Mode of death in patients with heart failure and a preserved ejection fraction: results from the Irbesartan in Heart Failure With Preserved Ejection Fraction Study (I-Preserve) trial.
BACKGROUND
The mode of death has been well characterized in patients with heart failure and a reduced ejection fraction; however, less is known about the mode of death in patients with heart failure and a preserved ejection fraction (HFPEF). The purpose of this study was to examine the mode of death in patients with HFPEF enrolled in the Irbesartan in Heart Failure With Preserved Ejection Fraction Study (I-Preserve) trial and to determine whether irbesartan altered the distribution of mode of death in HFPEF.


RESULTS
All deaths were reviewed by a clinical end-point committee, and the mode of death was assigned by consensus of the members. The annual mortality rate was 5.2% in the I-Preserve trial. There were no significant differences in mortality rate between the placebo and irbesartan groups. The mode of death was cardiovascular in 60% (including 26% sudden, 14% heart failure, 5% myocardial infarction, and 9% stroke), noncardiovascular in 30%, and unknown in 10%. There were no differences in the distribution of mode-specific mortality rates between placebo and irbesartan.


CONCLUSIONS
Sixty percent of the deaths in patients with HFPEF were cardiovascular, with sudden death and heart failure death being the most common. Treatment with irbesartan did not affect overall mortality or the distribution of mode-specific mortality rates.


BACKGROUND
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00095238.
Zile
Michael R
MR
RHJ Department of Veterans Affairs Medical Center and Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC 29425, USA. zilem@musc.edu
Gaasch
William H
WH
Anand
Inder S
IS
Haass
Markus
M
Little
William C
WC
Miller
Alan B
AB
Lopez-Sendon
Jose
J
Teerlink
John R
JR
White
Michel
M
McMurray
John J
JJ
Komajda
Michel
M
McKelvie
Robert
R
Ptaszynska
Agata
A
Hetzel
Scott J
SJ
Massie
Barry M
BM
Carson
Peter E
PE
D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds / Q000494:pharmacology / Q000627:therapeutic use; D002423:Cause of Death; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D000077405:Irbesartan; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects*; D016019:Survival Analysis; D015996:Survival Rate; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan