In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 12 ( 2020-12-22), p. e0244231-
Abstract:
This study assessed the association between heart failure (HF) medication (angiotensin-converting-enzyme inhibitors (ACEI)/angiotensin-receptor blockers (ARB), beta-blockers (BB), mineralocorticoid-receptor antagonists (MRA) and diuretics) and HF readmissions in a real-world unselected group of patients after a first hospital admission for HF. Furthermore we analysed readmission rates for ACEI versus ARB and for carvedilol versus β1-selective BB and we investigated the effect of HF medication in relation to time since discharge. Methods and findings Medication at discharge was determined with dispensing data from the Dutch PHARMO Database Network including 22,476 patients with HF between 2001 and 2015. After adjustment for age, gender, number of medications and year of admission no associations were found for users versus non-users of ACEI/ARB (hazard ratio, HR = 1.01; 95%CI 0.96–1.06), BB (HR = 1.00; 95%CI 0.95–1.05) and readmissions. The risk of readmission for patients prescribed MRA (HR = 1.11; 95%CI 1.05–1.16) or diuretics (HR = 1.17; 95%CI 1.09–1.25) was higher than for non-users. The HR for ARB relative to ACEI was 1.04 (95%CI 0.97–1.12) and for carvedilol relative to β1-selective BB 1.33 (95%CI 1.20–1.46). Post-hoc analyses showed a protective effect shortly after discharge for most medications. For example one month post discharge the HR for ACEI/ARB was 0.77 (95%CI 0.69–0.86). Although we did try to adjust for confounding by indication, probably residual confounding is still present. Conclusions Patients who were prescribed carvedilol have a higher or at least a similar risk of HF readmission compared to β1-selective BB. This study showed that all groups of HF medication -some more pronounced than others- were more effective immediately following discharge.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0244231
DOI:
10.1371/journal.pone.0244231.g001
DOI:
10.1371/journal.pone.0244231.g002
DOI:
10.1371/journal.pone.0244231.g003
DOI:
10.1371/journal.pone.0244231.g004
DOI:
10.1371/journal.pone.0244231.g005
DOI:
10.1371/journal.pone.0244231.g006
DOI:
10.1371/journal.pone.0244231.g007
DOI:
10.1371/journal.pone.0244231.t001
DOI:
10.1371/journal.pone.0244231.t002
DOI:
10.1371/journal.pone.0244231.t003
DOI:
10.1371/journal.pone.0244231.s001
DOI:
10.1371/journal.pone.0244231.s002
DOI:
10.1371/journal.pone.0244231.s003
DOI:
10.1371/journal.pone.0244231.s004
DOI:
10.1371/journal.pone.0244231.r001
DOI:
10.1371/journal.pone.0244231.r002
DOI:
10.1371/journal.pone.0244231.r003
DOI:
10.1371/journal.pone.0244231.r004
DOI:
10.1371/journal.pone.0244231.r005
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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