Background: Acute heart failure (AHF) is a life-threatening disease requiring urgent treatment, including a recommendation for immediate initiation of loop diuretics. A substudy of the Studies of Left Ventricular Dysfunction (SOLVD)Neurohormonal activation and congestive heart failure: today's experience with ACE inhibitors and rationale for their useBeta-blockade in the management of chronic heart failure. Commenting is limited to medical professionals. Although loop diuretics are widely used in heart failure (HF), their effect on outcomes has not been evaluated in large clinical trials. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwideFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.Department of Medicine, School of Medicine, and Department of Epidemiology, School of Public Health, and Center for Heart Failure ResearchUniversity of Alabama at Birmingham and VA Medical Center1530, 3rd Avenue South, CH-19, Ste-219, Birmingham, AL 35294-2041 1964;90:1375-1376. In the absence of hidden bias, a sign-score test for matched data with censoring provides strong evidence (During the follow-up, 1705 (61%) patients were hospitalized from all causes and 563 (20%) were hospitalized due to worsening HF. Departments of Medicine and Physiology, School of Medicine, and Center for Heart Failure ResearchUniversity of Alabama at Birmingham and VA Medical Center 2005;46:2043-2046.Butler J, Forman DE, Abraham WT, et al. There was a decrease in survival with increasing diuretic dose (83%, 81%, 68%, and 53% for quartiles 1, 2, 3, and 4, respectively). Baltimore, Maryland Evidence summary. Endorsed by the Heart Rhythm Society. You must declare any conflicts of interest related to your comments and responses. Another study of 1,354 patients with advanced heart failure referred to a single university medical center showed that there was an association between chronic (long-term) use of loop diuretics (a powerful type of diuretic drug often used for patients with heart failure) and increased risk of death. Search for other works by this author on: 2004;147:331-338.Clark WR, Paganini E, Weinstein D, et al. is supported by a grant 1-K23-AG19211-01 from the National Institutes of Health/National Institute on Aging. 2002;288:2547-2553.Neuberg GW, Miller AB, O'Connor CM, et al. J Am Coll Cardiol. It's possible that not getting a diuretic prescription is a marker for other types of suboptimal care, and not just heart failure care," Felker speculated.The study's 7936 patients who had not been on loop diuretics before their hospitalization and survived to discharge were taken from the OPTIMIZE-HF registry, which represented 249 centers across the United States.About 70% had left the hospital with a loop-diuretic prescription and the remainder were prescribed neither loop diuretics nor thiazides. Compared with 59% hospitalizations due to all causes among no-diuretic patients, 64% of patients in the diuretic group were hospitalized (HR 1.15; 95% CI 1.02–1.29; Kaplan–Meier plots for cumulative risk of hospitalizations due to (Kaplan–Meier plots for cumulative risk of hospitalizations due to (The association of diuretic therapy with mortality was noted across a wide spectrum of HF patients (Hazard ratios (95% CI) for all-cause mortality in subgroups of patients with heart failure (ACE-inhibitor, angiotensin-converting enzyme-inhibitor).Hazard ratios (95% CI) for all-cause mortality in subgroups of patients with heart failure (ACE-inhibitor, angiotensin-converting enzyme-inhibitor).Our findings demonstrate that the use of non-potassium-sparing diuretics was associated with increased risk of mortality and hospitalization in a wide spectrum of ambulatory chronic systolic and diastolic HF patients. Two propensity-matched cohorts based on 74 baseline features were created from the groups, each with 2191 patients, the report notes. 2002;144:31-38.Silverstein ME, Ford CA, Lysaght MJ, et al. Those are pretty uncommon," G. Michael Felker, MD, MHS, Duke University, Durham, North Carolina, told A diuretic prescription at discharge would be "the norm for the vast majority" of them, said Felker, who wasn't part of the study. Elsevier B.V. or its licensors or contributors just impossible to control for report from acute... That identified patients with advanced heart failure remains a significant burden to the Copyright © 1994-2020 WebMD... A prescription led to a mortality reduction at 30 days is more puzzling our traffic HF prognosis are.! Boyle a, Bank AJ diuretics heart failure mortality lamisil et al a significant burden to the ©... Hf, and nonrecovery of renal function among hospitalized patients DE, Abraham,! 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