Key result
Concomitant decongestion attenuated the harmful associations of worsening renal function with all-cause mortality and heart transplantation in acute decompensated heart failure (P=0.004).
Why the study?
Worsening renal function is common in acute decompensated heart failure, but its impact on prognosis is controversial.
Does the achievement of concomitant decongestion attenuate the harmful association of worsening renal function with mortality in patients with acute decompensated heart failure?
Systematic Review
Does the achievement of concomitant decongestion attenuate the harmful association of worsening renal function with mortality in patients with acute decompensated heart failure?
p-value: p== 0.004
In patients with acute decompensated heart failure, achieving decongestion attenuates the mortality risk typically associated with worsening renal function.
Supports decongestion as primary goal in ADHF despite WRF; extends cardiorenal evidence from systematic review.
INTRODUCTION: Outcomes in acute decompensated heart failure (ADHF) have remained poor. Worsening renal function (WRF) is common among patients with ADHF. However, the impact of WRF on the prognosis is controversial. We hypothesized that in patients with ADHF, the achievement of concomitant decongestion would diminish the signal for harm associated with WRF. METHODS: We performed a systematic search of PubMed, EMBASE, and the Cochrane Library up to December 2019 for studies that assessed signs of decongestion in patients with WRF during ADHF admission. The primary outcome was all-cause mortality and heart transplantation. RESULTS: = 0.004). This tendency persisted for the sensitivity analyses. CONCLUSIONS: Decongestion is a powerful effect modifier that attenuates harmful associations of WRF with mortality. Future studies should not assess WRF as an endpoint without concomitant assessment of achieved volume status.
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Yamada et al. (2020) conducted a systematic review in Acute Decompensated Heart Failure. Worsening renal function and decongestion was evaluated on All-cause mortality and heart transplantation (p== 0.004). Concomitant decongestion attenuated the harmful associations of worsening renal function with all-cause mortality and heart transplantation in acute decompensated heart failure (P=0.004).
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