Evidence map›Paper›PMID 25287144›Full record

Trial reportEuropean journal of heart failure2014

Diuretic response in patients with acute decompensated heart failure: characteristics and clinical outcome--an analysis from RELAX-AHF.

Adriaan A Voors, Beth A Davison, John R Teerlink, G Michael Felker, Gad Cotter, Gerasimos Filippatos, Barry H Greenberg, Peter S Pang, Bruce Levin, Tsushung A Hua and 4 more

3 registry-linked trialsAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of heart failure, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 65 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04298229 phase3completedstarted 2020, after this paper: background citation

A Randomized, Open-label Study of Dapagliflozin in Patients With or Without Type 2 Diabetes Admitted With Acute Heart Failure

Ran2020Enrolled240Registered outcomes3Posted comparisons0ConditionsDiabetes Mellitus, Type 2, Heart FailureArmsDapagliflozin 10 mg, Protocolized Diuretic Therapy
PMID 27266853PMID 26299229PMID 26041600PMID 25838436PMID 24879974PMID 24585267PMID 24379278PMID 24247300PMID 23356556PMID 23333145PMID 23141816PMID 21732835other papers from this trial
Open the trial in the graph
NCT00520806 phase2 / phase3completednot on this map

A Phase II/III, Multicenter, Randomized, Double-blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Relaxin in Subjects With Acute Heart Failure

TypeinterventionalSponsorCorthera, Inc.(formerly BAS Medical, Inc.), a member of the Novartis group of companiesRan2007 to 2012Enrolled1,161ConditionsHeart Failure, CongestiveArmsRelaxin, Placebo
NCT02638142 recruitingnot on this mapstarted 2015, after this paper: background citation

Continuous Versus Bolus Intermittent Loop Diuretic Infusion in Acutely Decompensated Heart Failure: Evaluation of Renal Function, Congestion Signs, BNP and Outcome

TypeobservationalSponsorUniversity of SienaRan2015 to 2028Enrolled370ConditionsAcute Heart FailureArmsContinuous Furosemide Infusion, Intermittent Furosemide Infusion
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  10. Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction.Clinical research in cardiology : official journal of the German Cardiac Society · 2017
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  20. Disconnect between the effects of serelaxin on renal function and outcome in acute heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
    Article

5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Adriaan A VoorsUniversity of Groningen, Groningen, the Netherlands.
Beth A Davison
John R Teerlink
G Michael Felker
Gad Cotter
Gerasimos Filippatos
Barry H Greenberg
Peter S Pang
Bruce Levin
Tsushung A Hua
Thomas Severin
Piotr Ponikowski
Marco Metra
RELAX-AHF Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe studied the characteristics and clinical outcome related to diuretic response and the effects of serelaxin in patients hospitalized for acute heart failure (AHF). METHODS AND

resultsRELAX-AHF was a double-blind, placebo-controlled trial, enrolling 1161 patients admitted to hospital for AHF who were randomized to 48 h i.v infusions of placebo or serelaxin (30 µg/kg per day) within 16 h from presentation. Diuretic response was defined as Δ weight kg/[(total i.v. dose)/40 mg] + [(total oral dose)/80 mg)] furosemide (or equivalent loop diuretic dose) up to day 5. Median diuretic response was -0.42 (-1.00, -0.14) kg/40 mg. A poor diuretic response was independently associated with Western-like region (Western Europe, North America, Israel, and Poland), lower diastolic blood pressure, the absence of oedema, higher blood urea nitrogen, and lower levels of aspartate aminotransferase and potassium (all P < 0.01). Randomization to serelaxin was associated with lower doses of i.v. loop diuretics and slightly less weight loss, resulting in a neutral effect on diuretic response. Worse diuretic response was independently associated both with less relief of dyspnoea, measured with a visual analogue scale (VAS) at day 5 (primary endpoint; P = 0.0002), and with a higher risk of cardiovascular death or rehospitalization for heart failure or renal failure through day 60 (secondary endpoint, P < 0.0001), but not with increased 180-day cardiovascular mortality (P = 0.507).

conclusionsIn patients hospitalized for AHF, a poor diuretic response was associated with a poor in-hospital and early post-discharge clinical outcome. Serelaxin had a neutral effect on diuretic response.

trial registrationNCT00520806.

Indexed as

Acute DiseaseAgedDiureticsDouble-Blind MethodFemaleFurosemideHeart FailureHumansLength of StayMalePlacebosTreatment OutcomeDiureticsFurosemidePlacebosDiuretic responseHeart failureRenal function

Identifiers

PMID25287144
PMCPMC4489340

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.