RT journal article
T1 Prognostic effect of the combined use of thiazides and loop diuretics at discharge following a hospitalization for acute heart failure
A1 Miñana, Gema
A1 Trullàs, Joan Carles
A1 de la Espriella, Rafael
A1 Núñez Aragon, Raquel
A1 Gasull, Andrea
A1 López Sáez, José Juan Bosco
A1 Montiel, Jorge
A1 Lorenzo Hernández, Miguel
A1 Fernández Cisnal, Agustín
A1 Valero, Ernesto
A1 Núñez-Vicent Bodí, Gonzalo
A1 Miró, Òscar
A1 Sanchis, Juan
A1 Bayés‑Genis, Antoni
A1 Núñez, Julio
A2 Medicina
K1 Tiazidas
K1 Diuréticos de asa
K1 Combinación de diuréticos
K1 Congestión
K1 Insuficiencia cardíaca aguda
K1 Thiazides
K1 Loop diuretics
K1 Diuretic combination
K1 Congestion
K1 Acute heart failure
AB 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 atdischarge 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 forAHF in a single teaching center. The association between thiazides on discharge across the intensity of LD treatment and30-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 showedleft 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%) deathsand 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 associationin 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-dayAHF readmission when they were prescribed in patients receiving high LD doses.
PB Springer
SN 1861-0684
YR 2025
FD 2025
LK http://hdl.handle.net/10498/38532
UL http://hdl.handle.net/10498/38532
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-may-2026