Associations between calcium channel blocker therapy and mortality in heart failure with preserved ejection fraction
Xinyi Wang1, Jianqing Ju1, Zhuo Chen1
1National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1 XiYuan CaoChang, Haidian District, Beijing 100091, China.
Insights
Calcium channel blockers (CCBs) may reduce mortality in patients with heart failure with preserved ejection fraction (HFpEF). This study found CCB use was associated with significantly lower risks of all-cause, cardiovascular, and noncardiovascular mortality in HFpEF patients.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Heart failure with preserved ejection fraction (HFpEF) lacks effective treatments.
- Calcium channel blockers (CCBs) are associated with improved outcomes in HFpEF.
Purpose of the Study:
- Investigate the impact of CCBs on mortality in HFpEF patients.
Main Methods:
- Post hoc analysis of the Aldosterone Antagonist Trial.
- Examined all-cause, cardiovascular, and noncardiovascular mortality.
- Utilized Cox proportional hazard models on 3440 HFpEF patients.
Main Results:
- CCB use was linked to a significantly lower risk of all-cause mortality (HR: 0.72, P=0.001).
- Reduced risks for cardiovascular (HR: 0.75, P=0.023) and noncardiovascular mortality (HR: 0.68, P=0.018) were observed with CCBs.
- Mortality rates were 37.3 per 1000 person-years with CCBs vs. 50.8 without.
Conclusions:
- CCB use is associated with reduced mortality in HFpEF.
- This suggests a potential therapeutic role for CCBs in managing HFpEF outcomes.
Aims:
Treatment of heart failure with preserved ejection fraction (HFpEF) is urgently needed; however, effective treatments are lacking. Current evidence showed a possible association between the use of calcium channel blockers (CCBs) and improved outcomes in HFpEF patients. We aimed to investigate the impact of CCBs on mortality in patients with HFpEF.
Methods And Results:
This was a post hoc analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial. The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular and noncardiovascular mortality. We analysed hazard ratios (HRs) in patients taking CCBs compared with those not taking CCBs using Cox proportional hazard models. We considered 3440 HFpEF patients. The mean follow-up period was 3.4 ± 1.7 years, and 530 patients died during the study period. All-cause mortality rates in patients taking and not taking CCB were 37.3 and 50.8 events per 1000 person-years, respectively. The adjusted HR for all-cause mortality was significantly lower in those taking CCBs than those not taking CCBs [HR: 0.72, 95% confidence interval (CI): 0.59-0.88, P = 0.001]. The risk of cardiovascular and noncardiovascular mortality was also significantly lower in patients taking CCBs than in those not taking CCBs (HR: 0.75, 95% CI: 0.59-0.96, P = 0.023 and HR: 0.68, 95% CI: 0.49-0.93, P = 0.018, respectively).
Conclusion:
The use of CCBs was associated with reduced risks of mortality in patients with HFpEF.
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