Prevalence of Midodrine Use in Patients Admitted With Systolic Congestive Heart Failure

Scoma, Christopher; Lee, Dae Hyun; Cohen, Adam Max; Fernandez, Joel

doi:10.1016/s0735-1097(21)02037-4

Cited by 4 publications

(2 citation statements)

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“…However, the increased use of GDMT in patients using midodrine did not improve prognosis. The authors concluded that midodrine was very commonly used in HFrEF patients, especially those with severely reduced left ventricular ejection fraction (LVEF), but noted a worse prognosis in this patient population [8] . Zakir et al demonstrated in a small cohort study that the use of midodrine was well tolerated in patients with advanced heart failure associated with hypotension and allowed for up-titration of GDMT in these patients which consequently led to an improvement in LVEF and clinical outcomes with a significant decrease in hospital admissions and total hospital days [9] .…”

Section: Discussionmentioning

confidence: 99%

Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature

Hajjiah¹,

Maadarani²,

Bitar³

et al. 2022

European Journal of Case Reports in Internal Medicine

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Hypotension in patients with heart failure is much more frequent in daily clinical practice than the 10–15% reported in clinical trials. In patients with heart failure with reduced ejection fraction (HFrEF), hypotension frequently limits the initiation and up-titration of guideline-directed medical therapy (GDMT). Midodrine is a peripheral alpha-1 agonist and a vasopressor anti-hypotensive agent approved for the treatment of orthostatic hypotension. We describe two cases where midodrine was prescribed in patients with HFrEF and hypotension.

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Section: Discussionmentioning

confidence: 99%

Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature

Hajjiah¹,

Maadarani²,

Bitar³

et al. 2022

European Journal of Case Reports in Internal Medicine

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“…Additionally, their left ventricular ejection fraction (LVEF) improved from 24.0% to 32.2% ( p < 0.001), and there were reduced hospital admissions (32 vs. 12; p = 0.02) and total hospital days (150 vs 58; p = 0.02). However, a poster presentation ( Scoma et al, 2021 ) indicated significantly higher all-cause mortality at 6 months following hospitalization in the midodrine group compared to the non-midodrine group (HR:6.7, 95% CI:5.2%–8.5%). There have been some recent case reports showing potential benefits (at least in terms of blood pressure improvement and a higher likelihood of GDMT) ( Hajjiah et al, 2022 ; Shiu et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Safety of midodrine in patients with heart failure with reduced ejection fraction: a retrospective cohort study

Wu,

Chen,

Tsai

2024

Front. Pharmacol.

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Background: Heart failure with reduced ejection fraction (HFrEF) poses significant health risks. Midodrine for maintaining blood pressure in HFrEF, requires further safety investigation. This study explores midodrine’s safety in HFrEF through extensive matched analysis.Methods: Patients with HFrEF (LVEF <50%) without malignancy, non-dialysis dependence, or non-orthostatic hypotension, were enrolled between 28 August 2013, and 27 August 2023. Propensity score matching (PSM) created 1:1 matched groups. Outcomes included mortality, stage 4 and 5 chronic kidney disease (CKD), emergency room (ER) visits, intensive care unit (ICU) admissions, hospitalizations, and respiratory failure. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated for each outcome, and Kaplan-Meier survival analysis was performed. Subgroup analyses were conducted based on gender, age (20-<65 vs. ≥65), medication refill frequency, and baseline LVEF.Results: After 1:1 PSM, 5813 cases were included in each group. The midodrine group had higher risks of respiratory failure (HR: 1.16, 95% CI: 1.08–1.25), ICU admissions (HR: 1.14, 95% CI: 1.06–1.23), hospitalizations (HR: 1.21, 95% CI: 1.12–1.31), and mortality (HR: 1.090, 95% CI: 1.01–1.17). Interestingly, midodrine use reduced ER visits (HR: 0.77, 95% CI: 0.71–0.83). Similar patterns of lower ER visit risk and higher risks for ICU admissions, respiratory failure, and overall hospitalizations were observed in most subgroups.Conclusion: In this large-scale study, midodrine use was associated with reduced ER visits but increased risks of respiratory failure, prolonged ICU stays, higher hospitalizations, and elevated mortality in HFrEF patients. Further research is needed to clarify midodrine’s role in hemodynamic support and strengthen existing evidence.

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Evaluation of Midodrine Utilization in Patients with Cancer and Heart Failure

Irizarry-Caro,

Song,

Miller

et al. 2024

Cardiovasc Drugs Ther

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Prevalence of Midodrine Use in Patients Admitted With Systolic Congestive Heart Failure

Cited by 4 publications

References 0 publications

Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature

Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature

Safety of midodrine in patients with heart failure with reduced ejection fraction: a retrospective cohort study

Evaluation of Midodrine Utilization in Patients with Cancer and Heart Failure

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