open access

Vol 27, No 3 (2023)
Original paper
Published online: 2023-09-11
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Impact of alpha-adrenergic receptor antagonists use on outcomes in patients with heart failure. A post-hoc analysis using Polish National Health Fund database

Bartosz Symonides1, Jacek Lewandowski1, Andrzej Śliwczyński2
·
Arterial Hypertension 2023;27(3):157-166.
Affiliations
  1. Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
  2. Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland

open access

Vol 27, No 3 (2023)
ORIGINAL PAPERS
Published online: 2023-09-11

Abstract

Background: The alpha-adrenolytics (AA) are not recommended in patients with ejection fraction (EF) reduced heart failure due to safety concerns. The aim of our study was to assess the safety of AA in patients hospitalized due to exacerbation of HF and the influence of these drugs on long-term endpoints.

Material and methods: Data collected by the National Health Fund tracking all patient admissions and taking of the drug prescriptions throughout the entire country was used. Patients hospitalized due to HF exacerbation were included. The primary outcome variable was all-cause mortality and the secondary was the first readmission due to HF or all-cause death occurring more than 30 days after discharge.

Results: Of 140 668 patients hospitalized in the year 2013 53 317 were included and followed for a median of 56.3 months. AA patients had lower long-term all-cause mortality (52.8% vs. 54.9%, unadjusted p = 0.038). The treatment with AA positively and independently affected long-term survival [adjusted hazard ratio (adjHR): 0.82, 95% confidence interval (CI): 0.78–0.87, p < 0.001], as well as secondary endpoint (adjHR: 0.85, 95% CI: 0.81–0.90, p < 0.001). Cox analysis in the subgroup treated with beta-blockers revealed that treatment with AA was associated with lower mortality (adjHR: 0.82, 95% CI: 0.75–0.90, p < 0.001) and lower incidence of secondary endpoint (adjHR: 0.85, 95% CI: 0.78–0.92, p < 0.001).

Conclusion: In compliant patients hospitalized due to HF exacerbation post discharge treatment with AA was safe and beneficial.

Abstract

Background: The alpha-adrenolytics (AA) are not recommended in patients with ejection fraction (EF) reduced heart failure due to safety concerns. The aim of our study was to assess the safety of AA in patients hospitalized due to exacerbation of HF and the influence of these drugs on long-term endpoints.

Material and methods: Data collected by the National Health Fund tracking all patient admissions and taking of the drug prescriptions throughout the entire country was used. Patients hospitalized due to HF exacerbation were included. The primary outcome variable was all-cause mortality and the secondary was the first readmission due to HF or all-cause death occurring more than 30 days after discharge.

Results: Of 140 668 patients hospitalized in the year 2013 53 317 were included and followed for a median of 56.3 months. AA patients had lower long-term all-cause mortality (52.8% vs. 54.9%, unadjusted p = 0.038). The treatment with AA positively and independently affected long-term survival [adjusted hazard ratio (adjHR): 0.82, 95% confidence interval (CI): 0.78–0.87, p < 0.001], as well as secondary endpoint (adjHR: 0.85, 95% CI: 0.81–0.90, p < 0.001). Cox analysis in the subgroup treated with beta-blockers revealed that treatment with AA was associated with lower mortality (adjHR: 0.82, 95% CI: 0.75–0.90, p < 0.001) and lower incidence of secondary endpoint (adjHR: 0.85, 95% CI: 0.78–0.92, p < 0.001).

Conclusion: In compliant patients hospitalized due to HF exacerbation post discharge treatment with AA was safe and beneficial.

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Keywords

heart failure treatment; alpha-blockers; mortality; readmissions

About this article
Title

Impact of alpha-adrenergic receptor antagonists use on outcomes in patients with heart failure. A post-hoc analysis using Polish National Health Fund database

Journal

Arterial Hypertension

Issue

Vol 27, No 3 (2023)

Article type

Original paper

Pages

157-166

Published online

2023-09-11

Page views

242

Article views/downloads

274

DOI

10.5603/ah.97054

Bibliographic record

Arterial Hypertension 2023;27(3):157-166.

Keywords

heart failure treatment
alpha-blockers
mortality
readmissions

Authors

Bartosz Symonides
Jacek Lewandowski
Andrzej Śliwczyński

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