Evidence map›Paper›PMID 26299229›Full record

Trial reportAmerican heart journal2015

Diuretic response in acute heart failure-an analysis from ASCEND-HF.

Jozine M ter Maaten, Allison M Dunning, Mattia A E Valente, Kevin Damman, Justin A Ezekowitz, Robert M Califf, Randall C Starling, Peter van der Meer, Christopher M O'Connor, Phillip J Schulte and 4 more

2 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in American heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 58 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 3 pooled it
9.1field-weighted citation impact, top 2% of its field
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 26041600PMID 25838436PMID 25287144PMID 24879974PMID 24585267PMID 24379278PMID 24247300PMID 23356556PMID 23333145PMID 23141816PMID 21732835other papers from this trial
Open the trial in the graph
NCT02638142 recruitingnot on this map

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

58 citing papers in PubMed, 3 syntheses or guidelines pooled it, 139 citations in OpenAlex.

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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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  14. Effects of natriuresis-guided diuretic therapy in men and women with acute heart failure: insights from PUSH-AHF.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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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 at 7 institutions in 3 countries.

Jozine M ter MaatenUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
Allison M DunningDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Mattia A E ValenteUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
Kevin DammanUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
Justin A EzekowitzMazankowski Alberta Heart Institute, Edmonton, Canada.
Robert M CaliffDuke Translational Medicine Institute, Durham, NC.
Randall C StarlingDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Peter van der MeerUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
Christopher M O'ConnorDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Phillip J SchulteDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Jeffrey M TestaniDepartment of Internal Medicine and Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT.
Adrian F HernandezDuke Clinical Research Institute, Duke University Medical Center, Durham, NC.
W H Wilson TangCleveland Clinic Foundation, Cleveland, OH.
Adriaan A VoorsUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: a.a.voors@umcg.nl.
Clinical Research Institute · USUniversity of Groningen · NLUniversity Medical Center Groningen · NLCanadian VIGOUR Centre · CACleveland Clinic · USDuke Medical Center · USYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiuretic unresponsiveness often occurs during hospital admission for acute heart failure (AHF) and is associated with adverse outcome. This study aims to investigate determinants, clinical outcome, and the effects of nesiritide on diuretic response early after admission for AHF.

methodsDiuretic response, defined as weight loss per 40 mg of furosemide or equivalent, was examined from hospital admission to 48 hours in 4,379 patients from the ASCEND-HF trial. As an additional analysis, a urinary diuretic response metric was investigated in 5,268 patients using urine volume from hospital admission to 24 hours per 40 mg of furosemide or equivalent.

resultsMean diuretic response was -0.42 kg/40 mg of furosemide (interquartile range -1.0, -0.05). Poor responders had lower blood pressure, more frequent diabetes, long-term use of loop diuretics, poorer baseline renal function, and lower urine output (all P < .01). Randomized nesiritide treatment was not associated with diuretic response (P = .987). Good diuretic response was independently associated with a significantly decreased risk of 30-day all-cause mortality or heart failure rehospitalization (odds ratio 0.44, 95% CI 0.29-0.65, highest vs lowest quintile, P < .001). Diuretic response based on urine output per 40 mg of furosemide showed similar results in terms of clinical predictors, association with outcome, and the absence of an effect of nesiritide.

conclusionsPoor diuretic response early after hospital admission for AHF is associated with low blood pressure, renal impairment, low urine output, and an increased risk of death or rehospitalization early after discharge. Nesiritide had a neutral effect on diuretic response.

Indexed as

Acute DiseaseAgedDisease ProgressionDiureticsDose-Response Relationship, DrugDouble-Blind MethodFemaleFollow-Up StudiesFurosemideHeart FailureHospital MortalityHumansIncidenceMaleMiddle AgedPatient AdmissionDiureticsFurosemide

Identifiers

PMID26299229
OpenAlexW1534539390

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.