Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia
Background The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or...
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| Format: | Article |
| Language: | English |
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Wiley
2020-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.013982 |
| _version_ | 1811332128814661632 |
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| author | Yu Sato Akiomi Yoshihisa Yu Hotsuki Koichiro Watanabe Yusuke Kimishima Takatoyo Kiko Yuki Kanno Tetsuro Yokokawa Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi |
| author_facet | Yu Sato Akiomi Yoshihisa Yu Hotsuki Koichiro Watanabe Yusuke Kimishima Takatoyo Kiko Yuki Kanno Tetsuro Yokokawa Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi |
| author_sort | Yu Sato |
| collection | DOAJ |
| description | Background The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or Z‐drugs (zolpidem, zopiclone, or eszopiclone), were enrolled and divided on the basis of their hypnotics: benzodiazepine group (n=488 [59.1%]) and Z group (n=338 [40.9%]). We compared the patient characteristics and postdischarge prognosis between the groups. The primary end points were rehospitalization for HF and cardiac death. The benzodiazepine group was older (age, 72.0 versus 69.0 years; P=0.010), had a higher prevalence of depression (17.4% versus 8.9%; P<0.001), and showed a higher use of loop diuretics (77.9% versus 67.8%; P=0.001). In the laboratory data, the benzodiazepine group demonstrated lower levels of hemoglobin (12.3 versus 13.0 g/dL; P=0.001), sodium (139.0 versus 140.0 mEq/L; P=0.018), and albumin (3.7 versus 3.9 g/dL; P=0.003). Kaplan‐Meier analysis showed that both end points were higher in the benzodiazepine group (rehospitalization for HF, log‐rank P=0.001; cardiac death, log‐rank P=0.043). Multiple Cox proportional hazard analysis revealed that the use of benzodiazepines was an independent predictor of rehospitalization for HF (hazard ratio, 1.530; 95% CI, 1.025–2.284; P=0.038). Furthermore, rehospitalization for HF was higher in the benzodiazepine group after propensity score matching (log‐rank P=0.036). Conclusions Benzodiazepine is associated with higher risk of rehospitalization for HF compared with Z‐drugs in patients with HF. |
| first_indexed | 2024-04-13T16:31:10Z |
| format | Article |
| id | doaj.art-29f74fad316d47259f9bbb028e8174b0 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:31:10Z |
| publishDate | 2020-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-29f74fad316d47259f9bbb028e8174b02022-12-22T02:39:33ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-04-019710.1161/JAHA.119.013982Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With InsomniaYu Sato0Akiomi Yoshihisa1Yu Hotsuki2Koichiro Watanabe3Yusuke Kimishima4Takatoyo Kiko5Yuki Kanno6Tetsuro Yokokawa7Satoshi Abe8Tomofumi Misaka9Takamasa Sato10Masayoshi Oikawa11Atsushi Kobayashi12Takayoshi Yamaki13Hiroyuki Kunii14Kazuhiko Nakazato15Takafumi Ishida16Yasuchika Takeishi17Department of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanBackground The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or Z‐drugs (zolpidem, zopiclone, or eszopiclone), were enrolled and divided on the basis of their hypnotics: benzodiazepine group (n=488 [59.1%]) and Z group (n=338 [40.9%]). We compared the patient characteristics and postdischarge prognosis between the groups. The primary end points were rehospitalization for HF and cardiac death. The benzodiazepine group was older (age, 72.0 versus 69.0 years; P=0.010), had a higher prevalence of depression (17.4% versus 8.9%; P<0.001), and showed a higher use of loop diuretics (77.9% versus 67.8%; P=0.001). In the laboratory data, the benzodiazepine group demonstrated lower levels of hemoglobin (12.3 versus 13.0 g/dL; P=0.001), sodium (139.0 versus 140.0 mEq/L; P=0.018), and albumin (3.7 versus 3.9 g/dL; P=0.003). Kaplan‐Meier analysis showed that both end points were higher in the benzodiazepine group (rehospitalization for HF, log‐rank P=0.001; cardiac death, log‐rank P=0.043). Multiple Cox proportional hazard analysis revealed that the use of benzodiazepines was an independent predictor of rehospitalization for HF (hazard ratio, 1.530; 95% CI, 1.025–2.284; P=0.038). Furthermore, rehospitalization for HF was higher in the benzodiazepine group after propensity score matching (log‐rank P=0.036). Conclusions Benzodiazepine is associated with higher risk of rehospitalization for HF compared with Z‐drugs in patients with HF.https://www.ahajournals.org/doi/10.1161/JAHA.119.013982benzodiazepineheart failureprognosisZ‐drugs |
| spellingShingle | Yu Sato Akiomi Yoshihisa Yu Hotsuki Koichiro Watanabe Yusuke Kimishima Takatoyo Kiko Yuki Kanno Tetsuro Yokokawa Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease benzodiazepine heart failure prognosis Z‐drugs |
| title | Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia |
| title_full | Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia |
| title_fullStr | Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia |
| title_full_unstemmed | Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia |
| title_short | Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia |
| title_sort | associations of benzodiazepine with adverse prognosis in heart failure patients with insomnia |
| topic | benzodiazepine heart failure prognosis Z‐drugs |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.013982 |
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