The following is a summary of “Impact of chronic renin-angiotensin-aldosterone inhibitors on short-term outcomes in patients with acute heart failure presenting to the emergency department. A propensity-matched analysis EAHFE cohort,” published in the October 2024 issue of Cardiology by Haro et al.  

Patients with acute heart failure (AHF) face high mortality risks. Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) may improve outcomes.  

Researchers conducted a retrospective study investigating the effect of chronic ACEI/ARB use on short-term outcomes in patients with AHF.  

They performed a secondary analysis of 17,920 patients in EAHFE (Epidemiology of Acute Heart Failure in Emergency Departments) from 45 Spanish EDs, comparing patients on chronic ACEI/ARB treatment (56%) to those not on these medications. Outcomes included all-cause in-hospital mortality and other clinical measures. Multiple regression and propensity matching were used for adjustment.  

The results showed patients on chronic ACEI/ARB treatment had reduced all-cause in-hospital mortality (aOR 0.76; 95% CI 0.71–0.82) and at 7-day follow-up (aOR 0.72; 95% CI 0.65–0.79). Sensitivity analysis showed benefits in patients with elevated natriuretic peptides (aOR 0.74; 95% CI 0.68–0.80), hospital admissions (aOR 0.78; 95% CI 0.73–0.84), and prior heart failure history (aOR 0.72; 95% CI 0.66–0.78).  

They concluded that chronic ACEI/ARB use was associated with better short-term outcomes, including lower in-hospital mortality, in patients with AHF.  

Source: internationaljournalofcardiology.com/article/S0167-5273(24)01237-3/abstract