Association of diuretic treatment at hospital discharge in patients with heart failure with all-cause short- and long-termmortality: A propensity score-matched analysis from SwedeHF

作者：Paren Par^*; Dahlstrom Ulf; Edner Magnus; Lappas Georgios; Rosengren Annika; Schaufelberger Maria

来源：International Journal of Cardiology, 2018, 257: 118-124.

DOI：10.1016/j.ijcard.2017.09.193

• Heart failure
• Diuretics
• Inpatients
• Mortality

Aims: Diuretics are recommended for treating congestive symptoms in heart failure (HF). The short-and long-term prognostic effects of diuretic treatment at hospital discharge have not been studied in randomized clinical trials or in a Western world population. We aimed to determine the association of diuretic treatment at discharge with the risk of short- and long-termall-cause mortality in real-life patients in Sweden with HF irrespective of EF.
Methods and results: From a Swedish nationwide HF register 26,218 patients discharged from hospital were included in the present study. A total of 87% of patients were treated with and 13% were not treated with diuretics at hospital discharge. In a 1:1 propensity score-matched cohort of 6564 patients, the association of diuretic treatment at hospital discharge with the risk of 90-day all-cause mortality was neutral (HR 0.89, 95% CI 0.74-1.07, p = 0.21) whereas the risk of long-term all-cause mortality (median follow-up: 2.85 years) was increased (HR 1.15, 95% CI 1.06-1.24, p < 0.001).
Conclusion: Diuretic treatment at hospital discharge was not associated with short-term mortality whereas it was associated with increased long-term mortality. Although we accounted for a wide range of clinical features, measured or unmeasured factors could still explain this increase in risk. However, our results suggest that diuretic treatment at hospital discharge may be regarded as a marker of increased long-term mortality.

• 出版日期2018-4-15
• 单位河北医科大学