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Renal Insufficiency and Heart Failure: Prognostic and Therapeutic Implications from a Prospective Cohort Study by Finlay A. McAlister; Justin Ezekowitz; Marcello Tonelli; Paul W. Armstrong is a Medicine article available to read on EtoBox.

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## Background: The prevalence, prognostic import, and impact of renal insufficiency on the benefits of ace inhibitors and beta-blockers in community-dwelling patients with heart failure are uncertain. ## Methods and results: We analyzed data from a prospective cohort of 754 patients with heart failure who had ejection fraction, serum creatinine, and weight measured at baseline. median age was 69 years, and 43% had an ejection fraction > or =35%. by the cockcroft-gault equation, 118 patients (16%) had creatinine clearances < or =30 ml/min and 301 (40%) had creatinine clearances between 30 and 59 ml/min. during follow-up (median 926 days), 385 patients (37%) died. even after adjustment for all other prognostic factors, survival was significantly associated with renal function (p=0.002) in patients with either systolic or diastolic dysfunction; patients exhibited a 1% increase in mortality for each 1-ml/min decrease in creatinine clearance. the associations with 1-year mortality reductions were similar for ace inhibitors (or 0.46 [95% ci 0.26 to 0.82] versus or 0.28 [95% ci 0.11 to 0.70]) and beta-blockers (or 0.40 [95% ci 0.23 to 0.70] versus or 0.41 [95% ci 0.19 to 0.85]) in patient

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Author

Finlay A. McAlister; Justin Ezekowitz; Marcello Tonelli; Paul W. Armstrong

Publisher

Ovid Technologies (Wolters Kluwer Health)

Published

2004

Language

EN

Field

Medicine (Health Sciences)