BACKGROUND: Aldosterone antagonists(AA) have been used to chronic heart failure and moderate to severe left ventricular systolic dysfunction. In acute decompensated heart failure(ADHF), There is little date about use of aldosterone antagonists.
OBJECTIVES: The aim of this study is to identify contemporary use of aldosterone antagoniasts in ADHF and clinical outcome of this drug use.
SUBJECTS AND METHODS: In Korean acute heart failure (KorHF) registry, we analyzed 2525 patients. The registry enrolled the patients who were hospitalized for ADHF treatment between November 2005 and November 2009. This database included 32 tertiary medical centers from South Korea and 362 variables about the epidemiologic characteristics, management, and prognosis of patients with acute heart failure. The use of AA was evaluated in this database. Mean follow-up period was 3.8 years.
RESULTS: Among 1009 patients eligible for aldosterone antagonist(AA) treatment, 392 (38.9%) received an AA at discharge. AA use in eligible patients was associated with lower systolic blood pressure (adjusted OR, 0.99; 95% CI, 0.99-01.00) and with having history of renal insufficiency (adjusted OR, 2.326; 95% CI, 1.599-3.383). Considering contraindication of AA therapy, inappropriate use was low. Patients with AA treatment had a lower prevalence of hypertension and chronic renal failure, and a higher one of smoking history. But there was no significant difference of death and readmission free survival rate between both groups.
CONCLUSIONS: Only one-third of eligible ADHF patients received aldosterone antagonist theraphy. Use of aldosterone antagonist therapy among patients with documented contraindications was low.
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