subodh ;
Lapuerta, Pablo ;
Pitt, Bertram .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 384 (02) :117-128
[5]   Lifetime Analysis of Hospitalizations and Survival of Patients Newly Admitted With Heart Failure [J].
Chun, Soohun ;
Tu, Jack V. ;
Wijeysundera, Harindra C. ;
Austin, Peter C. ;
Wang, Xuesong ;
Levy, Daniel ;
Lee, Douglas S. .
CIRCULATION-HEART FAILURE, 2012, 5 (04) :414-421
[6]   The annual global economic burden of heart failure [J].
Cook, Christopher ;
Cole, Graham ;
Asaria, Perviz ;
Jabbour, Richard ;
Francis, Darrel P. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2014, 171 (03) :368-376
[7]   Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction [J].
Cunningham, Jonathan W. ;
Vaduganathan, Muthiah ;
Claggett, Brian L. ;
Kulac, Ian J. ;
Desai, Akshay S. ;
Jhund, Pardeep S. ;
de Boer, Rudolf A. ;
DeMets, David ;
Hernandez, Adrian F. ;
Inzucchi, Silvio E. ;
Kosiborod, Mikhail N. ;
Lam, Carolyn S. P. ;
Martinez, Felipe ;
Shah, Sanjiv J. ;
McGrath, Martina M. ;
O'Meara, Eileen ;
Wilderang, Ulrica ;
Lindholm, Daniel ;
Petersson, Magnus ;
Langkilde, Anna Maria ;
McMurray, John J., V ;
Solomon, Scott D. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2022, 80 (14) :1302-1310
[8]   Hemodynamic-Guided Heart Failure Management in Patients With Either Prior HF Hospitalization or Elevated Natriuretic Peptides [J].
Desai, Akshay S. ;
Maisel, Alan ;
Mehra, Mandeep R. ;
Zile, Michael R. ;
Ducharme, Anique ;
Paul, Sara ;
Sears, Samuel F. ;
Smart, Frank ;
Bhatt, Kunjan ;
Krim, Selim ;
Henderson, John ;
Johnson, Nessa ;
Adamson, Philip B. ;
Costanzo, Maria Rosa ;
Lindenfeld, Joann .
JACC-HEART FAILURE, 2023, 11 (06) :691-698
[9]   Recency of Heart Failure Hospitalization, Outcomes, and the Effect of Empagliflozin An EMPEROR-Pooled Analysis [J].
Ferreira, Joao Pedro ;
Zannad, Faiez ;
Butler, Javed ;
Filippatos, Gerasimos ;
Pocock, Stuart ;
Iwata, Tomoko ;
Sumin, Mikhail ;
Zeller, Cordula ;
Januzzi, James L. ;
Anker, Stefan D. ;
Packer, Milton .
JACC-HEART FAILURE, 2023, 11 (06) :702-712
[10]   A proportional hazards model for the subdistribution of a competing risk [J].
Fine, JP ;
Gray, RJ .
JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 1999, 94 (446) :496-509