Development of circulatory-renal limitations to angiotensin-converting enzyme inhibitors identifies patients with severe heart failure and early mortality
Michelle Kittleson, MD*,
Shelley Hurwitz, PhD*,
Monica R. Shah, MD*,
Anju Nohria, MD*,
Eldrin Lewis, MD*,
Michael Givertz, MD, FACC*,
James Fang, MD, FACC*,
John Jarcho, MD, FACC*,
Gilbert Mudge, MD, FACC* and
Lynne W. Stevenson, MD, FACC*,*
* Departments of Medicine and Cardiology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
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Figure 1 Kaplan-Meier plot of survival without left ventricular assist device or transplant for 173 patients on angiotensin-converting enzyme inhibitors (ACEI), 45 patients with circulatory-renal limitations (CRLimit) not on intravenous (IV) inotropes, and 14 patients with CRLimit on IV inotropes. Patients on angiotensin-converting enzyme inhibitors had significantly longer survival time than patients with CRLimit (p < 0.0001). CRLimit patients who did not receive IV inotropes had significantly longer survival times than CRLimit patients who received IV inotropes (p = 0.002). The numbers of patients remaining at three-month intervals up to 24 months are noted on the plot.
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