%0 Journal Article 
%A Miñana, Gema
%A Trullàs, Joan Carles
%A de la Espriella, Rafael
%A Núñez Aragon, Raquel
%A Gasull, Andrea
%A López Sáez, José Juan Bosco
%A Montiel, Jorge
%A Lorenzo Hernández, Miguel
%A Fernández Cisnal, Agustín
%A Valero, Ernesto
%A Núñez-Vicent Bodí, Gonzalo
%A Miró, Òscar
%A Sanchis, Juan
%A Bayés‑Genis, Antoni
%A Núñez, Julio
%T Prognostic effect of the combined use of thiazides and loop diuretics at discharge following a hospitalization for acute heart failure
%D 2025
%@ 1861-0684
%U http://hdl.handle.net/10498/38532
%X Aims There is limited information regarding the clinical impact of the concurrent use of thiazides and loop diuretics (LD)
after an episode of acute heart failure (AHF) hospitalization. We aimed to evaluate the impact of thiazide prescription at
discharge on top of LD on the short-term risk of AHF readmission.
Methods We included 3384 consecutive patients discharged from January 2008 to September 2021 after an admission for
AHF in a single teaching center. The association between thiazides on discharge across the intensity of LD treatment and
30-day AHF readmission was explored by Cox regression analysis. A validation cohort of 622 patients was also examined.
Results The mean age of the patients was 73.8 ± 11.2 years, 1672 (47.5%) were women, and 1733 (51.2%) patients showed
left ventricular ejection fraction > 50%. The median (IQR) NT-proBNP was 3409 (1829–6963) pg/mL. At discharge, 754
(22.3%) patients received high LD doses (> 80 mg/day) and 187 (5.5%) thiazides. At 30 days, we registered 76 (2.2%) deaths
and 449 (13.3%) AHF readmissions. Thiazides at discharge were not associated with the risk of 30-day AHF readmission
(HR = 0.92). However, this association was differentially influenced by the intensity of LD doses (p-value for interaction
= 0.030), with a lower AHF-readmission risk in those with LD dose > 80 mg/day (p = 0.038), and a neutral association
in those receiving low LD dose (≤ 80 mg/day) (p = 0.541).
Conclusions In patients discharged after an episode of AHF, thiazide prescription was associated with a lower risk of 30-day
AHF readmission when they were prescribed in patients receiving high LD doses.

%K Tiazidas
%K Diuréticos de asa
%K Combinación de diuréticos
%K Congestión
%K Insuficiencia cardíaca aguda
%K Thiazides
%K Loop diuretics
%K Diuretic combination
%K Congestion
%K Acute heart failure
%~ Universidad de Cádiz