Influence of Intravenous Nitrate Treatment on Early Mortality Among Patients With Acute Heart Failure. NITRO-EAHFE Study

Early intravenous nitroglycerin use in prehospital setting and in the emergency department to treat patients with acute heart failure: Insights from the EAHFE Spanish registry

“…None of them reported significant changes in mortality rates. A latter report that analyzed the impact of NTG administration in the ED to patients with AHF also did not observe any association with short-term survival [13]. Very recently, to assess the importance of vasodilator therapy in the management of AHF, the GALACTIC study has been conducted [4].…”

Clinical phenotypes of acute heart failure based on signs and symptoms of perfusion and congestion at emergency department presentation and their relationship with patient management and outcomes

“…This was observed despite the fact that the majority of patients, irrespective of the phenotype, received drugs directed to reduce congestion (diuretics and vasodilators). Currently, it is widely accepted that, while clearly improving symptoms in patients with AHF, these drugs have no impact on patient survival . Remarkably, in the current study, the presence of congestion conditioned longer hospital stay, with increases of 27% and 52% of prolonged admissions depending on the concomitant absence or presence of hypoperfusion, respectively, compared to the warm‐dry group.…”

Temporal trends in nitrate utilization for acute heart failure in elderly emergency patients: A single-centre observational study

“…In 2012, this recommendation was downgraded to Class IIa [8,10], as the scientific basis supporting its utilization seemed limited, with very few patients enrolled in randomized controlled trials evaluating Temporal trends in nitrate utilization in elderly emergency patients 7 nitrates in AHF [6,7]. Furthermore, some studies reported an absence of benefit in patients treated with nitrates [23,24], whereas others reported a significant improvement in terms of mortality and severe outcome after nitrate utilization [16,25]. A systematic review concluded that prescription of nitrates is based more on a clinical dogma than on high-quality trials, and reliable data on survival benefit are lacking [26].…”