title: Inotropic agents use in patients hospitalized with acute decompensated heart failure: a retrospective analysis from a 22-year registry in a Middle-Eastern Country (1991-2013).
abstract: BACKGROUND
  Data about the use of positive inotropic agents in patients hospitalized with acute decompensated heart failure (ADHF) is limited.
  
  
  METHODS
  The records of 8066 patients with ADHF who were hospitalized at Hamad Medical Corporation, Qatar from 1991 to 2013 were analyzed to explore demographics and clinical characteristics of the patients according to inotropic agents use.
  
  
  RESULTS
  Eight hundred fifty eight patients [10.6%, 95% CI (10 to 11.3%)] received intravenous inotropic support. Patients receiving inotropes were more likely to be female and have preserved ejection fraction when compared to those not receiving inotropic agents. Comorbidities associated with higher likelihood of receiving inotropic treatment included acute myocardial infarction, chronic renal impairment, dyslipidemia, hypertension, obesity and hyperglycemia. Patient on inotropes were more likely to undergone percutaneous coronary intervention (PCI), intra-aortic balloon pump support and intubation. There were no differences in the mean plasma BNP and CK-MB levels between the 2 groups. Heart failure patients receiving inotropes also were more likely to have complications including ventricular tachycardia (2.0% vs. 0.9%, p = 0.003), prolonged hospital stay (8.0 vs. 5.0 days, p = 0.001), cardiac arrest (14.6% vs. 3.2%, p = 0.001) and in-hospital mortality (30.8% vs. 9.1 %, p = 0.001). Over the study period there was an increase use of inotropic agents and decreased mortality rates.
  
  
  CONCLUSIONS
  Inotropic use increased over the period whereas; female gender and conventional cardiac risk factors were predictors of inotropic agents use in the study.
authors.affiliation: Department of Clinical Pharmacology, Heart Hospital, Hamad Medical Corporation, P.O Box 3050, Doha, Qatar.
authors.forename: Amer H S
authors.initials: AHS
authors.lastname: Aljundi
authors.affiliation: Department of Clinical Pharmacology, Heart Hospital, Hamad Medical Corporation, P.O Box 3050, Doha, Qatar.
authors.forename: Shaban F K
authors.initials: SFK
authors.lastname: Mohammed
authors.affiliation: Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Patel
authors.affiliation: Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.affiliation: Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Arabi
authors.affiliation: Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Hajar A
authors.initials: HA
authors.lastname: AlBinali
authors.affiliation: Department of Clinical Pharmacology, Heart Hospital, Hamad Medical Corporation, P.O Box 3050, Doha, Qatar. jalsuwaidi@hotmail.com.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D015897:Comorbidity; D052279:Creatine Kinase, MB Form / Q000097:blood; D018450:Disease Progression; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology*; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007423:Intra-Aortic Balloon Pumping / Q000706:statistics & numerical data; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009765:Obesity / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data; D011158:Population Growth; D011780:Qatar / Q000453:epidemiology; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012121:Respiration, Artificial; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000453:epidemiology*
chemical_list: D002316:Cardiotonic Agents; D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form