PMID- 34568630
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210929
IS  - 2434-0790 (Electronic)
IS  - 2434-0790 (Linking)
VI  - 3
IP  - 9
DP  - 2021 Sep 10
TI  - Importance of Optimized Guideline-Based Therapy for Preventing Rehospitalization 
      of Chronic Heart Failure Patients　- From the KUNIUMI Acute Cohort.
PG  - 511-519
LID - 10.1253/circrep.CR-21-0088 [doi]
AB  - Background: Because the effectiveness of strengthening guideline-based therapy 
      (GBT) to prevent heart failure (HF) rehospitalization of chronic HF patients 
      remains unclear, this study investigated the characteristics of HF patients in 
      the Kobe University Heart Failure Registry in Awaji Medical Center (KUNIUMI) 
      acute cohort. Methods and Results: We studied 254 rehospitalized HF patients from 
      the KUNIUMI Registry. Optimized GBT was defined as a Class I or IIa 
      recommendation for chronic HF based on the guidelines of the Japanese Circulation 
      Society. The primary endpoint was all-cause death or first HF rehospitalization 
      after discharge. Outcomes tended to be more favorable for patients who had rather 
      than had not received optimized GBT (hazard ratio [HR] 0.82; 95% confidence 
      interval [CI] 0.57-1.19; P=0.27). Similarly, among New York Heart Association 
      (NYHA) Class IV patients, outcomes tended to be more favorable for those who had 
      rather than had not undergone optimized GBT (HR 0.73; 95% CI 0.47-1.12; P=0.15). 
      Importantly, outcomes were significantly more favorable among NYHA Class IV 
      patients aged <79 years who had rather than had not undergone optimized GBT (HR 
      0.33; 95% CI 0.14-0.82; P=0.02). Multivariate Cox regression analysis showed that 
      optimized GBT was the only independent factor for the prediction of the primary 
      endpoint. Conclusions: Optimized GBT can be expected to play an important role as 
      the next move for chronic HF patients.
CI  - Copyright (c) 2021, THE JAPANESE CIRCULATION SOCIETY.
FAU - Odajima, Susumu
AU  - Odajima S
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe 
      University Graduate School of Medicine Kobe Japan.
FAU - Tanaka, Hidekazu
AU  - Tanaka H
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe 
      University Graduate School of Medicine Kobe Japan.
FAU - Fujimoto, Wataru
AU  - Fujimoto W
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe 
      University Graduate School of Medicine Kobe Japan.
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Kuroda, Koji
AU  - Kuroda K
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Yamashita, Soichiro
AU  - Yamashita S
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Imanishi, Junichi
AU  - Imanishi J
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Iwasaki, Masamichi
AU  - Iwasaki M
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Todoroki, Takashi
AU  - Todoroki T
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Okuda, Masanori
AU  - Okuda M
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Hayashi, Takatoshi
AU  - Hayashi T
AD  - Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
FAU - Konishi, Akihide
AU  - Konishi A
AD  - Clinical & Translational Research Center, Kobe University Hospital Kobe Japan.
FAU - Shinohara, Masakazu
AU  - Shinohara M
AD  - Division of Epidemiology, Kobe University Graduate School of Medicine Kobe Japan.
FAU - Toh, Ryuji
AU  - Toh R
AD  - Division of Evidence-based Laboratory Medicine, Kobe University Graduate School 
      of Medicine Kobe Japan.
FAU - Hirata, Ken-Ichi
AU  - Hirata KI
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe 
      University Graduate School of Medicine Kobe Japan.
AD  - Division of Evidence-based Laboratory Medicine, Kobe University Graduate School 
      of Medicine Kobe Japan.
LA  - eng
PT  - Journal Article
DEP - 20210813
PL  - Japan
TA  - Circ Rep
JT  - Circulation reports
JID - 101746642
PMC - PMC8423620
OTO - NOTNLM
OT  - Guideline-based therapy
OT  - Heart failure
OT  - Rehospitalization
COIS- H.T. is a consultant for AstraZeneca and Ono Pharmaceutical. K.H. has received 
      research funding from Daiichi Sankyo, Actelion Pharmaceuticals Japan, Terumo, 
      Abbott Vascular Japan, Otsuka Pharmaceutical, Kowa, Takeda Pharmaceutical, Nihon 
      Medi-Physics, Novartis Pharma Company, Bayer, Biotronic Japan, FUJIFILM Toyama 
      Chemical, Medtronic Japan, and Sysmex. The remaining authors have no conflicts of 
      interest to declare.
EDAT- 2021/09/28 06:00
MHDA- 2021/09/28 06:01
PMCR- 2021/08/13
CRDT- 2021/09/27 06:21
PHST- 2021/07/04 00:00 [received]
PHST- 2021/07/05 00:00 [accepted]
PHST- 2021/09/27 06:21 [entrez]
PHST- 2021/09/28 06:00 [pubmed]
PHST- 2021/09/28 06:01 [medline]
PHST- 2021/08/13 00:00 [pmc-release]
AID - 10.1253/circrep.CR-21-0088 [doi]
PST - epublish
SO  - Circ Rep. 2021 Aug 13;3(9):511-519. doi: 10.1253/circrep.CR-21-0088. eCollection 
      2021 Sep 10.