Outcomes of diuretics in rheumatic heart disease with compensated chronic heart failure: a retrospective study

Abstract

Aims The purpose of this retrospective propensity score-matched study was to evaluate the superiority of different application approaches [continuous diuretics use (CDU) vs. intermittent diuretics use (IDU)] and types [loop diuretics (LDs) vs. thiazide diuretics (TDs)] of diuretics on long-term outcomes for rheumatic heart disease (RHD) patients with compensated chronic heart failure (CHF). Methods and results A total of 494 RHD patients with compensated CHF were analysed after propensity score matching. Cox proportional hazards regression model was used to investigate the associations of different diuretic application approaches and types with all-cause mortality, cardiovascular death (CVD), and cerebrovascular death. Binary logistic regression analyses were used to evaluate the associations of different diuretic application approaches and types with 1-, 3-, and 5-year heart failure (HF) re-hospitalization as well as new-onset atrial fibrillation (AF). In the comparison between IDU and CDU strategies for RHD patients with compensated CHF, CDU was associated with increased risks of all-cause mortality [adjusted hazard ratio (HR) = 2.47, 95% confidence interval (CI): 1.54-3.97, P < 0.001] and CVD (adjusted HR = 3.67, 95% CI: 1.95-6.89, P < 0.001) except cerebrovascular death (adjusted HR = 1.07, 95% CI: 0.34-3.41, P = 0.905). CDU was also associated with increased risks of 3-year [adjusted odds ratio (OR) = 1.80, 95% CI: 1.09-2.96, P = 0.022] and 5-year (adjusted OR = 2.02, 95% CI: 1.18-3.45, P = 0.010) HF re-hospitalization risk and new-onset AF (adjusted OR = 2.34, 95% CI: 1.31-4.20, P = 0.004) except 1-year HF re-hospitalization risk (adjusted OR = 1.54, 95% CI: 0.88-2.70, P = 0.130). In the comparison between TDs and LDs among study participants receiving IDU strategy, LDs were only associated with decreased 1-year HF re-hospitalization risk (adjusted OR = 0.30, 95% CI: 0.12-0.77, P = 0.012) rather than all-cause mortality, CVD, cerebrovascular death, 3and 5-year HF rehospitalization, and new-onset AF (all adjusted P > 0.05). In the comparison between TDs and LDs among study participants receiving CDU strategy, LDs were not associated with cerebrovascular death and 1-year HF re-hospitalization (both adjusted P > 0.05) but with increased risks of all-cause mortality (adjusted

Metastatic patterns and prognosis of patients with primary malignant cardiac tumor

“…Among multivariate Cox regression analyses, all variables in univariate analysis with p-value < 0.05 were entered into model 1 (age at diagnosis, median household income, histopathology and size); Model 2: it is the same as Model 1, and also including sex. Sex is one of the important sociodemographic characteristics in cardiovascular disease; Model 3: it is the same as Model 2, and also including surgery (21)(22)(23). Surgical resection is one of the important treatments of PMCT.…”

Association of Digoxin Application Approaches With Long-Term Clinical Outcomes in Rheumatic Heart Disease Patients With Heart Failure: A Retrospective Study

“…Blood sample analyses were executed by standard lab protocols. Echocardiography was carried out according to our previous protocol ( 15 ). The date of entry into the study was the RHD first diagnosis date.…”

Impact of renin‐angiotensin system inhibitors on long‐term clinical outcomes of patients with rheumatic heart disease

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“…AF was diagnosed according to prior history of AF or electrocardiographic findings at enrolment as well as during follow‐up. Coexisting medical conditions were evaluated according to relevant guidelines as follows: hypertension (HT), 12 coronary heart disease, 13 HF, 14 type 2 diabetes mellitus, 15 and stroke 16,17 . Cardiac standard chamber quantification was determined by echocardiography according to recommendations from the European Association of Echocardiography 18 .…”