Abstract 2951: Differences of Treatment Strategies Between Heart Failure Patients with a Preserved and a Depressed Left Ventricular Function
Background Chronic heart failure (HF) is a major health problem and is associated with high morbidity and mortality. Several effective treatment strategies are available, including beta-blocker, ACE-inhibitors, which have contributed to reducing morbidity and mortality rates. However, most randomized clinical trials in HF examined systolic dysfunction. An estimated 30–50% of patients with heart failure have a preserved left ventricular ejection fraction (LVEF). Accordingly, we sought to analysis and compare a range of treatment strategies of heart failure with preserved versus reduced LVEF using propensity score analysis.
Method and Result We enrolled 3,578 consecutive patients hospitalized with HF in 14 hospitals in Japan. Among them, 3,175 patients (men/women 59%/41%, 70 ± 13 years) who were discharged alive were followed. LVEF was preserved (≥ 50%) in 963 pts (34%) and reduced (≤ 40%) in 1294 (46%). During a mean follow-up period of 2.8 ± 1.3 years there were 525 cardiac deaths. Propensity score matching revealed that beta-blocker, and ACE-inhibitors were significantly improved prognosis and angiotensin-II receptor blocker had tended to decrease cardiac mortality in depressed LVEF pts. However, no treatment strategies had improved mortality of patients with preserved LVEF. Only statin had a tendency to improve cardiac mortality. (Table⇓)
Conclusions: The treatment strategies might be different between depressed and preserved LVEF patients. Statin had a possibility of improve cardiac mortality in pts with preserved LVEF.