ArticleThe American journal of medicine2012
Renin-angiotensin inhibition in systolic heart failure and chronic kidney disease.
Article in The American journal of medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Association between evidence-based medication at discharge and outcomes in patients with heart failure: a systematic review and meta-analysis.Heart failure reviews · 2021Pooled it
- Heart failure in patients with chronic kidney disease: a systematic integrative review.BioMed research international · 2014Pooled it
- Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving β-blockers.Clinical cardiology · 2018Trial
- Rate-control versus rhythm-control strategies and outcomes in septuagenarians with atrial fibrillation.The American journal of medicine · 2013Trial
- Effects of enalapril in systolic heart failure patients with and without chronic kidney disease: insights from the SOLVD Treatment trial.International journal of cardiology · 2013Trial
- Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial.European heart journal · 2013Trial
- Lower Risk of Death and Kidney Failure Associated with Higher Target (vs Below-Target) Doses of RAS Inhibitors in Octogenarians with HFrEF.The American journal of medicine · 2025Article
- Outcomes of KDIGO-Defined CKD in U.S. Veterans With HFpEF, HFmrEF, and HFrEF.JACC. Heart failure · 2025Article
- Association between acupuncture treatment exposure and mortality in patients with heart failure: a nationwide cohort study.Frontiers in cardiovascular medicine · 2025Article
- Exploring diagnostic biomarkers of type 2 cardio-renal syndrome based on secreted proteins and bioinformatics analysis.Scientific reports · 2024Article
- Pathophysiological Link and Treatment Implication of Heart Failure and Preserved Ejection Fraction in Patients with Chronic Kidney Disease.Biomedicines · 2024Review
- An Updated Review of the Management of Chronic Heart Failure in Patients with Chronic Kidney Disease.Reviews in cardiovascular medicine · 2024Review
- Looking for the ideal medication for heart failure with reduced ejection fraction: a narrative review.Frontiers in cardiovascular medicine · 2024Review
- Renin-Angiotensin Inhibition and Outcomes in HFrEF and Advanced Kidney Disease.The American journal of medicine · 2023Article
- Cardiorenal syndrome: Pathophysiology as a key to the therapeutic approach in an under-diagnosed disease.Journal of clinical ultrasound : JCU · 2022Review
- Evidence based review of management of cardiorenal syndrome type 1.World journal of methodology · 2021Review
- Systolic Blood Pressure and Outcomes in Older Patients with HFpEF and Hypertension.The American journal of medicine · 2021Article
- Length of stay and readmission in older adults hospitalized for heart failure.Archives of medical science : AMS · 2021Article
- Role of comorbidities in heart failure prognosis Part 2: Chronic kidney disease, elevated serum uric acid.European journal of preventive cardiology · 2020Review
- Digoxin Initiation and Outcomes in Patients with Heart Failure with Preserved Ejection Fraction.The American journal of medicine · 2020Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe role of renin-angiotensin inhibition in older patients with systolic heart failure with chronic kidney disease remains unclear.
methodsOf the 1665 patients (aged≥65 years) with systolic heart failure (ejection fraction<45%) and chronic kidney disease (estimated glomerular filtration rate<60 mL/min/1.73 m(2)), 1046 received angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Propensity scores for the receipt of these drugs, estimated for each of the 1665 patients, were used to assemble a matched cohort of 444 pairs of patients receiving and not receiving these drugs who were balanced on 56 baseline characteristics.
resultsDuring more than 8 years of follow-up, all-cause mortality occurred in 75% and 79% of matched patients with chronic kidney disease receiving and not receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, respectively (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.74-0.996; P=.045). There was no significant association with heart failure hospitalization (HR, 0.86; 95% CI, 0.72-1.03; P=.094). Similar mortality reduction (HR, 0.83; 95% CI, 0.70-1.00; P=.046) occurred in a subgroup of matched patients with estimated glomerular filtration rate less than 45 mL/min/1.73 m(2). Among 171 pairs of propensity-matched patients without chronic kidney disease, the use of these drugs was associated with a significant reduction in all-cause mortality (HR, 0.72; 95% CI, 0.55-0.94; P=.015) and heart failure hospitalization (HR, 0.71; 95% CI, 0.52-0.95; P=.023).
conclusionDischarge prescription of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was associated with a significant modest reduction in all-cause mortality in older patients with systolic heart failure with chronic kidney disease, including those with more advanced chronic kidney disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.