Evidence map›Paper›PMID 38872265›Full record

Observational studyESC heart failure2024

Phenotype and outcomes according to loop diuretic use in pulmonary arterial hypertension.

Giulio Savonitto, Davide Barbisan, Pietro Ameri, Carlo Maria Lombardi, Simonetta Monti, Mauro Driussi, Piero Gentile, Luke Howard, Matteo Toma, Matteo Pagnesi and 14 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Observational
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

24 authors.

Giulio SavonittoCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Via Valdoni 7, 34149, Trieste, Italy.ORCID 0000-0001-6324-9821
Davide BarbisanCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Via Valdoni 7, 34149, Trieste, Italy.
Pietro AmeriCardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Carlo Maria LombardiCardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Simonetta MontiCardiology and Pneumology Division, Fondazione Monasterio, Pisa, Italy.
Mauro DriussiCardiology, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
Piero GentileDe Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.
Luke HowardImperial College London, Faculty of Medicine, National Heart & Lung Institute, London, UK.
Matteo TomaCardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Matteo PagnesiCardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Valentino ColliniCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Via Valdoni 7, 34149, Trieste, Italy.
Carolina BauleoCardiology and Pneumology Division, Fondazione Monasterio, Pisa, Italy.
Marianna AdamoCardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Luciana D'AngeloDe Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.
Chiara NalliCardiac Surgery, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
Alberto GiannoniCardiology and Pneumology Division, Fondazione Monasterio, Pisa, Italy.
Veronica VecchiatoCardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Emma Di PoiRheumatology Clinic, Department of Medicine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
Edoardo AiroCardiology and Pneumology Division, Fondazione Monasterio, Pisa, Italy.
Marco MetraCardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Andrea GarasciaDe Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.
Gianfranco SinagraCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Via Valdoni 7, 34149, Trieste, Italy.
Francesco Lo GiudiceNational Pulmonary Hypertension Service, Department of Cardiology, Hammersmith Hospital, Imperial College NHS Trust, London, UK.
Davide StolfoCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Via Valdoni 7, 34149, Trieste, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe use of loop diuretics in pulmonary arterial hypertension (PAH) is less frequent compared with heart failure. The clinical and prognostic characteristics of PAH patients according to loop diuretic use remain unexplored. In this study, we retrospectively analysed the characteristics and survival of PAH patients requiring different doses of loop diuretics. METHODS AND

resultsPatients diagnosed with PAH between 2001 and 2022 at seven European centres for the management of PAH. According to the median equivalent dose of furosemide in the overall cohort, patients were divided into two subgroups: no/low-dose loop diuretic and high-dose loop diuretic. Primary outcome was 5 year all-cause mortality. Among the 397 patients included, 227 (57%) were treated with loop diuretics. Median daily furosemide equivalent dose was 25 mg, and accordingly patients were divided in no/low dose (i.e. ≤25 mg, n = 257, 65%) vs. high dose (i.e. >25 mg, n = 140, 35%). Patients in the high-dose group were older, more likely to have comorbidities, and had a more severe disease according to the ESC/ERS risk category. Crude 5 year survival was significantly shorter in patients in the high-dose group, but after adjustment for age, sex, and risk category, high loop diuretic dose was not significantly associated with the primary outcome.

conclusionsUse of high dose of loop diuretics in PAH is associated with a higher burden of comorbidities, more severe disease, and worse survival. However, in PAH, the need of high loop diuretic dose is a marker of disease severity and not an independent prognostic factor.

Indexed as

PhenotypePulmonary Arterial HypertensionSodium Potassium Chloride Symporter InhibitorsAgedDose-Response Relationship, DrugFemaleFollow-Up StudiesFurosemideHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateTreatment OutcomeFurosemideSodium Potassium Chloride Symporter InhibitorsComorbiditiesCongestionDiureticsPrognosisPulmonary hypertension

Identifiers

PMID38872265
PMCPMC11424338

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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.