scholarly journals Effects of Liraglutide on Worsening Renal Function Among Patients With Heart Failure With Reduced Ejection Fraction

2020 ◽  
Vol 13 (5) ◽  
Author(s):  
Brahim Redouane ◽  
Stephen J. Greene ◽  
Marat Fudim ◽  
Muthiah Vaduganathan ◽  
Andrew P. Ambrosy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Renal Function ◽  
Ejection Fraction ◽  
Cystatin C ◽  
Regression Models ◽  
Reduced Ejection Fraction ◽  
Logistic Regression Models ◽  
Patients With Heart Failure ◽  
Rank Score

Background: The FIGHT (Functional Impact of GLP-1 [glucagon-like peptide-1] for Heart Failure Treatment) trial randomized 300 patients with heart failure with reduced ejection fraction (HFrEF) and a recent hospitalization for heart failure to liraglutide versus placebo. While there was no difference in the primary outcome (rank score of time to death, time to rehospitalization for heart failure, and change in NT-proBNP [N-terminal pro-B-type natriuretic peptide]), there was a significant increase in cystatin C among patients randomized to liraglutide raising concern of adverse renal outcomes. We performed a post hoc analysis of FIGHT to investigate whether liraglutide was associated with worsening renal function (WRF). Methods: The relationship between randomization to liraglutide and WRF was evaluated using logistic regression models. Two hundred seventy-four patients (91%) had complete data to assess for WRF defined as: increase in SCr ≥0.3 mg/dL, or ≥25% decrease in estimated glomerular filtration rate, or an increase in cystatin C ≥0.3 mg/L from baseline to 180-days. Results: Patients with WRF (n=113, 41%), compared with those without, were older, had more comorbidities, and lower utilization of guideline-directed medical treatment. Logistic regression models showed that age and baseline cystatin C levels were associated with WRF. In adjusted models, liraglutide was not associated with excess risk of WRF compared with placebo (odds ratio, 1.02 [95% CI, 0.62–1.67]). There was also no difference in the rank score when WRF was added as a fourth-tier outcome. Conclusions: Liraglutide was not associated with WRF among patients with HFrEF and a recent hospitalization for heart failure. These data support the relative renal safety profile of liraglutide among patients with HFrEF. Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01800968.

scholarly journals Serum Osteoprotegerin and Carotid Intima-Media Thickness Are Related to High Arterial Stiffness in Heart Failure with Reduced Ejection Fraction

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 764
Author(s):  
Lajos Fehérvári ◽  
Attila Frigy ◽  
Lóránd Kocsis ◽  
István Adorján Szabó ◽  
Timea Magdolna Szabo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Arterial Stiffness ◽  
Ejection Fraction ◽  
Regression Models ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Logistic Regression Models

Arterial stiffness (AS) is a complex vascular phenomenon with consequences for central hemodynamics and left-ventricular performance. Circulating biomarkers have been associated with AS; however, their value in heart failure is poorly characterized. Our aim was to evaluate the clinical and biomarker correlates of AS in the setting of heart failure with reduced ejection fraction (HFrEF). In 78 hospitalized, hemodynamically stable patients (20 women, 58 men, mean age 65.8 ± 1.41 years) with HFrEF, AS was measured using aortic pulse wave velocity (PWV). Serum OPG, RANKL, sclerostin, and DKK-1 were determined, and the relationships between the clinical variables, vascular-calcification-related biomarkers, and PWV were evaluated by correlation analysis and linear and logistic regression models. OPG and the OPG/RANKL ratio were significantly higher in the group of patients (n = 37, 47.4%) with increased PWV (>10 m/s). PWV was positively correlated with age, left-ventricular ejection fraction, and carotid intima-media thickness (cIMT), and negatively correlated with the glomerular filtration rate. OPG and cIMT were significantly associated with PWV in the logistic regression models when adjusted for hypertension, EF, and the presence of atherosclerotic manifestations. Elevated serum OPG, together with cIMT, were significantly related to increased AS in the setting of HFrEF.

scholarly journals Associations of worsening renal function with loop diuretics in patients with heart failure with different ejection fraction categories

2020 ◽  
Author(s):  
Marvin Owusu-Ayeman ◽  
Xin He ◽  
Weihao Liang ◽  
Wengen Zhu ◽  
Yuzhong Wu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Equivalent Dose ◽  
Loop Diuretics ◽  
Close Monitoring ◽  
Odds Ratios ◽  
Reduced Ejection Fraction ◽  
Worsening Renal Function ◽  
Patients With Heart Failure

Abstract Background Heart failure patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) have different sensitivity to plasma volume change after decongestion, but the possible differential effects of loop diuretics dosage on worsening renal function (WRF) in heart failure (HF) categories remain unclear. Methods In 972 patients with HFpEF and 427 patients with HFrEF, we assessed the risk of WRF with the average daily furosemide equivalent dose, using multivariable logistic regression. WRF was defined as an increase in serum creatinine levels of more than 26.5 mmol/L during hospitalization. Results In patients with HFpEF and HFrEF, between-group differences in average daily furosemide equivalent dose (18.9 mg/d vs. 26.8 mg/d) and the prevalence of WRF (25.3% vs. 14.3%) were significant (p < 0.001). In multivariable-adjusted analyses, a doubling of the average furosemide equivalent dose was associated with higher risk of WRF in all patients, patients with HFpEF and HFrEF, with odds ratios amounting to 1.42, 1.41 and 1.60 (p ≤ 0.022), respectively. There was no interaction between heart failure categories and average furosemide equivalent dose (p = 0.37). The adjusted odds ratios of risk of WRF associated with intravenous furosemide were 1.26 (95% confidence interval [CI], 1.08–1.46; p = 0.002) in HFpEF but not significant in HFrEF(p = 0.099). Conclusions The risk of WRF was associated with higher furosemide dosage in both HF subtypes. Our observations highlight that close monitoring is required to prevent further renal impairment in all HF patients while using loop diuretics.

scholarly journals Loop diuretics, renal function and clinical outcome in patients with heart failure and reduced ejection fraction

2015 ◽  
Vol 18 (3) ◽  
pp. 328-336 ◽  
Author(s):  
Kevin Damman ◽  
John Kjekshus ◽  
John Wikstrand ◽  
John G.F. Cleland ◽  
Michel Komajda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Clinical Outcome ◽  
Ejection Fraction ◽  
Loop Diuretics ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

PULMONARY ARTERIAL CAPACITANCE AND RENAL FUNCTION IN PATIENTS WITH HEART FAILURE WITH PRESERVED AND REDUCED EJECTION FRACTION

2018 ◽  
Vol 71 (11) ◽  
pp. A726
Author(s):  
Hesam Mostafavi Toroghi ◽  
Kevin Lo ◽  
Benjamin Horn ◽  
Napatt Kanjanahattakij ◽  
Erum Malik ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Pulmonary Arterial
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