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Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes.

Publication ,  Journal Article
Cooper, LB; Mentz, RJ; Gallup, D; Lala, A; DeVore, AD; Vader, JM; AbouEzzeddine, OF; Bart, BA; Anstrom, KJ; Hernandez, AF; Felker, GM
Published in: J Card Fail
September 2016

BACKGROUND: Though commonly noted in clinical practice, it is unknown if decongestion in acute heart failure (AHF) results in increased serum bicarbonate. METHODS AND RESULTS: For 678 AHF patients in the DOSE-AHF, CARRESS-HF, and ROSE-AHF trials, we assessed change in bicarbonate (baseline to 72-96 hours) according to decongestion strategy, and the relationship between bicarbonate change and protocol-defined decongestion. Median baseline bicarbonate was 28 mEq/L. Patients with baseline bicarbonate ≥28 mEq/L had lower ejection fraction, worse renal function and higher N-terminal pro-B-type natriuretic peptide than those with baseline bicarbonate <28 mEq/L. There were no differences in bicarbonate change between treatment groups in DOSE-AHF or ROSE-AHF (all P > .1). In CARRESS-HF, bicarbonate increased with pharmacologic care but decreased with ultrafiltration (median +3.3 vs -0.9 mEq/L, respectively; P < .001). Bicarbonate change was not associated with successful decongestion (P > .2 for all trials). CONCLUSIONS: In AHF, serum bicarbonate is most commonly elevated in patients with more severe heart failure. Despite being used in clinical practice as an indicator for decongestion, change in serum bicarbonate was not associated with significant decongestion.

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Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

September 2016

Volume

22

Issue

9

Start / End Page

738 / 742

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Statistics, Nonparametric
  • Severity of Illness Index
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
  • Male
 

Citation

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Cooper, L. B., Mentz, R. J., Gallup, D., Lala, A., DeVore, A. D., Vader, J. M., … Felker, G. M. (2016). Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes. J Card Fail, 22(9), 738–742. https://doi.org/10.1016/j.cardfail.2016.01.007
Cooper, Lauren B., Robert J. Mentz, Dianne Gallup, Anuradha Lala, Adam D. DeVore, Justin M. Vader, Omar F. AbouEzzeddine, et al. “Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes.J Card Fail 22, no. 9 (September 2016): 738–42. https://doi.org/10.1016/j.cardfail.2016.01.007.
Cooper LB, Mentz RJ, Gallup D, Lala A, DeVore AD, Vader JM, et al. Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes. J Card Fail. 2016 Sep;22(9):738–42.
Cooper, Lauren B., et al. “Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes.J Card Fail, vol. 22, no. 9, Sept. 2016, pp. 738–42. Pubmed, doi:10.1016/j.cardfail.2016.01.007.
Cooper LB, Mentz RJ, Gallup D, Lala A, DeVore AD, Vader JM, AbouEzzeddine OF, Bart BA, Anstrom KJ, Hernandez AF, Felker GM. Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes. J Card Fail. 2016 Sep;22(9):738–742.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

September 2016

Volume

22

Issue

9

Start / End Page

738 / 742

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Statistics, Nonparametric
  • Severity of Illness Index
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
  • Male