High- loop diuretics doses at discharge after acute heart failure hospitalization and two years mortality: An observational study

Abstract

To determine if high-loop diuretics doses at discharge after acute heart failure are associated with higher two-years mortality. The study was prospective observational. We enrolled all consecutive patients discharged after acute heart failure hospitalization between January 2013 and December 2016. The loop-diuretics used were furosemide and the doses were considered high if there were over 80 mg a day at discharge. The primary end point was 2 years total mortality. Patients were followed at our heart failure department and telephonic contact was established with the patients. In total, 1488 patients were included, wiyh a mean age of 74.3 ± 14.5 years and 51.9% of men. The etiology of heart failure was ischemic in 63.8% of cases. Furosemide was prescribed at highly doses for 42.6% of patients ( n = 634; group 1). In a Cox model, high furosemide doses were significantly associated with an increase two years global mortality [HR: 2.56; CI 95% (1.72–3.68)]. Impaired left ventricular ejection fraction, anemia, chronic obstructive pulmonary disease, atrial fibrillation and renal dysfunction were other factors that impacted negatively the primary end point. High -loop doses at discharge after hospitalization for acute heart failure are associated with an increased two-years mortality in chronic heart failure treated patients.