Relation between dose of loop diuretics and outcomes in a heart failure population: results of the ESCAPE trial.

Journal Article (Journal Article)

BACKGROUND: We examined the relation of maximal in-hospital diuretic dose to weight loss, changes in renal function, and mortality in hospitalised heart failure (HF) patients. METHODS: In ESCAPE, 395 patients received diuretics in-hospital. Weight was measured at baseline, discharge, and every other day before discharge. Weight loss was defined as the difference between baseline and last in-hospital weight. Mortality was assessed using a log-logistic model with non-zero background. RESULTS: Median weight loss: 2.8 kg (0.7, 6.1); mean: 3.7 kg (22% of values <0). Weight loss and maximum in-hospital dose were correlated (p=0.0007). Baseline weight, length of stay, and baseline brain natriuretic peptide were significant predictors of weight loss. After adjusting for these, dose was not a significant predictor of weight loss. A strong relation between dose and mortality was seen (p=0.003), especially at >300 mg/day. Dose remained a significant predictor of mortality after adjusting for baseline variables that significantly predicted mortality. Correlation between maximal dose and creatinine level change was not significant (r=0.043; p=0.412) CONCLUSIONS: High diuretic doses during HF hospitalisation are associated with increased mortality and poor 6-month outcome.

Full Text

Duke Authors

Cited Authors

  • Hasselblad, V; Gattis Stough, W; Shah, MR; Lokhnygina, Y; O'Connor, CM; Califf, RM; Adams, KF

Published Date

  • October 2007

Published In

Volume / Issue

  • 9 / 10

Start / End Page

  • 1064 - 1069

PubMed ID

  • 17719273

Pubmed Central ID

  • PMC3127394

International Standard Serial Number (ISSN)

  • 1388-9842

Digital Object Identifier (DOI)

  • 10.1016/j.ejheart.2007.07.011


  • eng

Conference Location

  • England