Association of time‐to‐IV ‐furosemide with mortality in acute heart failure: data from REPORT‐HF

Ouwerkerk, W. et al. (2023) Association of time‐to‐IV ‐furosemide with mortality in acute heart failure: data from REPORT‐HF. European Journal of Heart Failure, 25(1), pp. 43-51. (doi: 10.1002/ejhf.2708) (PMID:36196060)

Abstract

Background: Acute heart failure (AHF) can be a life-threatening medical condition. Delaying administration of intravenous furosemide (time-to-diuretics) has been postulated to increase mortality, but prior reports have been inconclusive. Objective: To evaluate the association between time-to-diuretics and mortality in the international REPORT-HF registry. Methods: We assessed the association of time-to-diuretics within the first 24-hours with in-hospital and 30-day post-discharge mortality in 15,078 patients from 7 world-regions in the REPORT-HF registry. We further tested for effect modification by baseline mortality risk (ADHERE risk-score), left ventricular ejection fraction (LVEF) and region. Results: The median time-to-diuretics was 67 (25th-75th percentiles 17-190) minutes. Women, patients with more signs and symptoms of heart failure, and patients from Eastern Europe or Southeast Asia had shorter time-to-diuretics. There was no significant association between time-to-diuretics and in-hospital mortality (P>0.1). The 30-day mortality risk increased linearly with longer time-to-diuretics (administered between hospital arrival and 8-hours post- hospital arrival) (P=0.016). This increase was more significant in patients with a higher ADHERE risk score (Pinteraction=0.008), and not modified by LVEF or geographic region (Pinteraction >0.1 for both). Conclusion: In REPORT-HF, longer time-to-diuretics was not associated with higher in-hospital mortality. However, we did found an association with increased 30-day mortality, particularly in high-risk patients, and irrespective of LVEF or geographic region.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Ouwerkerk, W., Tromp, J., Cleland, J. G.F., Angermann, C. E., Dahlstrom, U., Ertl, G., Hassanein, M., Perrone, S. V., Ghadanfar, M., Schweizer, A., Obergfell, A., Dickstein, K., Filippatos, G., Collins, S. P., and Lam, C. S.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: European Journal of Heart Failure
• Publisher: Wiley
• ISSN: 1388-9842
• ISSN (Online): 1879-0844
• Published Online: 04 October 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in European Journal of Heart Failure 25(1): 43-51
• Publisher Policy: Reproduced under a Creative Commons License