Prognostic Effect of the Dose of Loop Diuretic Over 5 Years in Chronic Heart Failure
Copyright © 2017 Elsevier Inc. All rights reserved..
BACKGROUND: High diuretic doses in chronic heart failure (HF) are potentially deleterious. We assessed the effect of dynamic furosemide dose on all-cause mortality among HF ambulatory patients.
METHODS AND RESULTS: A cohort of 560 ambulatory patients from an outpatient clinic specialized in HF, with median age 70 years, 67% male, and 89% with moderate-severely reduced ejection fraction, was retrospectively followed for up to 5 years. Dynamic furosamide exposure was categorized as low (0-59 mg/d), medium (60-119 mg/d), high (120-159 mg/d), and very high (≥160 mg/d). Extended Cox models were used to estimate the association between time-varying diuretic dose and mortality. A dose-dependent crude association between higher doses of furosemide and death (hazard ratio [HR] = 1.34, 95% confidence interval (CI): 1.06-2.16; HR = 2.09, 95% CI: 1.54-2.84, for high and very high dose, respectively) was totally explained by patients' characteristics and disease severity indicators (adjusted HR = 0.94, 95% CI: 0.63-1.38; HR = 1.10, 95% CI: 0.79-1.55, for high and very high dose, respectively).
CONCLUSION: In this context, higher doses of diuretic did not impair survival, but rather indicated greater severity of the patient's condition.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
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| Enthalten in: |
Journal of cardiac failure - 23(2017), 8 vom: 10. Aug., Seite 589-593 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Laszczyńska, Olga [VerfasserIn] |
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| Links: |
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| Themen: |
7LXU5N7ZO5 |
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| Anmerkungen: |
Date Completed 09.07.2018 Date Revised 09.07.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cardfail.2017.04.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM270785183 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: High diuretic doses in chronic heart failure (HF) are potentially deleterious. We assessed the effect of dynamic furosemide dose on all-cause mortality among HF ambulatory patients | ||
| 520 | |a METHODS AND RESULTS: A cohort of 560 ambulatory patients from an outpatient clinic specialized in HF, with median age 70 years, 67% male, and 89% with moderate-severely reduced ejection fraction, was retrospectively followed for up to 5 years. Dynamic furosamide exposure was categorized as low (0-59 mg/d), medium (60-119 mg/d), high (120-159 mg/d), and very high (≥160 mg/d). Extended Cox models were used to estimate the association between time-varying diuretic dose and mortality. A dose-dependent crude association between higher doses of furosemide and death (hazard ratio [HR] = 1.34, 95% confidence interval (CI): 1.06-2.16; HR = 2.09, 95% CI: 1.54-2.84, for high and very high dose, respectively) was totally explained by patients' characteristics and disease severity indicators (adjusted HR = 0.94, 95% CI: 0.63-1.38; HR = 1.10, 95% CI: 0.79-1.55, for high and very high dose, respectively) | ||
| 520 | |a CONCLUSION: In this context, higher doses of diuretic did not impair survival, but rather indicated greater severity of the patient's condition | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a dose | |
| 650 | 4 | |a loop diuretics | |
| 650 | 4 | |a prognosis | |
| 650 | 7 | |a Diuretics |2 NLM | |
| 650 | 7 | |a Sodium Potassium Chloride Symporter Inhibitors |2 NLM | |
| 650 | 7 | |a Furosemide |2 NLM | |
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| 700 | 1 | |a Severo, Milton |e verfasserin |4 aut | |
| 700 | 1 | |a Friões, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Lourenço, Patrícia |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Sérgio |e verfasserin |4 aut | |
| 700 | 1 | |a Bettencourt, Paulo |e verfasserin |4 aut | |
| 700 | 1 | |a Lunet, Nuno |e verfasserin |4 aut | |
| 700 | 1 | |a Azevedo, Ana |e verfasserin |4 aut | |
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