TY - JOUR TI - Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF AU - Voors, A.A. AU - Davison, B.A. AU - Felker, G.M. AU - Ponikowski, P. AU - Unemori, E. AU - Cotter, G. AU - Teerlink, J.R. AU - Greenberg, B.H. AU - Filippatos, G. AU - Teichman, S.L. AU - Metra, M. AU - Teichman, S.L. AU - Massie, B.M. AU - Goldstein, S. AU - Bohm, M. AU - Francis, G. AU - Davis, C.E. AU - Boldueva, S. AU - Moiseev, V. AU - Shogenov, Z. AU - Ruda, M. AU - Vishnevsky, A. AU - Boyarkin, M. AU - Simanenkov, V. AU - Tereschenko, S. AU - Shwartz, Y. AU - Orlikova, O. AU - Arkhipov, M. AU - Libov, I. AU - Sardinov, R. AU - Suvorov, A. AU - Marmor, A. AU - Katz, A. AU - Zimlichman, R. AU - Omary, M. AU - Hershkoviz, R. AU - Goland, S. AU - Keren, A. AU - Aronson, D. AU - Grzybowski, J. AU - Musial, W. AU - Apró, D. AU - Lupkovics, G. AU - Stamate, C. AU - Salajan, A. AU - Matei, A. AU - Levy, P. AU - Pang, P. AU - Collins, S. AU - Gupta, D. AU - Van Mieghem, W. AU - Muyldermans, L. AU - Vervoort, G. JO - European Journal of Heart Failure PY - 2011 VL - 13 TODO - 9 SP - 961-967 PB - John Wiley and Sons Ltd SN - null TODO - 10.1093/eurjhf/hfr060 TODO - angiotensin receptor antagonist; beta adrenergic receptor blocking agent; calcium channel blocking agent; creatinine; digoxin; dipeptidyl carboxypeptidase inhibitor; hydralazine; placebo; relaxin, acute heart failure; aged; article; blood pressure regulation; creatinine blood level; female; groups by age; human; kidney dysfunction; major clinical study; male; mortality; multicenter study (topic); outcome assessment; pathophysiology; post hoc analysis; predictor variable; prevalence; priority journal; randomized controlled trial (topic); risk assessment; systolic blood pressure TODO - Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of <0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P 0.01), and Day 180 (P 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP. © 2011 The Author. ER -