{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:40:16Z","timestamp":1761975616560,"version":"3.40.4"},"reference-count":23,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>Objectives: Patients with heart failure (HF) and reduced left-ventricular ejection fraction (LVEF) benefit from angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) therapy. While dose reduction\/discontinuation (r\/d) of \u03b2-blockers (BB) and furosemide in acute decompensated HF (ADHF) worsen outcomes, data on ACEI\/ARB are lacking. Methods: To determine the frequency and reasons for ACEI\/ARB therapy r\/d in ADHF patients, we studied 174 patients with LVEF &lt;40% on ACEI\/ARB and BB therapy upon admission over 1 year. Results: ACEI\/ARB doses were r\/d in 17.2% because of acute kidney injury (56.7%), hypotension (23.3%), and hyperkalemia (10%). Clinical characteristics were similar between patients with r\/d and continued therapy. Admission and discharge creatinine (Cr) levels were higher in the r\/d group. On multivariate analysis, admission Cr and admission systolic blood pressures were independent predictors of r\/d. Among patients with renal dysfunction cited as the r\/d reason, Cr did not significantly rise in 23.5%. The r\/d group had a longer length of stay (LOS). Conclusions: ACEI\/ARB dose is reduced and\/or discontinued in nearly one-fifth of all ADHF admissions, and LOS is longer in the ACEI\/ARB r\/d group. While impaired renal function is the most frequently cited reason, nearly one-fourth of the patients had stable renal function. ACEI\/ARB r\/d therapy in the setting of ADHF merits further study.<\/jats:p>","DOI":"10.1159\/000457946","type":"journal-article","created":{"date-parts":[[2017,4,3]],"date-time":"2017-04-03T21:18:48Z","timestamp":1491254328000},"page":"121-125","source":"Crossref","is-referenced-by-count":28,"title":["Discontinuation\/Dose Reduction of Angiotensin-Converting Enzyme Inhibitors\/Angiotensin Receptor Blockers during Acute Decompensated Heart Failure in African-American Patients with Reduced Left-Ventricular Ejection Fraction"],"prefix":"10.1159","volume":"137","author":[{"given":"Jesse A.","family":"Kane","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph K.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Abbas","family":"Haidry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Salciccioli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Lazar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2017,4,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706043162301"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250501"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1998.1098"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14284-5"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.885210"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.03.008"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016637385"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.04.026"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.04.009"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.06.030"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.02.349"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.03.011"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.11.084"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1159\/000347037"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.10.013"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.12.015"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.04.162"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.11.037"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520420066040"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105033441802"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000091"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8776"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2016.02.008"}],"container-title":["Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/457946","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/crd\/article-pdf\/137\/2\/121\/3895797\/000457946.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/crd\/article-pdf\/137\/2\/121\/3895797\/000457946.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:32:58Z","timestamp":1745429578000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000457946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,5,11]]},"published-print":{"date-parts":[[2017,2,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000457946","archive":["Portico"],"relation":{},"ISSN":["0008-6312","1421-9751"],"issn-type":[{"type":"print","value":"0008-6312"},{"type":"electronic","value":"1421-9751"}],"subject":[],"published":{"date-parts":[[2017]]}}}