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Association of diuretic treatment at hospital discharge in patients with heart failure with all-cause short- and long-termmortality: A propensity score-matched analysis from SwedeHF
Sahlgrenska Univ Hosp Molndal, Sweden; Univ Gothenburg, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0001-6353-8041
Karolinska Univ Hosp, Sweden.
Univ Gothenburg, Sweden.
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2018 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 257, p. 118-124Article in journal (Refereed) Published
Abstract [en]

Aims: Diuretics are recommended for treating congestive symptoms in heart failure (HF). The short-and long-term prognostic effects of diuretic treatment at hospital discharge have not been studied in randomized clinical trials or in a Western world population. We aimed to determine the association of diuretic treatment at discharge with the risk of short- and long-termall-cause mortality in real-life patients in Sweden with HF irrespective of EF. Methods and results: From a Swedish nationwide HF register 26,218 patients discharged from hospital were included in the present study. A total of 87% of patients were treated with and 13% were not treated with diuretics at hospital discharge. In a 1:1 propensity score-matched cohort of 6564 patients, the association of diuretic treatment at hospital discharge with the risk of 90-day all-cause mortality was neutral (HR 0.89, 95% CI 0.74-1.07, p = 0.21) whereas the risk of long-term all-cause mortality (median follow-up: 2.85 years) was increased (HR 1.15, 95% CI 1.06-1.24, p amp;lt; 0.001). Conclusion: Diuretic treatment at hospital discharge was not associated with short-term mortality whereas it was associated with increased long-term mortality. Although we accounted for a wide range of clinical features, measured or unmeasured factors could still explain this increase in risk. However, our results suggest that diuretic treatment at hospital discharge may be regarded as a marker of increased long-term mortality. (C) 2017 The Authors. Published by Elsevier Ireland Ltd.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2018. Vol. 257, p. 118-124
Keywords [en]
Heart failure; Diuretics; Inpatients; Mortality
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-147077DOI: 10.1016/j.ijcard.2017.09.193ISI: 000427530200036PubMedID: 29506681OAI: oai:DiVA.org:liu-147077DiVA, id: diva2:1199729
Note

Funding Agencies|Swedish Research Council [340-2013-5187, 521-2013-4236]; Swedish Heart and Lung Foundation [20110155, 2015-0438]; Goteborg Medical Society [GLS-331961]; Swedish National Board of Health and Welfare; Swedish Association of local authorities and Regions; Swedish Society of Cardiology; [ALFGBG-427301]; [ALFGBG136761]

Available from: 2018-04-22 Created: 2018-04-22 Last updated: 2018-04-22

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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
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