Withdrawing renin-angiotensin inhibitors\/angiotensin receptor-neprilysin inhibitors and mineralocorticoid receptor antagonists tied to higher one-year mortality, morbidity<\/p>\n<\/h3>\n
By Lori Solomon HealthDay Reporter<\/b>
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WEDNESDAY, March 26, 2025 (HealthDay News) — In patients with heart failure with improved ejection fraction (EF), pharmacological therapy is rarely withdrawn, according to a study published online March 17 in Circulation<\/em>.<\/p>\n Christian Basile, M.D., from the Karolinska Institutet in Stockholm, and colleagues assessed rates, patient profiles, and associations with morbidity\/mortality of renin-angiotensin inhibitors (RASi), angiotensin receptor-neprilysin inhibitors (ARNi), beta-blockers (BBL), and mineralocorticoid receptor antagonist (MRA) withdrawal in patients with heart failure with improved EF. The analysis included 8,728 patients with heart failure with improved EF (first recorded EF <40 percent and a later EF \u226540 percent).<\/p>\n The researchers found that the withdrawal rates at the time of the improved EF registration were 4.4 percent for RASi\/ARNi, 3.3 percent for BBL, and 17.2 percent for MRA. Lower use of other heart failure medications, higher EF at the later EF registration, and a longer time between the two EF assessments were predictors of withdrawal. Withdrawal was independently associated with a higher risk for cardiovascular mortality\/hospitalization at one year for heart failure by 38 percent for RASi\/ARNi and 36 percent for MRA after weighting, but there was no association for BBL. There was an association with a higher risk for the primary outcome in the subgroup of patients withdrawn from BBL with an improved EF of 40 to 49 percent versus \u226550 percent.<\/p>\n “These results are hypothesis-generating and highlight the need for randomized controlled trials testing BBL withdrawal in patients with heart failure with improved EF,” the authors write.<\/p>\n Several authors disclosed ties to the pharmaceutical industry.<\/p>\n