Prognostic implications of diuretic dose in chronic XXXX .

@entity1 @entity712 @entity1372 @entity1483 @entity204
BACKGROUND: Prognostic implications of diuretics dose are not completely understood. We aim to study the association between diuretic doses and long-term prognosis in @entity1 with chronic stable @entity712 ( @entity712 ). METHODS AND RESULTS: We conducted a retrospective cohort study of 244 @entity1 followed at an outpatient @entity712 clinic. Admission criteria were clinical stability in the previous 3 months and optimized medical therapy. Demographic characteristics, clinical, and laboratory parameters were recorded. @entity1 were followed for 2 years and the outcome was defined as all-cause @entity204 or hospital admission due to @entity712 worsening. @entity1 on  <= 80 mg @entity1483 were compared with those on higher doses. @entity1 were grouped according to @entity1483 dose ( <= 80 mg and >80 mg/d) and according to volemia as assessed by the @entity1372 retention score: <3 (euvolemia) versus >=  3 (hypervolemia). @entity1 on higher diuretic doses (n = 79) were older, more hypervolemic, and more symptomatic. @entity1 on >80 mg @entity1483 had a higher risk of @entity204 or hospital admission (hazard ratio [HR]: 2.07, 95% confidence interval [CI]: 1.37-3.1). For each 40-mg @entity1483 tablet, there was a 67% increase in risk of an adverse outcome within 2 years. The increase in risk was independent of other variables crudely associated with prognosis. Among euvolemic @entity1 , those on  <= 80 mg/d @entity1483 performed better than those on higher doses. Among hypervolemic @entity1 , the diuretic dose had no prognostic implications. CONCLUSIONS: Higher diuretic doses associated strongly and independently with adverse long-term outcome in chronic @entity712 . Possibly, in euvolemic @entity1 , efforts should be made to reduce diuretic dose.
