Use of loop diuretics in patients with chronic heart failure: an observational overview.

Autor:	Scholte NT; Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands., Aydin D; Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands., Linssen GC; Department of Cardiology, Hospital Group Twente, Almelo, The Netherlands., Koudstaal S; Department of Cardiology, Groene Hart Hospital, Gouda, The Netherlands., Rademaker PC; Department of Cardiology, ZorgSaam, Terneuzen, The Netherlands., Geerlings PR; Department of Cardiology, St. Jans Gasthuis Weert, Weert, The Netherlands., van Gent MW; Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Aksoy I; Department of Cardiology, Admiraal De Ruyter Hospital, Goes, The Netherlands., Oosterom L; Department of Cardiology, Dijklander Hospital, Hoorn, The Netherlands., Boersma E; Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands., Brunner-La Rocca HP; Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands., Brugts JJ; Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands j.brugts@erasmusmc.nl.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2023 Nov 27; Vol. 10 (2). Date of Electronic Publication: 2023 Nov 27.
DOI:	10.1136/openhrt-2023-002497
Abstrakt:	Introduction: This study aimed to evaluate the use and dose of loop diuretics (LDs) across the entire ejection fraction (EF) spectrum in a large, 'real-world' cohort of chronic heart failure (HF) patients. Methods: A total of 10 366 patients with chronic HF from 34 Dutch outpatient HF clinics were analysed regarding diuretic use and diuretic dose. Data regarding daily diuretic dose were stratified by furosemide dose equivalent (FDE)>80 mg or ≤80 mg. Multivariable logistic regression models were used to assess the association between diuretic dose and clinical features. Results: In this cohort, 8512 (82.1%) patients used diuretics, of which 8179 (96.1%) used LDs. LD use was highest among HF with reduced EF (HFrEF) patients (81.1%) followed by HF with mild-reduced EF (76.1%) and HF with preserved ejection fraction EF (73.8%, p<0.001). Among all LDs users, the median FDE was 40 mg (IQR: 40-80). The results of the multivariable analysis showed that New York Heart Association classes III and IV and diabetes mellitus were one of the strongest determinants of an FDE >80 mg, across all HF categories. Renal impairment was associated with a higher FDE across the entire EF spectrum. Conclusion: In this large registry of real-world HF patients, LD use was highest among HFrEF patients. Advanced symptoms, diabetes mellitus and worse renal function were significantly associated with a higher diuretic dose regardless of left ventricular ejection fraction. Competing Interests: Competing interests: MvG has had speaker engagements with Abbott, Novartis and Vifor. H‐PB‐LR has received research grants and/or fees from AstraZeneca, Boehringer Ingelheim, Novartis, Roche Diagnostics and Vifor; and has had speaker engagements with Boehringer Ingelheim and Novartis. JJB received independent research grant from Abbott for ISS and has had speaker engagement or advisory boards in the past 5 years with Astra Zeneca, Abbott, Boehringer Ingelheim, Bayer, Daiichi Sankyo, Novartis and Vifor. All other authors declare to have no conflicts of interest. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu