Heart failure & cardiomyopathiesSecondary analysis
Outpatient Loop Diuretic Use and the Effect of Natriuresis-Guided Diuretic Therapy: A Prespecified Sub-Analysis of the PUSH-AHF Study
- Secondary analysis of the PUSH-AHF randomised trial
- prespecified sub-analysis
Authors' conclusion
Outpatient LD use results in reduced natriuresis. However, the beneficial effects of natriuresis-guided diuretic therapy on 24-h natriuresis were consistent, regardless of previous LD use.
Study context
- Population
- Patients hospitalised for acute decompensated HFrandomized
- Participants
- 310 patients
- Comparison
- Natriuresis-guided therapy vs standard of care, by outpatient loop diuretic use
- No prior loop diuretics (LD) usen = 133reference
- 0-1 mg bumetaniden = 65
- >1 mg bumetaniden = 112
- Primary endpoint
- 24-h natriuresis and combined endpoint of HF rehospitalization or all-cause mortality
Primary result
As reported in the abstract
Effect of natriuresis-guided therapy by outpatient LD use
Natriuresis-guided therapy significantly increased 24-h natriuresis regardless of outpatient LD use
p for interaction = 0.420
No interaction for HF rehospitalization or all-cause mortality at 180 days
p for interaction = 0.881
Further findings
24-h natriuresis by outpatient LD dose
- 24-h natriuresis by outpatient LD dose: p for trend = 0.002
Baseline characteristics by outpatient LD dose
- Higher outpatient LD doses: longer HF history and worse renal function
- P for trend < 0.001
Original publication
Outpatient Loop Diuretic Use and the Effect of Natriuresis-Guided Diuretic Therapy: A Prespecified Sub-Analysis of the PUSH-AHF Study. Eur J Heart Fail. Published 29 October 2025. doi:10.1002/ejhf.70080
Summarised from the published abstract; every number is checked against it