SHORT-TERM OUTCOME IN CHRONIC HEART FAILURE WITH THE ADDITION OF HYDRALAZINEISOSORBIDE TO STANDARD ANTI-FAILURE THERAPY- A PROSPECTIVE COMPARISON
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 33
Abstract
BACKGROUND In spite of improvements in the clinical management of patients with Heart Failure (HF), hospitalisation rates remain high. HF accounts for nearly 3% of the total healthcare expenditure and these costs are on the rise. We assess the effect of the fixed-dose combination of isosorbide dinitrate and hydralazine on the 60-day all-cause readmission rates in subjects who were discharged alive from their first hospitalisation. The aim of this study was to see 60 days’ outcome of Chronic Heart Failure patients on optimal anti-failure therapy in NYHA III and IV classes on addition of Hydralazine plus Nitrates (H + ISDN) and to compare it with patients without them. MATERIALS AND METHODS This prospective cohort study was undertaken at Department of Cardiology, KMC, Mangalore, affiliated to Manipal University, Manipal. Chronic Heart Failure patients in NYHA class III and IV and patients on conventional Heart Failure therapy including Diuretics and ACE inhibitors were included in this study. The study period extended from 1st May 2015 to 30th April 2016. RESULTS The mean age of an overall study population was found to be 60.26 ± 11.41. Eighty subjects who were on treatment for chronic heart failure were followed up for a period of one month. From the cohort of 80 subjects, patients started on hydralazine plus nitrates formed one arm (n= 40) and those who were being managed without them but on conventional anti-failure therapy formed the other arm (n= 40). In the hydralazine plus nitrates arm, a significant difference in mean heart rate (p= 0.010), JVP (p < 0.001), respiratory rate (p= 0.002), EDD (p= 0.010) and ESD (p= 0.007) was observed on admission and follow-up in one month. CONCLUSION In conclusion, we would recommend H + ISDN as a promising combianation, since it has shown numerically evident symptom improvement; substantial reduction in 60 days mortality and reduction in hospital readmissions.
Authors and Affiliations
Narasimha Pai D, Shiji Thomas, Syed Waleem Pasha, K. Padmanabha Kamath, R. L. Kamath, Chaithra Nayak, Francis N. P. Monteiro
Keywords
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- EP ID EP541666
- DOI 10.14260/jemds/2018/823
- Views 60
- Downloads 0
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