Calcium channel blocker use and outcomes in patients with heart failure and mildly reduced and preserved ejection fraction

被引：11

作者：

Matsumoto, Shingo ^{[1
,2
]}

Kondo, Toru ^{[1
,3
]}

Yang, Mingming ^{[1
,4
]}

Campbell, Ross T. ^{[1
]}

Docherty, Kieran F. ^{[1
]}

de Boer, Rudolf A. ^{[5
]}

Desai, Akshay S. ^{[6
]}

Lam, Carolyn S. P. ^{[7
]}

Packer, Milton ^{[8
]}

Pitt, Bertram ^{[9
]}

Rouleau, Jean L. ^{[10
]}

Vaduganathan, Muthiah ^{[6
]}

Zannad, Faiez ^{[11
]}

Zile, Michael R. ^{[12
]}

Solomon, Scott D. ^{[6
]}

Jhund, Pardeep S. ^{[1
]}

McMurray, John J. V. ^{[1
,13
]}

机构：

[1] Univ Glasgow, British Heart Fdn Cardiovasc Res Ctr, Glasgow City, Scotland

[2] Toho Univ, Fac Med, Dept Internal Med, Div Cardiovasc Med, Tokyo, Japan

[3] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Japan

[4] Southeast Univ, Zhongda Hosp, Sch Med, Dept Cardiol, Nanjing, Peoples R China

[5] Erasmus MC, Rotterdam, Netherlands

[6] Harvard Med Sch, Brigham & Womens Hosp, Cardiovasc Div, Boston, MA USA

[7] Singapore & Duke Natl Univ Singapore, Natl Heart Ctr Singapore, Singapore, Singapore

[8] Univ Texas Southwestern Med Ctr Dallas, Dept Clin Sci, Dallas, TX USA

[9] Univ Michigan, Sch Med, Ann Arbor, MI USA

[10] Univ Montreal, Inst Cardiol Montreal, Montreal, PQ, Canada

[11] Univ Lorraine, Nancy, France

[12] Med Univ South Carolina, Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA

[13] Univ Glasgow, British Heart Fdn Cardiovasc Res Ctr, 126 Univ Pl, Glasgow City G12 8TA, Scotland

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2023年 / 25卷 / 12期

关键词：

Calcium channel blocker; Heart failure and preserved ejection fraction; Heart failure and mildly reduced ejection fraction; Dihydropyridine; Non-dihydropyridine; RESISTANT HYPERTENSION; EUROPEAN-SOCIETY; AMLODIPINE; SPIRONOLACTONE;

D O I：

10.1002/ejhf.3044

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

AimsPatients with heart failure (HF) and mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) are often treated with calcium channel blockers (CCBs), although the safety of CCBs in these patients is uncertain. We aimed to investigate the association between CCB use and clinical outcomes in patients with HFmrEF/HFpEF; CCBs were examined overall, as well as by subtype (dihydropyridine and non-dihydropyridine).Methods and resultsWe pooled individual patient data from four large HFpEF/HFmrEF trials. The association between CCB use and outcomes was assessed. Among the 16 954 patients included, the mean left ventricular ejection fraction (LVEF) was 56.8%, and 13 402 (79.0%) had HFpEF (LVEF >= 50%). Altogether, 5874 patients (34.6%) received a CCB (87.6% dihydropyridines). Overall, the risks of death and HF hospitalization were not higher in patients treated with a CCB, particularly dihydropyridines. The risk of pump failure death was significantly lower (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.60-0.96), while the risk of stroke was higher (HR 1.26, 95% CI 1.06-1.50) in patients treated with a CCB compared to those not. These risks remained different in patients treated and not treated with a CCB after adjustment for other prognostic variables. Although the majority of patients were treated with dihydropyridine CCBs, the pattern of outcomes was broadly similar for both dihydropyridine and non-dihydropyridine CCBs.ConclusionAlthough this is an observational analysis of non-randomized treatment, there was no suggestion that CCBs were associated with worse HF outcomes. Indeed, CCB use was associated with a lower incidence of pump failure death.

引用

页码：2202 / 2214

页数：13

共 36 条

[1]

Heidenreich Paul A, 2022, Circulation, V145, pe895, DOI [10.1161/CIR.0000000000001073, 10.1161/CIR.0000000000001063]

[2]

McDonagh Theresa A, 2021, Eur Heart J, V42, P3599, DOI [10.1002/ejhf.2333, 10.1016/j.rec.2022.05.005, 10.1093/eurheartj/ehab368]

[3] Treatment of Hypertension: A Review [J].