Loop diuretic adjustments in patients with chronic heart failure: Insights from HF-ACTION

American Heart Journal
Marat FudimRobert J Mentz

Abstract

The relationship between diuretic use or change in diuretic use and outcomes in chronic heart failure (HF) remains poorly defined. We evaluated the association between diuretic use and changes in health status, exercise capacity, and clinical events in a large randomized trial of subjects with HF. HF-ACTION randomized 2,331 outpatients with HF and ejection fraction ≤35% to aerobic exercise training versus usual care. We grouped patients according to loop diuretic use from baseline through 6 months: continued use, never use, initiated, and discontinued. The association between diuretic use and changes in health status, exercise capacity, and clinical outcomes (all-cause mortality/hospitalization, cardiovascular mortality, and HF hospitalization) through 12 months was assessed using Cox proportional hazards models and generalized linear regression models, respectively. A total of 2,004 (86%) patients had complete data on diuretic use. There was no association between diuretic status and Kansas City Cardiomyopathy Questionnaire, 6-minute walk distance, or peak Vo2 in adjusted analyses (all P > .05). A dose increase was associated with decrease in 6-minute walk distance (-4.25 m, SE 1.12 m, P < .001) and change in Kansas City Cardi...Continue Reading

References

Jan 1, 1987·British Heart Journal·J BaylissP Poole-Wilson
Apr 12, 2000·Journal of the American College of Cardiology·C P GreenJ A Spertus
Aug 23, 2003·Journal of the American College of Cardiology·Michael DomanskiUNKNOWN Studies of Left Ventricular Dysfunction
Jun 21, 2005·Journal of the American College of Cardiology·Lynne Warner StevensonLisa Mielniczuk
Jun 13, 2006·The American Journal of Cardiology·Shervin EshaghianGregg C Fonarow
Jan 24, 2007·American Heart Journal·David J WhellanUNKNOWN HF-ACTION Trial Investigators
Apr 9, 2009·JAMA : the Journal of the American Medical Association·Christopher M O'ConnorUNKNOWN HF-ACTION Investigators
Apr 9, 2009·JAMA : the Journal of the American Medical Association·Kathryn E FlynnUNKNOWN HF-ACTION Investigators
Jul 10, 2010·European Journal of Heart Failure·Peter K BonfilsNiels Gadsbøll
Aug 10, 2010·American Heart Journal·Husam M Abdel-QadirDouglas S Lee
Jul 16, 2013·Clinical Pharmacology and Therapeutics·T G von LuederH Krum
Jan 27, 2015·European Journal of Heart Failure·Adam D DeVoreAdrian F Hernandez
Dec 24, 2015·European Journal of Heart Failure·Kevin DammanJohn J V McMurray

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