当前位置： SCI文献检索 > EUROPEAN JOURNAL OF HEART FAILURE期刊下所有文献 > Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme.

Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme.

Abstract：

AIMS:Heart failure (HF) and chronic obstructive pulmonary disease are common partners. Bronchodilators are associated with adverse cardiovascular outcomes in patients with pulmonary disease. The outcome of patients with HF prescribed bronchodilators is poorly defined. METHODS AND RESULTS:The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme randomized 7599 patients with symptomatic HF to receive candesartan or placebo. The relative risk conveyed by bronchodilator therapy was examined using a multivariable Cox proportional hazards model. The prevalence of bronchodilator therapy was similar in patients with reduced and preserved systolic function (respectively, 8.7 vs. 9.2%, P = 0.46). Beta-blocker utilization was markedly lower in patients receiving bronchodilators compared with those without (overall 31.9 vs. 57.6%, P < 0.0001). Bronchodilator use was associated with increased all-cause mortality [HR 1.26 (1.09-1.45), P = 0.0015], cardiovascular death [HR 1.21 (1.03-1.42), P = 0.0216], HF hospitalization [HR 1.49 (1.29-1.72), P < 0.0001], and major adverse cardiovascular events [HR 1.32 (1.17-1.76), P < 0.0001]. The adverse outcomes were consistent in patients with reduced and preserved systolic function. No significant interaction was observed between bronchodilators and beta-blockade with respect to outcomes. CONCLUSION:Bronchodilator use is a powerful independent predictor of worsening HF and increased mortality in a broad spectrum of patients with HF. Whether this relates to a toxic effect of bronchodilators, underlying pulmonary disease, or both is unclear and warrants further investigation.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Hawkins NM,Wang D,Petrie MC,Pfeffer MA,Swedberg K,Granger CB,Yusuf S,Solomon SD,Ostergren J,Michelson EL,Pocock SJ,Maggioni AP,McMurray JJ,CHARM Investigators and Committees.

doi

10.1093/eurjhf/hfq040

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

557-65

issue

eissn

1388-9842

issn

1879-0844

pii

hfq040

journal_volume

pub_type

杂志文章,随机对照试验

在线工具

Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme.