Heart failure & cardiomyopathies
Loop Diuretic Down-Titration at Discharge in Patients Hospitalized for Acute Heart Failure
Main finding · All-cause death and/or HF readmissionResult — go to the resultHazard ratio 1.34 95% CI 0.86–2.06Authors' conclusion
In patients hospitalized for AHF, furosemide down-titration does not imply an increased risk of mortality and/or heart failure readmission. However, FO status modifies the effect of down-titration on the outcome. In patients with severe congestion or residual congestion at discharge, down-titration was associated with an increased risk of mortality and/or heart failure readmission.
Study context
- Population
- Patients hospitalised for acute HF (median age 86 y, 62% women, 80% HFpEF)
- Participants
- 410 patients
- Exposure
- Furosemide down-titration vs stable/up-titration at discharge
- Outcome
- Composite of:
- Time to all-cause death
- HF readmission
Main finding
All-cause death and/or HF readmission
Hazard ratio
1.34
95% CI 0.86–2.06
P = 0.184
Down-titration vs Stable/up-titration
HR 1.34 (95% CI 0.86–2.06); P = 0.184
As reported in the abstract
Observational data: associations, not effects.
Further findings
Death and/or worsening HF, by fluid overload status
- Risk associated with diuretic strategy at discharge significantly influenced by fluid overload (FO) status (clinical congestion scores, BNP, cancer antigen 125)
Original publication
Loop Diuretic Down-Titration at Discharge in Patients Hospitalized for Acute Heart Failure. ESC Heart Fail. Published 7 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it