Observational studyPloS one2015
Use of Loop Diuretics is Associated with Increased Mortality in Patients with Suspected Coronary Artery Disease, but without Systolic Heart Failure or Renal Impairment: An Observational Study Using Propensity Score Matching.
Observational study in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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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.
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.
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Who cites it
14 citing papers in PubMed, 38 citations in OpenAlex.
- Repurposing drugs for the prevention of vascular dementia using evidence from drug target Mendelian randomization.Nature aging · 2026Article
- Impact of Acute Kidney Injury, Co-Existing with and without Chronic Kidney Disease on the Short-Term Adverse Outcomes Following Atherosclerotic Cardiovascular Disease Events in Patients with Diabetes.Journal of multidisciplinary healthcare · 2025Article
- Combination diuretic therapies in heart failure: Insights from GUIDE-IT.American heart journal plus : cardiology research and practice · 2024Article
- Recommendations of apex health bodies remain localized: not in conformity with international implementation policy for urological disorders.The Lancet regional health. Southeast Asia · 2024Review
- Type 2 Myocardial Infarction and Long-Term Mortality Risk Factors: A Retrospective Cohort Study.Advances in therapy · 2023Article
- Diuretic treatment before and after transcatheter aortic valve implantation: A Danish nationwide study.PloS one · 2023Article
- Use of diuretics and outcomes in patients with type 2 diabetes: findings from the EMPA-REG OUTCOME trial.European journal of heart failure · 2021Article
- Increased mortality in elderly heart failure patients receiving infusion of furosemide compared to elderly heart failure patients receiving bolus injection.Journal of geriatric cardiology : JGC · 2020Article
- Impact of drugs on venous thromboembolism risk in surgical patients.European journal of clinical pharmacology · 2019Review
- Loop diuretics in chronic heart failure: how to manage congestion?Heart failure reviews · 2019Review
- Loop diuretics decrease the renal elimination rate and increase the plasma levels of trimethylamine-N-oxide.British journal of clinical pharmacology · 2018Observational
- Which method is best for an early accurate diagnosis of acute heart failure? Comparison between lung ultrasound, chest X-ray and NT pro-BNP performance: a prospective study.Internal and emergency medicine · 2017Article
- Polypharmacotherapy and blood products as risk factors for venous thromboembolism in postsurgical patients: a case-control study.International journal of clinical pharmacy · 2017Article
- Propensity Score Weighting Compared to Matching in a Study of Dabigatran and Warfarin.Drug safety · 2017Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLoop diuretics are widely used in patients with heart and renal failure, as well as to treat hypertension and peripheral edema. However, there are no randomized, controlled trials (RCT) evaluating their long term safety, and several observational reports have indicated adverse effects. We sought to evaluate the impact of loop diuretics on long term survival in patients with suspected coronary artery disease, but without clinical heart failure, reduced left ventricular ejection fraction or impaired renal function. METHOD AND
findingsFrom 3101 patients undergoing coronary angiography for suspected stable angina pectoris, subjects taking loop diuretics (n=109) were matched with controls (n=198) in an attempted 1:2 ratio, using propensity scores based on 59 baseline variables. During median follow-up of 10.1 years, 37.6% in the loop diuretics group and 23.7% in the control group died (log-rank p-value 0.005). Treatment with loop diuretics was associated with a hazard ratio (95% confidence interval) of 1.82 (1.20, 2.76), and the number needed to harm was 7.2 (4.1, 30.3). Inclusion of all 3101 patients using propensity score weighting and adjustment for numerous covariates provided similar estimates. The main limitation is the potential of confounding from unmeasured patient characteristics.
conclusionsThe use of loop diuretics in patients with suspected coronary artery disease, but without systolic heart failure or renal impairment, is associated with increased risk of all-cause mortality. Considering the lack of randomized controlled trials to evaluate long term safety of loop diuretics, our data suggest caution when prescribing these drugs to patients without a clear indication.
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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.