{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:43:57Z","timestamp":1790912637445,"version":"4.1.0"},"reference-count":20,"publisher":"S. Karger AG","issue":"5-6","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiorenal Med"],"published-print":{"date-parts":[[2021]]},"abstract":"<b><i>Objective:<\/i><\/b> The aim of the study was to determine patterns and predictors of utilization of angiotensin-converting enzyme inhibitors\/angiotensin receptor blockers (ACEI\/ARBs) in patients with acute heart failure (AHF) and changes in kidney function at admission, hospitalization, and discharge in relation to clinical outcomes. <b><i>Methods:<\/i><\/b> This retrospective analysis of the Veterans\u2019 Health Administration data (2016) included patients with heart failure (HF) with reduced ejection fraction who were hospitalized. Patients with an estimated glomerular filtration &#x3c;15 cm<sup>3<\/sup>\/min\/1.73 m<sup>2<\/sup> and those on dialysis were excluded. Patients were categorized based on the use of ACEI\/ARB as continued, initiated, discontinued, or no therapy. Multivariable logistic regression evaluated predictors of being discharged home on an ACEI\/ARB. Cox regression analysis evaluated outcomes (30 and 180-day mortality\/HF readmissions). <b><i>Results:<\/i><\/b> 3,652 patients were included, of which 37% of patients hospitalized for AHF had ACEI\/ARB discontinued on admission, or not initiated. After adjusting for age, blood pressure, and serum potassium, a per-unit increase in admission serum creatinine (SCr) was independently associated with lower rates of continuation or initiation of ACEI\/ARB odds ratio 0.51 95% confidence interval (CI) (0.46\u20130.57). Discharge on ACEI\/ARB was independently associated with lower odds of 30- and 180-day mortality hazard ratio (HR) 0.36 95% CI (0.25\u20130.52), and HR 0.23 95% CI (0.19\u20130.27), respectively. <b><i>Conclusion:<\/i><\/b> Higher SCr at admission is an important determinant of ACEI\/ARB being discontinued or withheld in patients admitted with AHF. ACEI\/ARB at discharge was associated with lower mortality in patients with AHF. <\/jats:p>","DOI":"10.1159\/000519014","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T21:06:15Z","timestamp":1633122375000},"page":"226-236","source":"Crossref","is-referenced-by-count":10,"title":["Patterns of Use and Clinical Outcomes with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Acute Heart Failure and Changes in Kidney Function: An Analysis of the Veterans\u2019 Health Administrative Database"],"prefix":"10.1159","volume":"11","author":[{"given":"Roy O.","family":"Mathew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Bryan","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padmavathi","family":"Tipparaju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3622-5725","authenticated-orcid":false,"given":"Evan","family":"Phelps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S.","family":"Sidhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sripal","family":"Bangalore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Herzog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.H. Wilson","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janani","family":"Rangaswami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9149(88)80087-0"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250501"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000504167"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004675"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.06.727"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.02.322"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.09.012"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1369"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.08.017"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000664"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)91194-9"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.05.047"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004644"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.07.019"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.030112"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/cc12503"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e3283629ca6"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1159\/000457946"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2016.05.008"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2146"}],"container-title":["Cardiorenal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/519014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/519014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:21:26Z","timestamp":1745421686000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000519014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":20,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2021,12,13]]},"published-print":{"date-parts":[[2021,12,16]]}},"URL":"https:\/\/doi.org\/10.1159\/000519014","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.16715611","asserted-by":"subject"}]},"ISSN":["1664-3828","1664-5502"],"issn-type":[{"value":"1664-3828","type":"print"},{"value":"1664-5502","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]}}}