| アブストラクト | Clinical evidence of oral inotrope use for advanced heart failure (HF) is limited. This study investigated the contemporary use and association of oral inotropes with prognosis in the outpatient treatment of advanced HF using a nationwide administrative claims database in Japan. Patients hospitalized with acute HF between 2014 and 2021 were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Associations of the drug use after discharge with the 2-year prognosis were examined in a propensity-matching cohort, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Of the 428,650 patients discharged with HF in 4433 hospitals, 14,374 (3.4%) had taken oral inotropes, most of whom (95.0%) took pimobendan. Patients taking oral inotropes were younger and more likely to receive HF drugs. Cardiomyopathy as the etiology and the use of intravenous inotropes during hospitalization were more frequently observed. In the 2-year prognosis, oral inotrope use was associated with higher all-cause mortality and HF rehospitalization rates (HR [95% CI]: 1.59 [1.51, 1.66] and 1.54 [1.48, 1.61], respectively). Concomitant use of pimobendan and beta-blockers was associated with lower mortality and HF rehospitalization (0.81 [0.74, 0.88] and 0.85 [0.79, 0.92], respectively) compared with pimobendan without beta-blockers. Although no association was found between oral inotrope use and favorable prognosis, concomitant use of beta-blockers may be a better strategy for oral inotrope use in advanced HF. |
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| ジャーナル名 | Journal of clinical pharmacology |
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| Pubmed追加日 | 2025/3/3 |
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| 投稿者 | Nakai, Michikazu; Iwanaga, Yoshitaka; Kanaoka, Koshiro; Sumita, Yoko; Nishioka, Yuichi; Myojin, Tomoya; Okada, Katsuki; Noda, Tatsuya; Imamura, Tomoaki; Miyamoto, Yoshihiro |
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| 組織名 | Department of Medical and Health Information Management, National Cerebral and;Cardiovascular Center, Suita, Japan.;Clinical Research Support Center, University of Miyazaki Hospital, Miyazaki,;Japan.;Department of Cardiology, Sakurabashi Watanabe Advanced Healthcare Hospital,;Osaka, Japan.;Department of Public Health, Health Management and Policy, Nara Medical;University, Kashihara, Japan.;Department of Cardiovascular Medicine, Osaka University Graduate School of;Medicine, Suita, Japan.;Department of Transformative System for Medical Information, Osaka University;Graduate School of Medicine, Suita, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40029113/ |
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