Higher Doses of RASIs May Help Older Heart Failure Patients
Author Information
Author(s): Ahmed Ali, Heidenreich Paul, Aronow Wilbert, Allman Richard, Faselis Charles, Sin Mo-kyung, Lam Phillip, Fonarow Gregg
Primary Institution: Washington DC Veterans Medical Center
Hypothesis
Can higher target doses of RASIs improve outcomes without causing kidney failure in octogenarians with HFrEF?
Conclusion
Using higher doses of RASIs in octogenarians with heart failure may lower the risk of death and kidney failure.
Supporting Evidence
- 70.3% of patients died during the follow-up period.
- 34.1% were hospitalized for heart failure.
- 1.7% developed kidney failure.
- Target-dose RASI use was associated with a significant 5% lower risk of death.
- There was a trend toward a lower risk of kidney failure.
- The composite endpoint of kidney failure or death had a lower risk with target-dose RASIs.
Takeaway
Giving older heart failure patients higher doses of certain medications might help them live longer and avoid kidney problems.
Methodology
Matched patients based on propensity scores for target-dose RASIs and analyzed outcomes over 5 years.
Potential Biases
Potential bias in matching patients based on propensity scores.
Limitations
The study did not include octogenarians in clinical trials, and kidney failure was not examined in detail.
Participant Demographics
Patients were octogenarians (≥80 years) with heart failure and reduced ejection fraction.
Statistical Information
P-Value
0.95
Confidence Interval
95% CI, 1–9%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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