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TUESDAY, Nov. 19, 2019 (HealthDay News) — For patients with heart failure with left ventricular assist devices (LVADs), neurohormonal blockade (NHB) is associated with improved survival, according to a study published online Nov. 18 in JAMA Cardiology<\/i> to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.<\/p>\n
Megan McCullough, M.D., from the Yale University School of Medicine in New Haven, Connecticut, and colleagues examined the association between NHB blockade and outcomes in a retrospective analysis using data for 2008 to 2016 from more than 170 centers involving patients with continuous-flow LVADs. Patients were stratified based on NHB exposure.<\/p>\n
A total of 12,144 patients met the inclusion criteria; 85.8 percent were receiving NHB. The researchers found that compared with patients not receiving NHB, those receiving any NHB medication at six months had a better survival rate at four years (56.0 versus 43.9 percent). After a sensitivity analysis with an adjusted model, this trend persisted, with patients receiving triple therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, \u03b2-blocker, and mineralocorticoid antagonist having the lowest risk for death versus patients in other groups (hazard ratio, 0.34). Use of NHB versus no NHB was associated with a higher score on the Kansas City Cardiomyopathy Questionnaire (66.6 versus 63.0) and longer distance on a six-minute walk test (1,103 versus 987 feet).<\/p>\n
“If significant benefits can be definitively demonstrated for neurohormonal blockade after LVAD placement, then algorithms of care should change,” write the authors of an accompanying editor’s note.<\/p>\n
One author disclosed financial ties to the pharmaceutical industry.<\/p>\n
Abstract\/Full Text<\/a><\/p>\n Editor’s Note<\/a><\/p>\n