Abstract
We aimed to evaluate the efficacy (short-term changes in surrogates of decongestion) and safety following the ambulatory administration of subcutaneous furosemide (SCF) in patients with WHF. Fifty-five ambulatory patients were treated with SCF administered by an elastomeric pump for at least 72 h. Surrogates of congestion were assessed at baseline, 72 h, and 30 days. Spot urinary sodium (uNa+) was assessed at baseline, 24-48-72 h, and 30 days. The median (IQI) of NT-proBNP and uNa+ at baseline was 5218 pg/mL (2856-10878) and 68±3 mmol/L, respectively. Following administration of SCF (median dose of 100 mg/daily), we found a sustained increase in uNa+ during the first 72 h of treatment compared to baseline, paralleled with evidence of decongestion at 72 h, and 30 days. No significant safety concerns were observed. SCF was an effective and safe diuretic strategy for outpatient congestion management.Graphical abstractNon-formulated subcutaneous furosemide in patients with WHF. Efficacy and safety.
Highlights
Fluid overload is the leading cause of morbidity in heart failure (HF) patients and is responsible for most decompensations [1]
This study aimed to evaluate the short-term changes in surrogates of decongestion/response to therapy [uNa+, New York Heart Association (NYHA) class, dyspnea visual analog scale (VAS), pedal edema score, weight, plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP), and antigen carbohydrate 125 (CA125)] after treatment with subcutaneous furosemide (SCF) for at least 72 h in patients with worsening heart failure (WHF) and volume overload
Exclusion criteria consisted of (1) acute decompensated heart failure requiring hospital admission, (2) cardiogenic shock, (3) symptomatic hypotension or any systolic blood pressure (SBP)
Summary
Fluid overload is the leading cause of morbidity in heart failure (HF) patients and is responsible for most decompensations [1]. Traditional therapeutic approaches for managing these patients include hospital admission and administration of intravenous loop diuretics [1, 2]. Alternative diuretic strategies to successfully and safely treat most HF. Associate Editor Marat Fudim oversaw the review of this article. This study aimed to evaluate the short-term changes in surrogates of decongestion/response to therapy [uNa+, New York Heart Association (NYHA) class, dyspnea visual analog scale (VAS), pedal edema score, weight, plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP), and antigen carbohydrate 125 (CA125)] after treatment with SCF for at least 72 h in patients with WHF and volume overload. Safety parameters in terms of shortterm changes in eGFR, serum sodium (Na+) and potassium (K+), and systolic blood pressure (SBP) were assessed.
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