کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5972433 | 1576192 | 2014 | 8 صفحه PDF | دانلود رایگان |
BackgroundRandomized controlled trials concerning pulmonary artery catheters (PACs) use have yielded little evidence of their beneficial effects on survival. This study aimed to evaluate the association between PACs and in-hospital mortality in patients with acute heart failure syndromes (AHFS).MethodsThe Acute Decompensated Heart Failure Syndromes (ATTEND) Registry is a prospective, observational, multicenter cohort study performed in Japan, since April 2007. We analyzed data from the ATTEND Registry and evaluated the effectiveness of PAC in AHFS treatment using propensity score-matching and the Cox proportional hazards model.ResultsFinal follow-up examinations of the 4842 patients were conducted in December 2012. During the study period, 813 patients (16.8%) were managed with PACs, of which 502 patients (PAC group) were propensity score-matched with 502 controls (Control group). Of the 1004 score-matched patients, 22 (4.4%) patients from the Control group and 7 (1.4%) from the PAC group died. The risk of all-cause death was lower in the PAC group than that in the Control group [hazard ratio (HR), 0.3; 95% confidence interval (CI), 0.13-0.70; p = 0.006]. PAC-guided therapy decreased all-cause mortality in patients with lower systolic blood pressure (SBP â¤Â 100 mm Hg; HR, 0.09; 95% CI, 0.01-0.70; p = 0.021) or inotropic therapy (HR, 0.22; 95% CI, 0.08-0.57; p = 0.002).ConclusionsThis study revealed that appropriate PAC use effectively decreases in-hospital mortality in AHFS patients, particularly those with lower SBP or receiving inotropic therapy, suggesting that real-world PAC use could improve AHFS management.
Journal: International Journal of Cardiology - Volume 172, Issue 1, 1 March 2014, Pages 165-172