• J. Cardiovasc. Pharmacol. Ther. · Jun 2011

    Prognostic implications of diuretic dose in chronic heart failure.

    • João Martins, Patrícia Lourenço, José Paulo Araújo, Joana Mascarenhas, Ricardo Lopes, Ana Azevedo, and Paulo Bettencourt.
    • Heart Failure Clinic, Serviço de Medicina Interna-Hospital S. João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Portugal.
    • J. Cardiovasc. Pharmacol. Ther. 2011 Jun 1; 16 (2): 185-91.

    BackgroundPrognostic implications of diuretics dose are not completely understood. We aim to study the association between diuretic doses and long-term prognosis in patients with chronic stable heart failure (HF).Methods And ResultsWe conducted a retrospective cohort study of 244 patients followed at an outpatient HF clinic. Admission criteria were clinical stability in the previous 3 months and optimized medical therapy. Demographic characteristics, clinical, and laboratory parameters were recorded. Patients were followed for 2 years and the outcome was defined as all-cause death or hospital admission due to HF worsening. Patients on ≤ 80 mg furosemide were compared with those on higher doses. Patients were grouped according to furosemide dose (≤ 80 mg and >80 mg/d) and according to volemia as assessed by the sodium retention score: <3 (euvolemia) versus ≥ 3 (hypervolemia). Patients on higher diuretic doses (n = 79) were older, more hypervolemic, and more symptomatic. Patients on >80 mg furosemide had a higher risk of death or hospital admission (hazard ratio [HR]: 2.07, 95% confidence interval [CI]: 1.37-3.1). For each 40-mg furosemide tablet, there was a 67% increase in risk of an adverse outcome within 2 years. The increase in risk was independent of other variables crudely associated with prognosis. Among euvolemic patients, those on ≤ 80 mg/d furosemide performed better than those on higher doses. Among hypervolemic patients, the diuretic dose had no prognostic implications.ConclusionsHigher diuretic doses associated strongly and independently with adverse long-term outcome in chronic HF. Possibly, in euvolemic patients, efforts should be made to reduce diuretic dose.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.