Author + information
- Stephen Greene,
- G. Michael Felker,
- Jie Sun,
- Andrew Ambrosy,
- Bradley Bart,
- Javed Butler,
- Adam DeVore,
- Marat Fudim,
- Adrian Hernandez,
- Steven McNulty and
- Robert Mentz
Background: Hemoconcentration correlates with superior decongestion and improved outcomes among acute heart failure (AHF) patients, but data are limited to those with preserved renal function receiving intravenous diuretics. The role of hemoconcentration in AHF complicated by cardiorenal syndrome (CRS) or managed with ultrafiltration is unknown.
Methods: The CARRESS-HF trial randomized 188 hospitalized AHF patients with CRS to a stepped pharmacologic regimen or ultrafiltration. In-hospital hemoglobin change was calculated and used to define hemoconcentrators (i.e., in-hospital increase) and non-hemoconcentrators (i.e., in-hospital decrease or no change).
Results: Of 150 (80%) patients with complete hemoglobin data, 82 were hemoconcentrators and 68 were non-hemoconcentrators. There were no significant differences in baseline characteristics between groups (Table). In-hospital weight loss, fluid loss, and worsening renal function were not significantly different. After adjustment, hemoconcentration was not associated with 60-day risk of death, rehospitalization or unscheduled visits (HR 1.07, 95% CI 0.67-1.70). This relationship did not differ by ultrafiltration use (P for interaction =0.59).
Conclusions: In this AHF cohort with CRS, hemoconcentration was not associated with decongestion or clinical outcomes, irrespective of ultrafiltration use. The clinical application of hemoconcentration in AHF may be limited to patients with preserved baseline renal function.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-259
- 2017 American College of Cardiology Foundation