Evidence map›Paper›PMID 30299270›Full record

ArticleAmerican journal of therapeutics

Renin-Angiotensin Inhibition and Outcomes in Nursing Home Residents With Heart Failure.

Cherinne Arundel, Helen M Sheriff, Phillip H Lam, Selma F Mohammed, Linda G Jones, Corrine Y Jurgens, Charity J Morgan, Charles Faselis, Richard M Allman, Gregg C Fonarow and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of therapeutics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 1 country.

Cherinne ArundelDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC.
Helen M SheriffDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC.
Phillip H LamDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC.
Selma F MohammedDivision of Cardiology, MedStar Washington Hospital Center, Washington, DC.
Linda G JonesSection of Geriatrics & Extended Care, Veterans Affairs Medical Center, Birmingham, AL.
Corrine Y JurgensOffice of Nursing Research, Stony Brook University, Stony Brook, NY.
Charity J MorganDepartment of Biostatistics, University of Alabama at Birmingham, Birmingham, AL.
Charles FaselisDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC.
Richard M AllmanDepartment of Medicine, George Washington University, Washington, DC.
Gregg C FonarowDepartment of Medicine, University of California, Los Angeles, CA.
Ali AhmedDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC.
George Washington University · USGeorgetown University · USMedStar Washington Hospital Center · USStony Brook University · USUniversity of Alabama at Birmingham · USUniversity of California, Los Angeles · USVeterans Health Administration · US

Funding

Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01 HL097047
6 · The paper itself

Abstract

backgroundAngiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs-ARBs) improve outcomes in heart failure (HF). Less is known about this association in nursing home (NH) residents.

methodsOf the 8024 hospitalized HF patients, 542 were NH residents, of whom 250 received ACEIs-ARBs. We assembled a propensity score-matched cohort of 157 pairs of NH residents receiving and not receiving ACEIs-ARBs balanced on 29 baseline characteristics (mean age, 83 years, 74% women, 17% African American), in which we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with ACEI-ARB use. We then checked for interaction in a matched cohort of 5130 patients (378 were NH residents) assembled from the 8024 patients.

resultsAmong 314 matched NH residents, HRs (95% CIs) for 30-day all-cause readmission, HF readmission, and all-cause mortality were 0.78 (0.47-1.28), 0.68 (0.29-1.60), and 1.26 (0.70-2.27), respectively. Respective HRs (95% CIs) at 1 year were 0.76 (0.56-1.02), 0.68 (0.42-1.09), and 1.04 (0.78-1.38). Among 5130 matched patients, ACEI-ARB use was associated with a significantly lower risk of all outcomes at both times, with no significant interactions, except for 1-year mortality, which was only significant in the non-NH subgroup (P for interaction, 0.026).

conclusionsWe found no evidence that the use of ACEIs or ARBs is associated with improved outcomes in patients with HF in the NH setting. However, we also found no evidence that this association is different in NH residents with HF versus non-NH patients with HF. Future larger studies are needed to demonstrate effectiveness of these drugs in the NH setting.

Indexed as

AgedAged, 80 and overAlabamaAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsDrug Therapy, CombinationFemaleHeart FailureHumansKaplan-Meier EstimateMaleNursing HomesPatient ReadmissionRegistriesTreatment OutcomeAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonists

Identifiers

PMID30299270
PMCPMC10502912
OpenAlexW2897630268

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.