Τίτλος:
Efficacy and safety of high dose versus low dose furosemide with or without dopamine infusion: The Dopamine in Acute Decompensated Heart Failure II (DAD-HF II) Trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims The role of low-dose dopamine infusion in patients with acute decompensated heart failure (ADHF) remains controversial. We aim to evaluate the efficacy and safety of high- versus low-dose furosemide with or without low-dose dopamine infusion in this patient population. Methods and results 161 ADHF patients (78 years; 46% female; ejection fraction 31%) were randomized to 8-hour continuous infusions of: a) high-dose furosemide (HDF, n = 50, 20 mg/h), b) low-dose furosemide and low-dose dopamine (LDFD, n = 56, 5 mg/h and 5 μg kg- 1 min- 1 respectively), or c) low-dose furosemide (LDF, n = 55, furosemide 5 mg/h). The main outcomes were 60-day and one-year all-cause mortality (ACM) and hospitalization for HF (HHF). Dyspnea relief (Borg index), worsening renal function (WRF, rise in serum creatinine (sCr) ≥ 0.3 mg/dL), and length of stay (LOS) were also assessed. The urinary output at 2, 4, 6, 8, and 24 h was not significantly different in the three groups. Neither the ACM at day 60 (4.0%, 7.1%, and 7.2%; P = 0.74) or at one year (38.1%, 33.9% and 32.7%, P = 0.84) nor the HHF at day 60 (22.0%, 21.4%, and 14.5%, P = 0.55) or one year (60.0%, 50.0%, and 47%, P = 0.40) differed between HDF, LDFD, and LDF groups, respectively. No differences in the Borg index or LOS were noted. WRF was higher in the HDF than in LDFD and LDF groups at day 1 (24% vs. 11% vs. 7%, P < 0.0001) but not at sCr peak (44% vs. 38% vs. 29%, P = 0.27). No significant differences in adverse events were noted. Conclusions In ADHF patients, there were no significant differences in the in-hospital and post-discharge outcomes between high- vs. low-dose furosemide infusion; the addition of low-dose dopamine infusion was not associated with any beneficial effects. © 2014 Elsevier Ireland Ltd.
Συγγραφείς:
Triposkiadis, F.K.
Butler, J.
Karayannis, G.
Starling, R.C.
Filippatos, G.
Wolski, K.
Parissis, J.
Parisis, C.
Rovithis, D.
Koutrakis, K.
Skoularigis, J.
Antoniou, C.-K.
Chrysohoou, C.
Pitsavos, C.
Stefanadis, C.
Nastas, J.
Tsaknakis, T.
Mantziari, L.
Giannakoulas, G.
Karvounis, H.
Kalogeropoulos, A.P.
Giamouzis, G.
Περιοδικό:
International Journal of Cardiology
Λέξεις-κλειδιά:
cardiotonic agent; diuretic agent; dopamine; furosemide, aged; blood pressure; controlled study; dose response; drug combination; drug effects; female; heart failure; heart rate; heart stroke volume; hemodynamics; hospital readmission; human; kidney; male; mortality; mortality; randomized controlled trial; single blind procedure; treatment outcome; urine; very elderly, Aged; Aged, 80 and over; Blood Pressure; Cardiotonic Agents; Diuretics; Dopamine; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Furosemide; Heart Failure; Heart Rate; Hemodynamics; Hospital Mortality; Humans; Kidney; Male; Patient Readmission; Single-Blind Method; Stroke Volume; Treatment Outcome; Urine
DOI:
10.1016/j.ijcard.2013.12.276
