Evidence map›Paper›PMID 27039131›Full record

ArticleJACC. Heart failure2016

In-Hospital Diuretic Agent Use and Post-Discharge Clinical Outcomes in Patients Hospitalized for Worsening Heart Failure: Insights From the EVEREST Trial.

Alicia Mecklai, Haris Subačius, Marvin A Konstam, Mihai Gheorghiade, Javed Butler, Andrew P Ambrosy, Stuart D Katz

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.9field-weighted citation impact, top 23% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

  1. Fluid Volume Homeostasis in Heart Failure: A Tale of 2 Circulations.Journal of the American Heart Association · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Alicia MecklaiWeill Cornell Medical College, New York, New York; New York University School of Medicine, New York, New York.
Haris SubačiusNorthwestern University Feinberg School of Medicine, Chicago, Illinois.
Marvin A KonstamThe CardioVascular Center of Tufts Medical Center and Tufts Medical Center, Boston, Massachusetts.
Mihai GheorghiadeNorthwestern University Feinberg School of Medicine, Chicago, Illinois.
Javed ButlerStony Brook School of Medicine, Stony Brook, New York.
Andrew P AmbrosyDuke University Medical Center, Durham, North Carolina.
Stuart D KatzNew York University School of Medicine, New York, New York. Electronic address: stuart.katz@nyumc.org.
Northwestern University · USCornell University · USDuke Medical Center · USNew York University · USStony Brook School · USTufts Medical Center · US

Funding

Project-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5M
Institutional Clinical and Translational Science AwardUL1TR000038 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI CRONSTEIN, BRUCE NEIL · 2012 to 2014
$16.8M
NCATS NIH HHS UL1 TR000038NCATS NIH HHS UL1 TR001445
6 · The paper itself

Abstract

objectivesThe aim of this study was to characterize the association between decongestion therapy and 30-day outcomes in patients hospitalized for heart failure (HF).

backgroundLoop diuretic agents are commonly prescribed for the treatment of symptomatic congestion in patients hospitalized for HF, but the association between loop diuretic agent dose response and post-discharge outcomes has not been well characterized.

methodsCox proportional hazards models were used to estimate the association among average loop diuretic agent dose, congestion status at discharge, and 30-day post-discharge all-cause mortality and HF rehospitalization in 3,037 subjects hospitalized with worsening HF enrolled in the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study With Tolvaptan) study.

resultsIn univariate analysis, subjects exposed to high-dose diuretic agents (≥160 mg/day) had greater risk for the combined outcome than subjects exposed to low-dose diuretic agents (18.9% vs. 10.0%; hazard ratio: 2.00; 95% confidence interval: 1.64 to 2.46; p < 0.0001). After adjustment for pre-specified covariates of disease severity, the association between diuretic agent dose and outcomes was not significant (hazard ratio: 1.11; 95% confidence interval: 0.89 to 1.38; p = 0.35). Of the 3,011 subjects with clinical assessments of volume status, 2,063 (69%) had little or no congestion at hospital discharge. Congestion status at hospital discharge did not modify the association between diuretic agent exposure and the combined endpoint (p for interaction = 0.84).

conclusionsShort-term diuretic agent exposure during hospital treatment for worsening HF was not an independent predictor of 30-day all-cause mortality and HF rehospitalization in multivariate analysis. Congestion status at discharge did not modify the association between diuretic agent dose and clinical outcomes.

Indexed as

MortalityAgedAntidiuretic Hormone Receptor AntagonistsBenzazepinesCause of DeathDisease ProgressionFemaleHeart FailureHospitalizationHumansMaleMiddle AgedPatient ReadmissionProportional Hazards ModelsRandomized Controlled Trials as TopicSodium Potassium Chloride Symporter InhibitorsAntidiuretic Hormone Receptor AntagonistsBenzazepinesSodium Potassium Chloride Symporter InhibitorsTolvaptanacute heart failureloop diuretic agentsoutcomes

Identifiers

PMID27039131
PMCPMC4930424
OpenAlexW2319255765

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.