Prognostic effect of the combined use of thiazides and loop diuretics at discharge following a hospitalization for acute heart failure
- 18.03.2025
- Original Paper
Erschienen in:
- Verfasst von
- Gema Miñana
- Joan Carles Trullàs
- Rafael de la Espriella
- Raquel Núñez-Aragon
- Andrea Gasull
- Juan-Bosco López-Saez
- Jorge Montiel
- Miguel Lorenzo-Hernández
- Agustín Fernández-Cisnal
- Ernesto Valero
- Gonzalo Núñez
- Vicent Bodí
- Òscar Miró
- Juan Sanchis
- Antoni Bayés-Genis
- Julio Núñez
- Erschienen in
- Clinical Research in Cardiology | Ausgabe 10/2025
Abstract
Aims
There is limited information regarding the clinical impact of the concurrent use of thiazides and loop diuretics (LD) after an episode of acute heart failure (AHF) hospitalization. We aimed to evaluate the impact of thiazide prescription at discharge on top of LD on the short-term risk of AHF readmission.
Methods
We included 3384 consecutive patients discharged from January 2008 to September 2021 after an admission for AHF in a single teaching center. The association between thiazides on discharge across the intensity of LD treatment and 30-day AHF readmission was explored by Cox regression analysis. A validation cohort of 622 patients was also examined.
Results
The mean age of the patients was 73.8 ± 11.2 years, 1672 (47.5%) were women, and 1733 (51.2%) patients showed left ventricular ejection fraction > 50%. The median (IQR) NT-proBNP was 3409 (1829–6963) pg/mL. At discharge, 754 (22.3%) patients received high LD doses (> 80 mg/day) and 187 (5.5%) thiazides. At 30 days, we registered 76 (2.2%) deaths and 449 (13.3%) AHF readmissions. Thiazides at discharge were not associated with the risk of 30-day AHF readmission (HR = 0.92). However, this association was differentially influenced by the intensity of LD doses (p-value for interaction = 0.030), with a lower AHF-readmission risk in those with LD dose > 80 mg/day (p = 0.038), and a neutral association in those receiving low LD dose (≤ 80 mg/day) (p = 0.541).
Conclusions
In patients discharged after an episode of AHF, thiazide prescription was associated with a lower risk of 30-day AHF readmission when they were prescribed in patients receiving high LD doses.
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- Titel
- Prognostic effect of the combined use of thiazides and loop diuretics at discharge following a hospitalization for acute heart failure
- Verfasst von
-
Gema Miñana
Joan Carles Trullàs
Rafael de la Espriella
Raquel Núñez-Aragon
Andrea Gasull
Juan-Bosco López-Saez
Jorge Montiel
Miguel Lorenzo-Hernández
Agustín Fernández-Cisnal
Ernesto Valero
Gonzalo Núñez
Vicent Bodí
Òscar Miró
Juan Sanchis
Antoni Bayés-Genis
Julio Núñez
- Publikationsdatum
- 18.03.2025
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Clinical Research in Cardiology / Ausgabe 10/2025
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692 - DOI
- https://doi.org/10.1007/s00392-025-02631-6
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