Worsening renal function in acute heart failure in the context of diuretic response
| Autor: | Michael M. Givertz, Marco Metra, Thomas Severin, Iziah E Sama, Barry H. Greenberg, Johanna E. Emmens, Yuya Matsue, Sylwia M. Figarska, Jozine M. ter Maaten, Gad Cotter, John R. Teerlink, B. Davison, Claudio Gimpelewicz, John G.F. Cleland, Adriaan A. Voors, G. Michael Felker, Peter S. Pang |
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| Přispěvatelé: | Cardiovascular Centre (CVC) |
| Rok vydání: | 2021 |
| Předmět: |
Kidney Disease
medicine.medical_treatment Left Worsening renal function AN ANALYSIS Cardiorespiratory Medicine and Haematology Cardiovascular Kidney THERAPY Ventricular Function Left CONGESTION chemistry.chemical_compound Ventricular Function Diuretics OUTCOMES Ejection fraction Furosemide Heart Disease HOSPITALIZATION Acute Disease Cardiology Cardiology and Cardiovascular Medicine medicine.drug medicine.medical_specialty STRATEGIES Decongestion Renal function Diuresis Context (language use) Outcomes Clinical Research Internal medicine medicine Humans HEMOCONCENTRATION Diuretic response ANTAGONIST Heart Failure Creatinine business.industry Acute heart failure Stroke Volume medicine.disease ROLOFYLLINE Cardiovascular System & Hematology chemistry Heart failure Diuretic business |
| Zdroj: | European Journal of Heart Failure, 365-374. Wiley STARTPAGE=365;ENDPAGE=374;ISSN=1388-9842;TITLE=European Journal of Heart Failure European journal of heart failure, vol 24, iss 2 |
| ISSN: | 1879-0844 1388-9842 |
| Popis: | BackgroundFor patients with acute heart failure (AHF), substantial diuresis after administration of loop diuretics is generally associated with better clinical outcomes but may cause creatinine to rise, suggesting renal function decline. We investigated the interaction between diuretic response and worsening renal function (WRF) on clinical outcomes in patients with AHF.Methods and resultsIn two AHF cohorts (PROTECT, n= 1698 and RELAX-AHF-2, n= 5586 in current analysis), the prognostic impact of WRF (creatinine ≥0.3mg/dl increase baseline-day 4; sensitivity analyses incorporated baseline renal function) by diuretic response (kg weight loss/40 mg furosemide equivalent baseline-day 4) was investigated with regard to (cardiovascular) death or cardiovascular/renal hospitalization using subpopulation treatment effect pattern plots (STEPP) and survival analyses. WRF occurred in 286 (16.8%) and 1031 (18.5%) patients in PROTECT and RELAX-AHF-2, respectively. Patients with WRF had higher left ventricular ejection fraction and lower estimated glomerular filtration rate at baseline (p |
| Databáze: | OpenAIRE |
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