Author + information
- Kirkwood F. Adams,
- Stephanie Dunlap,
- Amanda Lee,
- Ileana Pina,
- Adrian Van Bakel,
- J. Herbert Patterson,
- Todd Schwartz,
- Frank McGrew,
- Hector Ventura and
- Ron Oren
Background: Loop diuretics are associated with a dose-related increase in mortality in patients (Pts) with heart failure (HF) but less is known about the pattern of this relationship.
Methods: The relationship between low and high doses of loop diuretic and mortality was investigated in the UNITE-HF Registry, a prospective, observational outpatient HF study that enrolled most Pts from 2000 to 2002. Baseline daily doses of loop diuretic were converted to milligram equivalents of furosemide (Furo mgEq). The relative risk of death at specific doses compared to no loop diuretic and among specific loop doses was assessed. Risk models were adjusted for mortality predictors unless indicated.
Results: The analysis cohort (n=1200) was 37% female, 37% African American, with mean (± SD) age of 58 ± 14 years, creatinine 1.43 ± 1.30 and LVEF of 31 ± 16. Loop diuretics were taken at baseline in 82% of Pts (median dose 40 mgEq/day, lower quartile < 20, upper quartile > 80). There were 623 deaths during 6.6 ± 3.7 years of follow-up. Mortality was not increased at low doses. Mortality was significantly less on 20 compared to 40 Furo mgEq/day (HR 0.64 95% CI 0.44 – 0.92, p<0.016) and 40 compared to 80 Furo mgEq/day (HR 0.73 95% CI 0.57 – 0.93, p<0.012). Mortality increased at high doses but relative risk did not differ among doses ≥ 120 Furo mgEq/day (all comparisons p>0.176).
Conclusions: Loop diuretic use was associated increased mortality at doses ≥ 80 Furo mgEq/day in this retrospective observational analysis of Pts with HF.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Heart Failure and Cardiomyopathies: Is Heart Failure With a Normal EF for Real?
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1121-252
- 2017 American College of Cardiology Foundation