Furosemide doses >40 mg/d in stable HFrEF patients were associated with a higher risk of all-cause mortality compared to low doses (HR 4.02; 95% CI 1.8-8.8; P=0.001).
Cohort (n=266)
Does higher furosemide prescription during the dry state reduce or worsen long-term survival in stable, optimally medicated outpatients with HFrEF?
In stable, optimally medicated patients with HFrEF, furosemide doses >40 mg/d during the dry state are associated with significantly increased long-term mortality.
Estimación del efecto: HR 4.02 (95% CI 1.8-8.8)
valor p: p=0.001
BACKGROUND: Furosemide is associated with poor prognosis in patients with heart failure and reduced ejection fraction (HFrEF). AIM: To evaluate the association between daily furosemide dose prescribed during the dry state and long-term survival in stable, optimally medicated outpatients with HFrEF. POPULATION AND METHODS: Two hundred sixty-six consecutive outpatients with left ventricular ejection fraction 80 mg). Cox regression was adjusted for significant confounders. RESULTS: The 3-year mortality rate was 33.8%. Mean dose of furosemide was 57.3 ± 21.4 mg/d. A total of 47.6% of patients received the low dose, 42.1% the intermediate dose, and 2.3% the high dose. Receiver operating characteristics for death associated with furosemide dose showed an area under the curve of 0.74 (95% confidence interval CI: 0.68-0.79; P 40 mg/d. An increasing daily dose of furosemide was associated with worse prognosis. Those receiving the intermediate dose (hazard ratio HR = 4.1; 95% CI: 2.57-6.64; P 40 mg/d, in a propensity score-matched cohort, had a greater risk of mortality than those receiving a low dose (HR = 4.02; 95% CI: 1.8-8.8; P = .001) and those not receiving furosemide (HR = 3.9; 95% CI: 0.07-14.2; P = .039). CONCLUSION: Furosemide administration during the dry state in stable, optimally medicated outpatients with HFrEF is unfavorably associated with long-term survival. The threshold dose was 40 mg/d.
Sargento et al. (Wed,) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=266). Furosemide vs. Low dose (0-40 mg/d) was evaluated on All-cause death (HR 4.02, 95% CI 1.8-8.8, p=0.001). Furosemide doses >40 mg/d in stable HFrEF patients were associated with a higher risk of all-cause mortality compared to low doses (HR 4.02; 95% CI 1.8-8.8; P=0.001).