Cardiac outcome prevention effectiveness of glucocorticoids in acute decompensated heart failure: COPE-ADHF study.

Abstract:

INTRODUCTION:Newly emerging evidence showed that glucocorticoids could potentiate natriuretic peptides' action by increasing the density of natriuretic peptide receptor A, leading to a potent diuresis and a renal function improvement in patients with acute decompensated heart failure (ADHF). Therefore, glucocorticoid therapy may be used in patients with ADHF. METHODS:One hundred two patients with ADHF were randomized to receive glucocorticoids or standard treatment. Change from baseline in serum creatinine (SCr) at day 7 and cardiovascular death within 30 days were recorded. The study was terminated early because of slow site initiation and patient enrolment. RESULTS:Glucocorticoid therapy seemed to be well tolerated. There was a remarkable SCr reduction after 7 days treatment. The change from baseline in SCr is -0.14 mg/dL in glucocorticoid group versus -0.02 mg/dL in standard treatment group (P < 0.05). Although sample size is limited, a cardiovascular death reduction at 30 days was observed in glucocorticoid group with odds ratio of 0.26 (3 deaths in glucocorticoid vs. 10 deaths in standard treatment group, P < 0.05). The survival benefit associated with glucocorticoid therapy persisted during the follow-up. Patient-assessed dyspnea and physician-assessed global clinical status were also improved in glucocorticoid group. CONCLUSIONS:Limited data indicate that glucocorticoid therapy may be used safely in patients with ADHF in short term. Glucocorticoid therapy did not cause heart failure deterioration. Further investigations are warranted.

journal_name

J Cardiovasc Pharmacol

authors

Liu C,Liu K,COPE-ADHF Study Group.

doi

10.1097/FJC.0000000000000048

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

333-8

issue

4

eissn

0160-2446

issn

1533-4023

pii

00005344-201404000-00006

journal_volume

63

pub_type

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