Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis

Damman, Kevin; Valente, Mattia A.E.; Voors, Adriaan A.; O’Connor, Christopher M.; Veldhuisen, Dirk J. van; Hillege, Hans L.

doi:10.1093/eurheartj/eht386

Cited by 880 publications

(810 citation statements)

References 103 publications

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“…There is still no study examining outcome of MRA use in patients with HF and normal left ventricular ejection fraction (LVEF) in a MI setting. Moreover, chronic kidney disease (CKD) is common in HF and is an important risk factor for worse outcome 8, 9. Even though MRAs have been found to reduce left ventricular mass and arterial stiffness in patients with CKD, CKD is a determinant for MRA use in HF by the risk of worsening renal function and hyperkalemia 10.…”

Section: Introductionmentioning

confidence: 99%

Association Between Mineralocorticoid Receptor Antagonist Use and Outcome in Myocardial Infarction Patients With Heart Failure

Löfman

Szummer

Olsson

et al. 2018

JAHA

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BackgroundThere are no studies of mineralocorticoid receptor antagonist (MRA) treatment examining outcome in unselected real‐life patients with myocardial infarction (MI) and heart failure (HF). There is uncertainty regarding effects of MRA in relation to left ventricular ejection fraction (LVEF) and chronic kidney disease (CKD). The aim was to assess MRA use and compare outcomes in MI patients with HF in relation to LVEF and CKD.Methods and ResultsPatients with MI and HF registered in the Swedish myocardial infarction registry, SWEDEHEART, 2005–2014, were included. Associations between MRA use and all‐cause mortality up to 3 years were assessed with multivariable Cox regression, stratified by EF groups and presence of CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m2). Of 45 071 patients with MI and HF, 4470 (9.9%) received MRA. Those with HF and LVEF <40% more often had MRA (19.6%) compared with those with LVEF 40% to 49% (9.1%) or LVEF ≥50% (4.7%). 8.6% of patients with CKD received MRA. After adjustment, MRA use was associated with lower mortality in those with LVEF <40% (hazard ratio [95% confidence interval] 0.81 [0.75–0.88]) and LVEF 40% to 49% (0.88 [0.75–1.03]) but not in those with LVEF ≥50% (1.29 [1.09–1.53]), with significant interaction between MRA and LVEF (P<0.0001). The association between MRA use and mortality was similar in those without (0.96 [0.88–1.05]) and with (0.92 [0.85–0.99]) CKD.ConclusionsIn patients with MI and HF, MRA use was associated with better long‐term survival in patients with LVEF <40% but not in those with LVEF ≥50%, while the mortality risk was similar in MRA‐treated patients with or without CKD.

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Section: Introductionmentioning

confidence: 99%

Association Between Mineralocorticoid Receptor Antagonist Use and Outcome in Myocardial Infarction Patients With Heart Failure

Löfman

Szummer

Olsson

et al. 2018

JAHA

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“…Так, по данным проспективных наблюдений за пациентами с ХСН, значимое ухудшение функции почек отмечалось у каждого четвер-того больного [28,29]. Проведенный метаана-лиз [30], включивший более 1 млн пациентов из 57 исследований, показал, что факторами риска ухудшения почечной функции являют-ся исходная ХБП, АГ и СД, возраст и использо-вание диуретиков.…”

Section: Discussionunclassified

Clinical Factors and Anticoagulation Level That Determine the Sudden Loss of Kidney Function in Patients Long-Taking Warfarin (A 5-Year Prospective, Observational Study)

et al. 2018

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“…Це збігаєть-ся з даними досліджень [10,22], які виявили значно більшу значущість вихідної ХХН, ніж ПФН у таких хворих. Це можна пояснити тим, що ШКФ <60 при поступленні асоціюється з більш високими рівнями NGAL, ніж ШКФ ≥60, імовірно, внаслідок некрозу клітин канальців нефрону в ході ГДСН.…”

Section: обговорення результатів дослідженняunclassified

Clinical significance of renal function worsening in patients with acute decompensated heart failure, depending on NGAL changes and initial renal function

Amosova¹,

Gorda²,

Bezrodnyi³

2017

ScienceRise: Medical Science

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Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis

Abstract: Across all subgroups of patients with HF, CKD, and WRF are prevalent and associated with a strongly increased mortality risk, especially CKD. Specific conditions may predict the occurrence of WRF and thereby poor prognosis.

Cited by 880 publications

References 103 publications

Association Between Mineralocorticoid Receptor Antagonist Use and Outcome in Myocardial Infarction Patients With Heart Failure

Association Between Mineralocorticoid Receptor Antagonist Use and Outcome in Myocardial Infarction Patients With Heart Failure

Clinical Factors and Anticoagulation Level That Determine the Sudden Loss of Kidney Function in Patients Long-Taking Warfarin (A 5-Year Prospective, Observational Study)

Clinical significance of renal function worsening in patients with acute decompensated heart failure, depending on NGAL changes and initial renal function

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