relation: https://eprints.gla.ac.uk/326396/
title: Loop diuretic utilisation with or without heart failure: impact on prognosis
creator: Friday, Jocelyn M.
creator: Cleland, John
creator: Pellicori, Pierpaolo
creator: Wolters, Maria
creator: McMurray, John J.V.
creator: Jhund, Pardeep S.
creator: Forsyth, Paul
creator: McAllister, David A.
creator: Graham, Fraser J.
creator: Jones, Yola
creator: Lewsey, Jim
description: Background and Aims:    Many patients are prescribed loop diuretics without a diagnostic record of heart failure. Little is known about their characteristics and prognosis.    Methods:    Glasgow regional health records (2009-2016) were obtained for adults with cardiovascular disease or taking loop diuretics. Outcomes were investigated using Cox models with hazard ratios adjusted for age, sex, socioeconomic deprivation, and co-morbid disease (adjHR).    Results:    Of 198,898 patients (median age 65 years; 55% women), 161,935 (81%) neither took loop diuretics nor had a diagnostic record of heart failure (reference group), 23,963 (12%) were taking loop diuretics but had no heart failure recorded, 7,844 (4%) had heart failure recorded and took loop diuretics and 5,156 (3%) had heart failure recorded but were not receiving loop diuretics.    Five-year mortality was only slightly higher for heart failure in absence of loop diuretics (22%; adjHR: 1.2 [95% CI 1.1-1.3]), substantially higher for those taking loop diuretics with no heart failure recorded (40%; adjHR: 1.8 [95% CI 1.7-1.8]) and highest for heart failure treated with loop diuretics (52%; adjHR: 2.2 [95% CI 2.0-2.2]).    Conclusions:    For patients with cardiovascular disease, many are prescribed loop diuretics without a diagnosis of heart failure being recorded. Mortality is more strongly associated with loop diuretic use than with a heart failure record. The diagnosis of heart failure may be often missed, or loop diuretic use is associated with other conditions with a prognosis similar to heart failure, or inappropriate loop diuretic use increases mortality; all might be true.
publisher: Oxford University Press (OUP) on behalf of European Society of Cardiology
date: 2024-06-07
type: Articles
type: PeerReviewed
format: text
language: en
rights: cc_by_4
identifier: https://eprints.gla.ac.uk/326396/1/326396.pdf
identifier:   Friday, J. M. et al.  (2024)  Loop diuretic utilisation with or without heart failure: impact on prognosis.   European Heart Journal <https://eprints.gla.ac.uk/view/journal_volume/European_Heart_Journal.html>,    (doi: 10.1093/eurheartj/ehae345 <https://doi.org/10.1093/eurheartj/ehae345>) (PMID:38845446)       (Early Online Publication)  
relation: 10.1093/eurheartj/ehae345