Timing of decongestion and its impact on acute heart failure prognosis

Aneta Kosiorek; Wojciech Tokarczyk; Oskar Szymański; Jan Biegus; Robert Zymliński

doi:10.5114/aoms/170249

Timing of decongestion and its impact on acute heart failure prognosis

Arch Med Sci. 2023 Aug 25;19(5):1551-1557. doi: 10.5114/aoms/170249. eCollection 2023.

Authors

Aneta Kosiorek¹, Wojciech Tokarczyk², Oskar Szymański², Jan Biegus¹, Robert Zymliński¹

Affiliations

¹ Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
² Student Scientific Organization, Wroclaw Medical University, Wroclaw, Poland.

Abstract

Introduction: The risk of unfavourable outcomes after an acute heart failure (AHF) episode remains high. Effective decongestion, reflected by haemoconcentration (HC), may guide therapy. Optimal timing of HC remains unspecified.

Methods: We analysed the AHF registry to evaluate the prognostic differences of various timing of HC. Subjects were divided into 3 groups by time of reaching HC.

Results: The groups differed in terms of 1-year occurrence of a composite of the mortality and AHF hospitalization (26% vs. 46% vs. 40%, early vs. late vs. no HC, p = 0.016).

Conclusions: Patients reaching HC earlier seem to present the best prognosis regarding the analysed composite endpoint.

Keywords: congestion; diuresis; diuretics; heart failure; renal function.