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Impact of Intravenous Loop Diuretics on Outcomes of Patients Hospitalized with Acute Decompensated Heart Failure: Insights from the ADHERE Registry

Peacock W.F.a · Costanzo M.R.b · De Marco T.c · Lopatin M.d · Wynne J.d · Mills R.M.d · Emerman C.L.e
aDepartment of Emergency Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, bMidwest Heart Foundation, Lombard, Ill., cDivision of Cardiology, University of California, San Francisco, Calif., dScios Inc., Fremont, Calif., and eDepartment of Emergency Medicine, Case Western Reserve University, Cleveland, Ohio, USA Cardiology 2009;113:12–19 (DOI:10.1159/000164149)


The optimal use of diuretics in decompensated heart failure remains uncertain. We analyzed data from the ADHERE registry to look at the impact of diuretic dosing. 62,866 patients receiving <160 mg and 19,674 patients ≥160 mg of furosemide were analyzed. The patients receiving the lower doses had a lower risk for in-hospital mortality, ICU stay, prolonged hospitalization, or adverse renal effects. These findings suggest that future studies should evaluate strategies for minimizing exposure to high doses of diuretics.


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