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- ACEI, angiotensin-converting enzyme inhibitors
- CHF, congestive heart failure
- CRI, chronic renal impairment
- GFR, glomerular filtration rate
- LVEF, left ventricular ejection fraction
Over the past three decades, there has been rapid progress in the diagnosis and management of patients with chronic congestive heart failure (CHF). However, the mortality from CHF remains high, partly due to comorbidity, the very existence of which may have excluded some patients from previous large-scale clinical trials. Hence, the full effect of modern treatment on non-trial “real life” patients with CHF in clinical practice remains uncertain.
Chronic renal impairment (CRI) and anaemia are common comorbidities associated with CHF, and are both independent predictors of poor prognosis.1 It has previously been shown that treatment with either angiotensin-converting enzyme inhibitors (ACEI) or β blockers improves prognosis in patients with CHF with or without CRI.2,3 Among the most recent treatments of CHF, ACEIs are potentially nephrotoxic and may cause worsening of anaemia.3 Thus, the relationship between treatment and outcome in patients with CHF with CRI and anaemia needs further investigation. We aimed to assess the effect of β blocker treatment on renal function and anaemia in consecutive ambulatory patients with CHF in routine clinical practice.
A retrospective case study of 134 consecutive patients (alive at the time of analysis) with stable CHF, attending our heart failure clinic between 2002 and 2004, was conducted. Serum creatinine and haemoglobin levels checked …