Effect of hypermultidrug therapy on the prognosis of patients with ejection fraction preserved heart failure

YU Hai-zhong; DOU Zeng-hua; LI Hu-ye; MA Zhan-qing; XIA Wen-ying

doi:10.3969/j.issn.1672-5301.2024.05.012

Abstract：Objective To investigate the relationship between multi drug therapy and the prognosis of patients with heart failure with preserved ejection fraction(HFpEF).Methods The past medication status of patients was obtained through electronic medical records.The patients were divided into 3 groups according to the number of drugs used:group 1 was patients who used<5 drugs;Group 2 was treated with 5-9 drugs;Group 3 was the patients with≥10 drugs.The baseline data of the three groups and the status of cardiovascular disease death,all-cause death,HF hospitalization,cardiovascular disease hospitalization and all cause hospitalization during the follow-up period were compared and analyzed.Results Among 1038 patients with HFpEF,7.32%were treated with less than 5 drugs;36.51%of the patients were treated with 5-9 drugs;56.17%of the patients were treated with more than 10 drugs.The group 2 and group 3(i.e.treated with more drugs)led to the increase of all cause hospitalization rate,which was an adverse/risk factor(P<0.05,OR were 1.229 and 1.342 respectively).The low hemoglobin,high LHFQ score and more comorbidities were the risk factors of multi drug therapy in HFpEF patients(P<0.05,OR were 1.289,1.273,1.604,2.105,respectively);Clinical physician management was a protective factor for multi drug treatment in HFpEF patients(P<0.05,OR=0.729).Older age,New York Heart Association(NYHA)≥Grade Ⅲ,hyperlipidemia,diabetes,history of myocardial infarction,left ventricular ejection fraction<50%,and drug use≥5 were risk factors for all-cause hospitalization of HFpEF patients(P<0.05,OR were 1.829,2.045,1.991,1.674,2.176,1.733,respectively);application β Receptor blockers were a protective factor for all-cause hospitalization in HFpEF patients(P<0.05,OR=0.806).Conclusion Hypermultidrug therapy is very common in HFpEF patients and is associated with an increased risk of hospitalization and any serious adverse events,but does not affect mortality.