Aims: To evaluate the impact of Angiotensin-Converting Enzyme Inhibitors (ACEIs)/
Angiotensin Receptors Blockers (ARBs) on in-hospital, 3- and 12-month all-cause mortality in Acute
Heart Failure (AHF) patients with left ventricular systolic dysfunction in 7 countries of the Middle East.
Methods and Results: Data was analysed from 2,683 consecutive patients admitted with AHF and
Left Ventricular Ejection Fraction (LVEF) (<40%) from 47 hospitals from February to November
2012. Analyses were evaluated using univariate and multivariate statistics. The overall mean age of the
cohort was 58±15, 72% (n=1,937) were males, 62% (n=1,651) had coronary artery disease, 57%
(n=1,539) were hypertensives and 47% (n=1,268) had diabetes. Overall cumulative mortality at inhospital,
3- and 12-month follow-up was 5.8% (n=155), 12.6% (n=338) and 20.4% (n=548), respectively.
Adjusting for demographic and clinical characteristics as well as medication in a multivariate
logistic regression model, ACEIs were associated with lower risk of in-hospital mortality (adjusted odds
ratio (aOR), 0.48; 95% Confidence Interval (CI): 0.25 to 0.94; p=0.031). At 3-month follow-up, both
ACEIs (aOR, 0.64; 95% CI: 0.43 to 0.95; p=0.025) and ARBs (aOR, 0.34; 95% CI: 0.18 to 0.62;
p<0.001) were associated with lower risk of mortality. Additionally, at 12-month follow-up, those prescribed
ACEIs (aOR, 0.71; 95% CI: 0.53 to 0.96; p=0.027) and ARBs (aOR, 0.47; 95% CI: 0.31 to 0.71;
p<0.001) were still associated with lower risk of mortality.
Conclusion: ACEIs and ARBs treatments were associated with lower mortality risk during admission
and up to 12-month of follow-up in Middle East AHF patients with left ventricular systolic dysfunction.