Door-to-diuretic time and mortality in patients with acute heart failure: A systematic review and meta-analysis

Am Heart J. 2024 Mar:269:205-209. doi: 10.1016/j.ahj.2023.12.012.

Abstract

Early decongestion therapy with intravenous diuretics may be associated with improved outcomes in acute heart failure (AHF), however data is conflicting. This meta-analysis sought to evaluate the impact of door-to-IV diuretic (D2D) time on mortality in patients with AHF. Pooled estimates from observational studies comprising 28,124 patients, early IV diuresis (reference time 30-105 minutes) was associated with a 23% reduction in 30-day mortality in AHF (OR 0.77; 95% CI 0.64-0.93), despite no significant in-hospital death reduction (OR 0.84; 95% CI 0.57-1.24).

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Diuretics* / administration & dosage
  • Diuretics* / therapeutic use
  • Heart Failure* / drug therapy
  • Heart Failure* / mortality
  • Hospital Mortality / trends
  • Humans
  • Time Factors
  • Time-to-Treatment / statistics & numerical data

Substances

  • Diuretics