caa a22 4500 606158200 CHVBK 20210128100618.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10557-015-6572-y doi (NATIONALLICENCE)springer-10.1007/s10557-015-6572-y Impact of Clinical Characteristics and Management on the Prognosis of Unselected Heart Failure Patients [Elektronische Daten] [Romain Eschalier, Chouki Chenaf, Aurélien Mulliez, Arab Yalioua, Guillaume Clerfond, Nicolas Authier, Charles Vorilhon, Bernard Citron, Bruno Pereira, Frédéric Jean, Géraud Souteyrand, Pascal Motreff, Alain Eschalier, Jean-René Lusson] Purpose: Heart failure (HF) is a major public health issue. This study conducted a real-life analysis of the impact of clinical characteristics and medical management of HF on its prognosis. Methods: Analysis was based on the EGB ("Echantillon Généraliste des Bénéficiaires”) database. A cohort comprising 1825 adult patients with a first admission for HF between 2009 and 2011 was created and followed until June 2013 (median 22.3 [7.7-34.5] months) for survival analysis. Results: Mean age was 77.3 ± 13.2years (53% ≥80years). The overall incidence of HF admission was 117 [112-122] per 100,000 population with a marked increase in patients >80years (1297 [1217-1348]). At discharge, only 8% of patients received recommended combination of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB), beta-blockers (BB) and mineralocorticoid receptor antagonists (MRA). Only prescription levels of BB and vitamin K antagonists, at discharge, increased during the study period. In-hospital mortality was 9% and survival was 71.6%[69.5-73.6] and 52.0%[49.4-54.6] at 12 and 36months, respectively. In multivariate analysis, female gender [HR:0.78 (0.67-0.91), p = 0.001], ACEi/ARB + BB + MRA [0.41 (0.28-0.60), p < 0.001] and ACEi/ARB + BB [0.47 (0.39-0.57) p < 0.001] treatments were associated with improved survival, conversely to age 70-79 [1.90 (1.20-3.00), p = 0.003] and ≥80 [3.50 (2.30-5.40), p < 0.001], cardiogenic shock [3.00 (2.10-4.40), p < 0.001], acute pulmonary edema [1.70 (1.10-2.50), p = 0.01], denutrition [1.80 (1.45-2.24), p < 0.001], dilated cardiomyopathy [1.20 (1.00-1.40), p = 0.02] and in-hospital acute renal failure [1.36 (1.05-1.78), p = 0.002]. Conclusions: These real-life HF data provide insight into prognostic factors and "real-world” pharmacological management in this unselected HF population, confirming the benefit of ACEi/ARB + BB ± MRAs on patient survival. Springer Science+Business Media New York, 2015 Heart failure nationallicence Epidemiology nationallicence Management nationallicence Therapeutics nationallicence Eschalier Romain Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut Chenaf Chouki Pharmacology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut Mulliez Aurélien Biostatistics Unit (Clinical Research and Innovation Direction), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France aut Yalioua Arab Cardiology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut Clerfond Guillaume Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut Authier Nicolas Pharmacology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut Vorilhon Charles Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut Citron Bernard Cardiology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut Pereira Bruno Biostatistics Unit (Clinical Research and Innovation Direction), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France aut Jean Frédéric Cardiology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut Souteyrand Géraud Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut Motreff Pascal Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut Eschalier Alain Pharmacology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut Lusson Jean-René Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/1(2015-02-01), 89-98 0920-3206 29:1<89 2015 29 10557 https://doi.org/10.1007/s10557-015-6572-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10557-015-6572-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Eschalier Romain Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Chenaf Chouki Pharmacology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Mulliez Aurélien Biostatistics Unit (Clinical Research and Innovation Direction), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Yalioua Arab Cardiology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Clerfond Guillaume Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Authier Nicolas Pharmacology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Vorilhon Charles Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Citron Bernard Cardiology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Pereira Bruno Biostatistics Unit (Clinical Research and Innovation Direction), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Jean Frédéric Cardiology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Souteyrand Géraud Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Motreff Pascal Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Eschalier Alain Pharmacology Department, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Lusson Jean-René Clermont Université, ISIT-CaVITI, BP 10448, 63001, Clermont-Ferrand, France aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/1(2015-02-01), 89-98 0920-3206 29:1<89 2015 29 10557