Τίτλος:
Relation of Decongestion and Time to Diuretics to Biomarker Changes and Outcomes in Acute Heart Failure
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Prompt treatment may mitigate the adverse effects of congestion in the early phase of heart failure (HF) hospitalization, which may lead to improved outcomes. We analyzed 814 acute HF patients for the relationships between time to first intravenous loop diuretics, changes in biomarkers of congestion and multiorgan dysfunction, and 1-year composite end point of death or HF hospitalization. B-type natriuretic peptide (BNP), high sensitivity cardiac troponin I (hscTnI), urine and serum neutrophil gelatinase–associated lipocalin, and galectin 3 were measured at hospital admission, hospital day 1, 2, 3 and discharge. Time to diuretics was not correlated with the timing of decongestion defined as BNP decrease ≥ 30% compared with admission. Earlier BNP decreases but not time to diuretics were associated with earlier and greater decreases in hscTnI and urine neutrophil gelatinase–associated lipocalin, and lower incidence of the composite end point. After adjustment for confounders, only no BNP decrease at discharge was significantly associated with mortality but not the composite end point (p = 0.006 and p = 0.062, respectively). In conclusion, earlier time to decongestion but not the time to diuretics was associated with better biomarker trajectories. Residual congestion at discharge rather than the timing of decongestion predicted a worse prognosis. © 2021 The Authors
Συγγραφείς:
Horiuchi, Y.
Wettersten, N.
van Veldhuisen, D.J.
Mueller, C.
Filippatos, G.
Nowak, R.
Hogan, C.
Kontos, M.C.
Cannon, C.M.
Müeller, G.A.
Birkhahn, R.
Taub, P.
Vilke, G.M.
Barnett, O.
McDonald, K.
Mahon, N.
Nuñez, J.
Briguori, C.
Passino, C.
Maisel, A.
Murray, P.T.
Περιοδικό:
AMERICAN JOURNAL OF CARDIOLOGY
Εκδότης:
HANLEY & BELFUS-ELSEVIER INC
Λέξεις-κλειδιά:
biological marker; brain natriuretic peptide; galectin 3; loop diuretic agent; neutrophil gelatinase associated lipocalin; troponin I; biological marker; brain natriuretic peptide; diuretic agent; galectin 3; neutrophil gelatinase associated lipocalin; troponin I, acute heart failure; aged; Article; cardiovascular mortality; clinical outcome; correlational study; disease association; female; hospital admission; hospital discharge; hospitalization; human; incidence; major clinical study; male; priority journal; retrospective study; treatment outcome; acute disease; blood; clinical trial; drug administration; heart failure; metabolism; middle aged; mortality; multicenter study; survival rate; time to treatment; urine; very elderly, Acute Disease; Aged; Aged, 80 and over; Biomarkers; Diuretics; Drug Administration Schedule; Female; Galectin 3; Heart Failure; Hospitalization; Humans; Lipocalin-2; Male; Middle Aged; Natriuretic Peptide, Brain; Retrospective Studies; Survival Rate; Time-to-Treatment; Troponin I
DOI:
10.1016/j.amjcard.2021.01.040
