Plasma Renin Activity Variation Following Admission Predicts Patient Outcome in Acute Decompensated Heart Failure with Reduced and Mildly Reduced Ejection Fraction

Overview

Journal Heliyon

Specialty Social Sciences

Date 2023 Feb 7

PMID 36747544

Authors

Kohei Azuma

Koichi Nishimura

Kyung-Duk Min

Kanae Takahashi

Yuki Matsumoto

Akiyo Eguchi

Yoshitaka Okuhara

Yoshiro Naito

Sinichiro Suna

Masanori Asakura

Masaharu Ishihara

Affiliations

Soon will be listed here.

Abstract

Purpose: Investigate the predictive impact of ΔPRA on the prognosis of ADHF patients with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF).

Methods: Retrospectively analyzed consecutive 116 HFrEF and HFmrEF patients admitted for ADHF. PRA measurements were acquired at admission and at discharge. The primary outcome was a composite of cardiovascular death and HF re-hospitalization.

Results: Out of 116 patients, 85 had PRA measurements both at admission and at discharge. Compared to admission, PRA level was significantly higher at discharge (0.8 (IQR 0.3-2.2) to 2.8 (IQR 1.0-7.2), p < 0.001). Tertiary groups ranked by PRA level on admission showed trend of poor prognosis in order of high, mid, and low PRA level (p = 0.07). On the contrary, PRA level at discharge significantly differentiated the prognosis and was poor in order of high, low, and mid (p = 0.026). Next, when the participants were divided into tertiary groups ranked by ΔPRA, prognosis worsened in the order of "minimal", "decreasing", and the "increasing" tier. Cubic splines analysis also indicate a similar tendency.

Conclusions: In ADHF patients with HFrEF and HFmrEF, patients with minimal ΔPRA showed the better prognosis over the those with either increasing or decreasing.

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