Abstract

BackgroundThis analysis was designed to investigate the relationship between drug application and mortality rate in Chinese older coronary artery disease (CAD)/chronic heart failure (CHF) patients with and without low glomerular filtration rate (GFR).MethodsAll 1050 Chinese hospitalized patients with diagnosed CAD were included in this analysis, and Cox Regression was used to analyze the relationship between drug application and mortality rate after multivariate adjustment. Low GFR was defined as GFR < 60 ml/min/1.73m2.ResultsThere were 372 patients (35.4%) with low GFR in patients with CAD (1050 patients), and 168 patients (51.4%) in patients with CHF (327 patients). In CAD patients without low GFR, clopidogrel [P = 0.028, odds ratio (OR): 0.620, 95% confidence interval (CI): 0.404–0.951] rather than aspirin (P = 0.173) was significantly associated with lower mortality rate. Statins (P < 0.001, OR: 0.287, 95% CI: 0.180–0.456) were significantly associated with lower mortality rate. In CAD patients with low GFR, aspirin, clopidogrel and statins had no significant relationship with mortality rate (P > 0.05 for all). In CHF patients without low GFR, statins were significantly associated with lower mortality rate (P < 0.001, OR: 0.220, 95% CI: 0.098–0.490). In CHF patients with low GFR, statins had no significant relationship with mortality rate (P > 0.05 for all).ConclusionClopidogrel but not aspirin was beneficial in Chinese older CAD patients without low GFR rather than those with low GFR, and statins benefited for Chinese older CAD/CHF patients without low GFR rather than those with low GFR. These discoveries might offer some help for the therapy of Chinese older patients with cardiovascular/renal diseases.

Highlights

  • This analysis was designed to investigate the relationship between drug application and mortality rate in Chinese older coronary artery disease (CAD)/chronic heart failure (CHF) patients with and without low glomerular filtration rate (GFR)

  • Except calcium channel blockers (CCBs) (P < 0.05), there was no difference in utilization ratios of other drugs between these patients with and without low GFR (P > 0.05 for all)

  • Beta-blockers, CCBs and nitrates had no significant relationship with survival time and mortality rate (P > 0.05 for all)

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Summary

Introduction

This analysis was designed to investigate the relationship between drug application and mortality rate in Chinese older coronary artery disease (CAD)/chronic heart failure (CHF) patients with and without low glomerular filtration rate (GFR). Renal function decline significantly accelerates disease progression, intensively increase mortality rate and severely complicate prognostic effects in older patients with CAD/CHF [1]. Drugs, such as anti-platelet drugs, beta-blockers, calcium channel blockers (CCBs), nitrates, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs), statins and digoxin, have gained widespread acceptance as the principal therapies for CAD/CHF [2, 3]. As a retrospective review of medical records, the goal of this analysis was to investigate the relationship between drug application and mortality rate in Chinese older CAD/CHF patients with and without low glomerular filtration rate (GFR)

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