Earlier Loop Diuretic Use Leads to Reduced Mortality in Heart Failure

HealthDay — For patients with acute heart failure, early treatment with loop diuretics is associated with lower in-hospital mortality, according to a study published in the Journal of the American College of Cardiology.

Yuya Matsue, MD, PhD, from Kameda Medical Center in Japan, and colleagues conducted a prospective multicenter observational cohort study involving patients with acute heart failure admitted through the emergency department. The authors examined the correlation between time to diuretic treatment (door-to-furosemide [D2F] time) and clinical outcome.

The researchers found that the median D2F time was 90 minutes among the 1291 patients treated with intravenous furosemide within 24 hours of emergency department arrival; 37.3% of patients were classified as the early-treatment group (D2F time of <60 minutes).

Compared with the non-early-treatment group, these patients were more likely to arrive by ambulance and had more signs of congestion. The early-treatment group had significantly lower in-hospital mortality (2.3% vs 6%). Earlier treatment remained significantly correlated with lower in-hospital mortality in multivariate analysis (odds ratio, 0.39).

“In this prospective multicenter, observational cohort study of patients presenting at the emergency department for acute heart failure, early treatment with intravenous loop diuretics was associated with lower in-hospital mortality,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Matsue Y, Damman K, Voors AA, et al. Time-to-furosemide treatment and mortality in patients hospitalized with acute heart failure. J Am Coll Cardiol. 2017 Jun 27;69(25):3042-3051. doi: 10.1016/j.jacc.2017.04.042.