title: Calcium channel blockers and outcomes in older patients with heart failure and preserved ejection fraction.
abstract: BACKGROUND
  Little is known about associations of calcium channel blockers (CCBs) with outcomes in patients with heart failure and preserved ejection fraction (EF).
  
  
  RESULTS
  Of the 10 570 hospitalized patients with heart failure and preserved EF, ≥65 years, EF ≥40%, in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF; 2003-2004), linked to Medicare data (through December 31, 2008), 7514 had no prior history of CCB use. Of these, 815 (11%) patients received new discharge prescriptions for CCBs. Propensity scores for CCB initiation, calculated for each of the 7514 patients, were used to assemble a matched cohort of 1620 (810 pairs) patients (mean age, 80 years; mean EF, 56%; 65% women; 10% black) receiving and not receiving CCBs, balanced on 114 baseline characteristics. The primary composite end point of all-cause mortality or heart failure hospitalization occurred in 82% and 81% of patients receiving and not receiving CCBs (hazard ratio for CCBs, 1.03; 95% confidence interval, 0.92-1.14). Hazard ratios (95% confidence intervals) for all-cause mortality, heart failure hospitalization, and all-cause hospitalization were 1.05 (0.94-1.18), 1.05 (0.91-1.21), and 1.03 (0.93-1.14), respectively. Similar associations were observed when we categorized patients into those receiving amlodipine and nonamlodipine CCBs. Among 7514 prematch patients, multivariable-adjusted and propensity-adjusted hazard ratios (95% confidence interval) for primary composite end point were 1.03 (0.95-1.12) and 1.02 (0.94-1.11), respectively.
  
  
  CONCLUSIONS
  In hospitalized older patients with heart failure, new discharge prescriptions for CCBs had no associations with composite or individual end points of mortality or heart failure hospitalization, regardless of the class of CCBs.
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Kanan
authors.initials: K
authors.lastname: Patel
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Momanna
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Charity
authors.initials: C
authors.lastname: Morgan
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Meredith
authors.initials: M
authors.lastname: Kilgore
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Love
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Prakash
authors.initials: P
authors.lastname: Deedwania
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: From the Department of Medicine, University of California, San Francisco (K.P.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Comprehensive Center for Healthy Aging (M.A.), Department of Biostatistics (C.M.) and Department of Health Care Organization and Policy (M.K.), School of Public Health, University of Alabama at Birmingham (M.A., C.M., M.K.); Department of Medicine, Case Western Reserve University, Cleveland, OH (T.E.L.); Department of Medicine, University of California, San Francisco, Fresno (P.D.); Department of Medicine, New York Medical College, Valhalla, NY (W.S.A.); Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany (S.D.A.); Center for Health and Aging, Veterans Affairs Medical Center, Washington, DC (A.A.). aliahmedmdmph@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D057216:Propensity Score; D013318:Stroke Volume; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers
keywords: calcium channel blockers; heart failure