Inhibition of the Renin-Angiotensin System Prevents Re-Hospitalization of Heart Failure Patients With Preserved Ejection Fraction

Abstract

Background Approximately half of the patients with chronic heart failure (CHF) show preserved systolic function, but less is known about CHF with preserved ejection fraction (EF). Methods and Results In a retrospective analysis, patients with CHF who had been admitted to hospital were divided into 2 groups: reduced EF (EF 40%) and preserved EF (EF >40%). The rate of preserved EF was 53.5% and those with preserved EF were older, more likely to be female, and had a lower serum hemoglobin concentration than those in the reduced EF group. In the multivariate analysis, only older age was independently related to CHF with preserved EF. CHF patients with preserved EF who were successfully discharged from hospital and then followed at the outpatient clinic were reviewed and re-hospitalization for CHF was examined by Cox hazard univariate analysis, which showed that prior CHF hospitalization, absence of hypertension, and non-use of angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin-receptor blocker (ARB) were predictors. In the multivariate analysis, non-use of ACEI/ARB was the sole predictor for CHF re-hospitalization. Conclusions CHF patients with preserved EF are older than those with reduced EF and use of ACEI/ARB prevents their re-hospitalization. (Circ J 2008; 72: 2004 - 2008)