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Physician-determined worsening heart failure: a novel definition for early worsening heart failure in patients hospitalized for acute heart failure--association with signs and symptoms, hospitalization duration, and 60-day outcomes.

Publication ,  Journal Article
Cotter, G; Metra, M; Weatherley, BD; Dittrich, HC; Massie, BM; Ponikowski, P; Bloomfield, DM; O'Connor, CM
Published in: Cardiology
2010

OBJECTIVES: To evaluate physician-determined worsening heart failure (PD-WHF) in patients admitted with acute heart failure (AHF). METHODS: The PROTECT pilot study evaluated rolofylline, an adenosine A(1) receptor antagonist, versus placebo in patients with AHF and renal impairment. Signs and symptoms of heart failure (HF) and diuretic administration were prospectively recorded daily for 7 days and patients were followed for 60 days. Patients were categorized into three groups: (A) PD-WHF, based on worsening symptoms and signs of HF and need for additional intravenous (IV) or mechanical therapy (n = 29); (B) increased IV diuretic therapy without PD-WHF (n = 61), and (C) neither PD-WHF nor increase in IV diuretic dose (n = 211). RESULTS: Patients in group A had slower resolution of dyspnea, longer mean (+/-SD) length of hospitalization (13.8 +/- 6.8 vs. 10.5 +/- 8.5 and 9.3 +/- 5.9 days in groups B and C, respectively; p < 0.05 for both), and higher 60-day death and cardiovascular or renal readmission rates [49.7 (95% confidence interval: 33.1-69.1) vs. 37.3 (26.4-50.9) vs. 19.5% (14.7-25.6) in groups B and C, respectively]. PD-WHF was a strong independent predictor of length of stay and 60-day death and cardiovascular or renal readmission. CONCLUSIONS: PD-WHF may be an indicator of short-term risk and treatment efficacy in AHF.

Duke Scholars

Published In

Cardiology

DOI

EISSN

1421-9751

Publication Date

2010

Volume

115

Issue

1

Start / End Page

29 / 36

Location

Switzerland

Related Subject Headings

  • Xanthines
  • Sodium Potassium Chloride Symporter Inhibitors
  • Severity of Illness Index
  • Renal Insufficiency
  • Prognosis
  • Patient Readmission
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
 

Citation

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Cotter, G., Metra, M., Weatherley, B. D., Dittrich, H. C., Massie, B. M., Ponikowski, P., … O’Connor, C. M. (2010). Physician-determined worsening heart failure: a novel definition for early worsening heart failure in patients hospitalized for acute heart failure--association with signs and symptoms, hospitalization duration, and 60-day outcomes. Cardiology, 115(1), 29–36. https://doi.org/10.1159/000249280
Cotter, Gad, Marco Metra, Beth Davison Weatherley, Howard C. Dittrich, Barry M. Massie, Piotr Ponikowski, Daniel M. Bloomfield, and Christopher M. O’Connor. “Physician-determined worsening heart failure: a novel definition for early worsening heart failure in patients hospitalized for acute heart failure--association with signs and symptoms, hospitalization duration, and 60-day outcomes.Cardiology 115, no. 1 (2010): 29–36. https://doi.org/10.1159/000249280.
Journal cover image

Published In

Cardiology

DOI

EISSN

1421-9751

Publication Date

2010

Volume

115

Issue

1

Start / End Page

29 / 36

Location

Switzerland

Related Subject Headings

  • Xanthines
  • Sodium Potassium Chloride Symporter Inhibitors
  • Severity of Illness Index
  • Renal Insufficiency
  • Prognosis
  • Patient Readmission
  • Middle Aged
  • Male
  • Length of Stay
  • Humans