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Early drop in systolic blood pressure and worsening renal function in acute heart failure: renal results of Pre-RELAX-AHF.

Abstract：

AIMS:We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. METHODS AND RESULTS:The Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of ≥0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30%). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P= 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P= 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P= 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P= 0.01), and Day 180 (P= 0.003) mortality. CONCLUSIONS:Worsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP. Trial registration clinicaltrials.gov identifier NCT00520806.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Voors AA,Davison BA,Felker GM,Ponikowski P,Unemori E,Cotter G,Teerlink JR,Greenberg BH,Filippatos G,Teichman SL,Metra M,Pre-RELAX-AHF study group.

doi

10.1093/eurjhf/hfr060

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

961-7

issue

9

eissn

1388-9842

issn

1879-0844

pii

hfr060

journal_volume

13

pub_type

杂志文章,多中心研究,随机对照试验

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