Does combination diuretic therapy reduce all-cause mortality or improve decongestion in patients with acute heart failure compared with usual care?
In patients with acute heart failure, combination diuretic therapy improves short-term decongestion (weight loss) but does not improve hard clinical outcomes such as mortality or hospital readmissions.
BACKGROUND: Acute heart failure (AHF) is a severe clinical syndrome associated with high morbidity and mortality. Effective management of congestion is a primary treatment goal and often requires hospitalisation. While loop-diuretics remain the cornerstone of AHF therapy, the optimal combination of diuretics to an effective decongestion remains uncertain. This systematic review aims to evaluate the efficacy and safety of various diuretic combinations compared with usual care in AHF patients. METHODS: statistic. The primary outcome was all-cause mortality, and secondary outcomes included serious adverse events (SAEs), hospital readmissions and kidney failure. Exploratory outcomes included changes in body weight and urinary output. RESULTS: 89.53%) caused significant in-hospital body weight reduction, indicating enhanced decongestion. Network meta-analysis showed similar results, and TSA indicated that there was enough information to accept secondary diuretics influencing decongestion. CONCLUSIONS: Combination diuretic therapy improves short-term decongestion but does not reduce all-cause mortality, SAEs, hospital readmissions or kidney failure in patients with AHF.
Nahiz et al. (Thu,) studied this question.