Τίτλος:
Effects of serelaxin in acute heart failure patients with renal impairment: results from RELAX-AHF
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Serelaxin showed beneficial effects on clinical outcome and trajectories of renal markers in patients with acute heart failure. We aimed to study the interaction between renal function and the treatment effect of serelaxin. Methods: In the current post hoc analysis of the RELAX-AHF trial, we included all patients with available estimated glomerular filtration rate (eGFR) at baseline (n = 1132). Renal impairment was defined as an eGFR <60 ml/min/1.73 m2 estimated by creatinine. Results: 817 (72.2 %) patients had a baseline eGFR <60 ml/min/1.73 m2. In placebo-treated patients, baseline renal impairment was related to a higher 180 day cardiovascular (HR 3.12, 95 % CI 1.33–7.30) and all-cause mortality (HR 2.81, 95 % CI 1.34–5.89). However, in serelaxin-treated patients, the risk of cardiovascular and all-cause mortality was less pronounced (HR 1.19, 95 % CI 0.54 –2.64; p for interaction = 0.106, and HR 1.15 95 % CI 0.56–2.34 respectively; p for interaction = 0.088). In patients with renal impairment, treatment with serelaxin resulted in a more pronounced all-cause mortality reduction (HR 0.53, 95 % CI 0.34–0.83), compared with patients without renal impairment (HR 1.30, 95 % CI 0.51–3.29). Conclusion: Renal dysfunction was associated with higher cardiovascular and all-cause mortality in placebo-treated patients, but not in serelaxin-treated patients. The observed reduction in (cardiovascular) mortality in RELAX-AHF was more pronounced in patients with renal dysfunction. These observations need to be confirmed in the ongoing RELAX-AHF-2 trial. © 2016, The Author(s).
Συγγραφείς:
Liu, L.C.Y.
Voors, A.A.
Teerlink, J.R.
Cotter, G.
Davison, B.A.
Felker, G.M.
Filippatos, G.
Chen, Y.
Greenberg, B.H.
Ponikowski, P.
Pang, P.S.
Prescott, M.F.
Hua, T.A.
Severin, T.M.
Metra, M.
Περιοδικό:
Clinical Research in Cardiology
Εκδότης:
Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
Λέξεις-κλειδιά:
creatinine; cystatin C; placebo; serelaxin; cardiovascular agent; recombinant protein; relaxin; serelaxin protein, human, acute heart failure; adult; Article; cardiovascular mortality; clinical trial; controlled study; disease severity; dyspnea; female; glomerulus filtration rate; human; kidney failure; major clinical study; male; numbers needed to treat; oliguria; proteinuria; uremia; acute disease; aged; complication; drug effects; heart failure; Kaplan Meier method; kidney; Kidney Diseases; middle aged; mortality; pathophysiology; randomized controlled trial (topic); retrospective study; time factor; treatment outcome; very elderly, Acute Disease; Aged; Aged, 80 and over; Cardiovascular Agents; Female; Glomerular Filtration Rate; Heart Failure; Humans; Kaplan-Meier Estimate; Kidney; Kidney Diseases; Male; Middle Aged; Randomized Controlled Trials as Topic; Recombinant Proteins; Relaxin; Retrospective Studies; Time Factors; Treatment Outcome
DOI:
10.1007/s00392-016-0979-8
