Evidence map›Paper›PMID 32762901›Full record

ArticleJournal of the American College of Cardiology2020

Loop Diuretic Prescription and 30-Day Outcomes in Older Patients With Heart Failure.

Charles Faselis, Cherinne Arundel, Samir Patel, Phillip H Lam, Stephen S Gottlieb, Michael R Zile, Prakash Deedwania, Gerasimos Filippatos, Helen M Sheriff, Qing Zeng and 6 more

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

Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
6.1field-weighted citation impact, top 3% 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

35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Cardiology research · 2025
    Article
  7. Review
  8. Article
  9. Article
  10. Diuretic Use in Heart Failure.Reviews in cardiovascular medicine · 2025
    Review
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Charles FaselisDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC; Department of Medicine, Uniformed Services University, Washington, DC. Electronic address: charles.faselis@va.gov.
Cherinne ArundelDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC; Department of Medicine, Georgetown University, Washington, DC.
Samir PatelDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC.
Phillip H LamDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, Georgetown University, Washington, DC; Department of Medicine, MedStar Washington Hospital Center, Washington, DC. Electronic address: https://twitter.com/PhilLamMD.
Stephen S GottliebDivision of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Section of Cardiology, Department of Medicine, Veterans Affairs Medical Center, Baltimore, Maryland.
Michael R ZileDivision of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Section of Cardiology, Department of Medicine, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.
Prakash DeedwaniaDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Division of Cardiology, Department of Medicine, University of California, San Francisco, California.
Gerasimos FilippatosDivision of Cardiology, Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Helen M SheriffDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC.
Qing ZengDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC.
Charity J MorganDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama.
Samuel WoppererDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, Georgetown University, Washington, DC; Department of Medicine, MedStar Washington Hospital Center, Washington, DC.
Tran NguyenDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC.
Richard M AllmanDepartment of Medicine, George Washington University, Washington, DC; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Gregg C FonarowDivision of Cardiology, Department of Medicine, University of California, Los Angeles, California.
Ali AhmedDepartment of Medicine, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC; Department of Medicine, Georgetown University, Washington, DC. Electronic address: ali.ahmed@va.gov.
University of California, Los Angeles · US

Funding

Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
HSRD VA I01 HX002422NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01 HL097047
6 · The paper itself

Abstract

backgroundHeart failure (HF) is a major source of morbidity and mortality. Fluid retention and shortness of breath are its cardinal manifestations for which loop diuretics are used. Although their usefulness is well accepted, less is known about their role in improving clinical outcomes.

objectivesThe purpose of this study was to determine the relationship between loop diuretics and clinical outcomes in patients with HF.

methodsOf the 25,345 older patients hospitalized for HF in the Medicare-linked OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) registry, 9,866 (39%) received no pre-admission diuretics. The study excluded 1,083 patients receiving dialysis and 847 discharged on thiazide diuretics. Of the remaining 7,936 patients, 5,568 (70%) were prescribed loop diuretics at discharge. Using propensity scores for receipt of loop diuretics estimated for each of the 7,936 patients, a matched cohort of 2,191 pairs of patients was assembled balanced on 74 baseline characteristics. Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes were estimated in the matched cohort.

resultsMatched patients (n = 4,382) had a mean age of 78 years, 54% were women, and 11% were African American. The 30-day all-cause mortality occurred in 4.9% (107 of 2,191) and 6.6% (144 of 2,191) of patients in the loop diuretic and no loop diuretic groups, respectively (HR when the use of loop diuretics was compared with nonuse: 0.73; 95% CI: 0.57 to 0.94; p = 0.016). Patients in the loop diuretic group had a significantly lower risk of 30-day HF readmission (HR: 0.79; 95% CI: 0.63 to 0.99; p = 0.037) but not of 30-day all-cause readmission (HR: 0.89; 95% CI: 0.79 to 1.01; p = 0.081). None of the associations was statistically significant during 60 days of follow-up.

conclusionsHospitalized older patients not taking diuretics prior to hospitalization for HF decompensation who received a discharge prescription for loop diuretics had significantly better 30-day clinical outcomes than those not discharged on loop diuretics. These findings provide new information about short-term clinical benefits associated with loop diuretic use in HF.

Indexed as

AgedAged, 80 and overCohort StudiesFemaleHeart FailureHumansMaleSodium Potassium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeSodium Potassium Chloride Symporter Inhibitorsheart failureloop diureticsoutcomes

Identifiers

PMID32762901
PMCPMC9067440
OpenAlexW3047531789

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.