Prevalence and outcome of diuretic resistance in heart failure.

Abstract:

:Diuretic resistance (DR) is common in patients with decompensated heart failure (HF), and is associated with adverse outcomes. To determine the prevalence of DR and its impact on survival among patients with decompensated HF, we prospectively evaluated the prevalence and influence on prognosis of DR (defined as persistent congestion despite ≥ 80 mg of furosemide per day) in a cohort of elderly patients from the Spanish HF registry (RICA) admitted for an acute decompensation of HF. Patients with new-onset HF were excluded. From the global cohort of 2067 patients, 435 (21%; 95% CI 19.3%-22.7%) patients met criteria for DR. Patients with DR had more comorbidities (hypercholesterolemia, diabetes mellitus, valvular disease, chronic kidney disease, and cancer) and a worse functional status compared to patients without DR. In addition, patients with DR had a higher proportion of ischemic etiology, more advanced functional class and lower left ventricular ejection fraction values. After 1 year of follow-up, all-cause mortality was higher in patients with DR with an adjusted hazard ratio of 1.37 (95% CI 1.06-1.79; p = 0.018). The prevalence of DR in a cohort of elderly patients admitted for acute HF decompensation is 21%. DR is an independent predictor of 1-year mortality.

journal_name

Intern Emerg Med

authors

Trullàs JC,Casado J,Morales-Rull JL,Formiga F,Conde-Martel A,Quirós R,Epelde F,González-Franco Á,Manzano L,Montero-Pérez-Barquero M

doi

10.1007/s11739-018-02019-7

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

529-537

issue

4

eissn

1828-0447

issn

1970-9366

pii

10.1007/s11739-018-02019-7

journal_volume

14

pub_type

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