In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications - An analysis from the Acute Decompensated Heart Failure National Registry (ADHERE)
In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications - An analysis from the Acute Decompensated Heart Failure National Registry (ADHERE)
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DOI：
10.1016/j.jacc.2005.03.051
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发表时间：
2005-07-05
影响因子：
24
通讯作者：
Wynne, J
中科院分区：
文献类型：
--
作者：
Abraham, WT;Adams, KF;Wynne, J
目的 我们试图比较接受四种静脉血管活性药物之一的肠外治疗的急性失代偿性心力衰竭 (ADHF) 患者的院内死亡率。 背景 关于静脉内血管活性药物的选择对 ADHF 住院患者院内死亡率影响的数据有限。 方法 这是对来自急性失代偿性心力衰竭国家登记处的观察性患者数据的回顾性分析(ADHERE)，一个多中心注册中心，旨在前瞻性地收集 ADHF 住院每次发作及其临床结果的数据。该分析包含前 65,180 例患者（2001 年 10 月至 2003 年 7 月）的数据。确定并审查了接受硝酸甘油、奈西立肽、米力农或多巴酚丁胺治疗的患者病例 (n = 15,230)。计算院内死亡率的危险因素和倾向评分调整优势比（OR）。结果接受静脉注射硝酸甘油或奈西立肽的患者比接受多巴酚丁胺或米力农治疗的患者院内死亡率较低。硝酸甘油的风险因素和倾向评分调整 OR 为 0.69（95% 置信区间 [CI] 0.53 至 0.89，p
OBJECTIVES We sought to compare the in-hospital mortality of patients with acute decompensated heart failure (ADHF) who were receiving parenteral treatment with one of four intravenous vasoactive medications.BACKGROUND There are limited data regarding the effects of the choice of intravenous vasoactive medication on in-hospital mortality in patients hospitalized with ADHF.METHODS This was a retrospective analysis of observational patient data from the Acute Decompensated Heart Failure National Registry (ADHERE), a multicenter registry designed to prospectively collect data on each episode of hospitalization for ADHF and its clinical outcomes. Data from the first 65,180 patient episodes (October 2001 to July 2003) were included in this analysis. Cases in which patients received nitroglycerin, nesiritide, milrinone, or dobutamine were identified and reviewed (n = 15,230). Risk factor and propensity score-adjusted odds ratios (ORs) for in-hospital mortality were calculated.RESULTS Patients who received intravenous nitroglycerin or nesiritide had lower in-hospital mortality than those treated with dobutamine or milrinone. The risk factor and propensity score-adjusted ORs for nitroglycerin were 0.69 (95% confidence interval [CI] 0.53 to 0.89, p