Key result
Early IV diuresis linked to ~23% lower 30-day mortality in acute heart failure.
Why the study?
Early decongestion with intravenous diuretics may improve outcomes in acute heart failure, but existing data remain conflicting.
Does early intravenous diuresis (door-to-diuretic time 30-105 minutes) reduce mortality in patients with acute heart failure?
Meta-Analysis (n=28,124)
Does early intravenous diuresis (door-to-diuretic time 30-105 minutes) reduce mortality in patients with acute heart failure?
Early administration of intravenous diuretics (within 30-105 minutes of arrival) in acute heart failure is associated with a significant reduction in 30-day mortality.
May support earlier IV diuresis in acute HF; extends observational meta-analysis but leaves RCTs open.
Early decongestion therapy with intravenous diuretics may be associated with improved outcomes in acute heart failure (AHF), however data is conflicting. This meta-analysis sought to evaluate the impact of door-to-IV diuretic (D2D) time on mortality in patients with AHF. Pooled estimates from observational studies comprising 28,124 patients, early IV diuresis (reference time 30-105 minutes) was associated with a 23% reduction in 30-day mortality in AHF (OR 0.77; 95% CI 0.64-0.93), despite no significant in-hospital death reduction (OR 0.84; 95% CI 0.57-1.24).
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Rodrigues et al. (2024) conducted a meta-analysis in Acute heart failure (AHF) (n=28,124). Early IV diuresis (door-to-IV diuretic time 30-105 minutes) was evaluated on 30-day mortality (OR 0.77, 95% CI 0.64-0.93). Early IV diuresis (door-to-IV diuretic time 30-105 minutes) was associated with a 23% reduction in 30-day mortality in patients with acute heart failure (OR 0.77; 95% CI 0.64-0.93).
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