Evidence map›Paper›PMID 38011993›Full record

Observational studyOpen heart2023

Use of loop diuretics in patients with chronic heart failure: an observational overview.

Niels Tb Scholte, Dilan Aydin, Gerard Cm Linssen, Stefan Koudstaal, Philip C Rademaker, Peter R Geerlings, Marco Wf van Gent, Ismail Aksoy, Liane Oosterom, Eric Boersma and 2 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Open heart, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 22% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
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

12 authors at 9 institutions in 1 country.

Niels Tb Scholte *Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
Dilan Aydin *Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.ORCID 0000-0001-7351-3139
Gerard Cm LinssenDepartment of Cardiology, Hospital Group Twente, Almelo, The Netherlands.
Stefan KoudstaalDepartment of Cardiology, Groene Hart Hospital, Gouda, The Netherlands.
Philip C RademakerDepartment of Cardiology, ZorgSaam, Terneuzen, The Netherlands.
Peter R GeerlingsDepartment of Cardiology, St. Jans Gasthuis Weert, Weert, The Netherlands.
Marco Wf van GentDepartment of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Ismail AksoyDepartment of Cardiology, Admiraal De Ruyter Hospital, Goes, The Netherlands.
Liane OosteromDepartment of Cardiology, Dijklander Hospital, Hoorn, The Netherlands.
Eric BoersmaDepartment of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.ORCID 0000-0003-1159-7802
Hans-Peter Brunner-La RoccaDepartment of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Jasper J BrugtsDepartment of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands j.brugts@erasmusmc.nl.
Erasmus MC · NLAdmiraal De Ruyter Ziekenhuis · NLAlbert Schweitzer Ziekenhuis · NLGroene Hart Ziekenhuis · NLMaastricht University Medical Centre · NLReinier de Graaf Hospital · NLSt.Jans Gasthuis Weert · NLZiekenhuis Groep Twente · NLZorg in Ontwikkeling · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aimed to evaluate the use and dose of loop diuretics (LDs) across the entire ejection fraction (EF) spectrum in a large, 'real-world' cohort of chronic heart failure (HF) patients.

methodsA total of 10 366 patients with chronic HF from 34 Dutch outpatient HF clinics were analysed regarding diuretic use and diuretic dose. Data regarding daily diuretic dose were stratified by furosemide dose equivalent (FDE)>80 mg or ≤80 mg. Multivariable logistic regression models were used to assess the association between diuretic dose and clinical features.

resultsIn this cohort, 8512 (82.1%) patients used diuretics, of which 8179 (96.1%) used LDs. LD use was highest among HF with reduced EF (HFrEF) patients (81.1%) followed by HF with mild-reduced EF (76.1%) and HF with preserved ejection fraction EF (73.8%, p<0.001). Among all LDs users, the median FDE was 40 mg (IQR: 40-80). The results of the multivariable analysis showed that New York Heart Association classes III and IV and diabetes mellitus were one of the strongest determinants of an FDE >80 mg, across all HF categories. Renal impairment was associated with a higher FDE across the entire EF spectrum.

conclusionIn this large registry of real-world HF patients, LD use was highest among HFrEF patients. Advanced symptoms, diabetes mellitus and worse renal function were significantly associated with a higher diuretic dose regardless of left ventricular ejection fraction.

Indexed as

Diabetes MellitusHeart FailureDiureticsFurosemideHumansPrognosisSodium Potassium Chloride Symporter InhibitorsStroke VolumeVentricular Function, LeftDiureticsFurosemideSodium Potassium Chloride Symporter InhibitorsHEART FAILUREHeart Failure, DiastolicHeart Failure, SystolicPharmacology, Clinical

Identifiers

PMID38011993
PMCPMC10685956
OpenAlexW4389060384

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Registered trials

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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.