Comparison of salt with low-dose furosemide and carperitide for treating acute decompensated heart failure: a single-center retrospective cohort study
Hypertonic saline with furosemide has been proposed for a long time as an effective therapeutic option for the treatment of acute decompensated heart failure (ADHF). We previously reported the efficacy of continuous infusion of 1.7 % hypertonic saline plus low-dose furosemide in treatment for ADHF....
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| Veröffentlicht in: | Heart and vessels 2017-04, Vol.32 (4), p.419-427 |
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| creator | Okuhara, Yoshitaka Hirotani, Shinichi Ando, Tomotaka Nishimura, Koichi Orihara, Yoshiyuki Komamura, Kazuo Naito, Yoshiro Mano, Toshiaki Masuyama, Tohru |
| description | Hypertonic saline with furosemide has been proposed for a long time as an effective therapeutic option for the treatment of acute decompensated heart failure (ADHF). We previously reported the efficacy of continuous infusion of 1.7 % hypertonic saline plus low-dose furosemide in treatment for ADHF. Although this therapeutic strategy can be a useful option for effective decongestion in treatment for ADHF, there is no study that assesses the effect and safety of saline supplementation compared with standard therapy in Japan. The aim of this study was to investigate the efficacy, safety, and cost-effectiveness of 1.7 % hypertonic saline plus low-dose furosemide infusion compared with carperitide. We compared clinical outcomes, adverse events, and cost for patients receiving carperitide (carperitide group) with those for patients receiving 1.7 % hypertonic saline plus low-dose furosemide (salt group) during the initial hospitalization for ADHF. The cost analysis was performed on the basis of the previous report about cost-effectiveness of acute heart failure. A total of 175 ADHF patients received either carperitide (
n
= 111) or 1.7 % hypertonic saline plus low-dose furosemide infusion (
n
= 64) as initial treatment. There were no differences in length of hospital stay (27 ± 19 vs. 25 ± 16 day,
p
= 0.170) and infusion period (7.2 ± 6.1 vs. 8.4 ± 7.5 day,
p
= 0.474) between the two groups. The incidence of rehospitalization did not differ at 1 month (7.6 vs. 6.6 %,
p
= 1.000) and 1 year (36.8 vs. 37.7 %,
p
= 0.907) between the two groups. The Kaplan–Meier curves revealed no significant difference for 1 year all-cause mortality between the two groups (log-rank,
p
= 0.724). The single hospitalization cost was 95,314 yen lower and the yearly hospitalization cost 125,628 yen lower in the salt group compared with the carperitide group. Thus, intravenous 1.7 % hypertonic saline plus low-dose furosemide infusion is as effective as carperitide in terms of clinical outcome and is a cost-effective therapeutic strategy for the treatment of ADHF. |
| doi_str_mv | 10.1007/s00380-016-0883-1 |
| format | Article |
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n
= 111) or 1.7 % hypertonic saline plus low-dose furosemide infusion (
n
= 64) as initial treatment. There were no differences in length of hospital stay (27 ± 19 vs. 25 ± 16 day,
p
= 0.170) and infusion period (7.2 ± 6.1 vs. 8.4 ± 7.5 day,
p
= 0.474) between the two groups. The incidence of rehospitalization did not differ at 1 month (7.6 vs. 6.6 %,
p
= 1.000) and 1 year (36.8 vs. 37.7 %,
p
= 0.907) between the two groups. The Kaplan–Meier curves revealed no significant difference for 1 year all-cause mortality between the two groups (log-rank,
p
= 0.724). The single hospitalization cost was 95,314 yen lower and the yearly hospitalization cost 125,628 yen lower in the salt group compared with the carperitide group. Thus, intravenous 1.7 % hypertonic saline plus low-dose furosemide infusion is as effective as carperitide in terms of clinical outcome and is a cost-effective therapeutic strategy for the treatment of ADHF.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-016-0883-1</identifier><identifier>PMID: 27469321</identifier><identifier>CODEN: HEVEEO</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Acute Disease ; Aged ; Aged, 80 and over ; Atrial Natriuretic Factor - administration & dosage ; Atrial Natriuretic Factor - economics ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Costs and Cost Analysis ; Diuretics - administration & dosage ; Diuretics - economics ; Drug therapy ; Echocardiography ; Female ; Follow-Up Studies ; Furosemide - administration & dosage ; Furosemide - economics ; Heart failure ; Heart Failure - drug therapy ; Heart Failure - mortality ; Hospitalization - economics ; Humans ; Infusions, Intravenous ; Japan ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Retrospective Studies ; Saline Solution, Hypertonic - administration & dosage ; Saline Solution, Hypertonic - economics ; Treatment Outcome ; Vascular Surgery</subject><ispartof>Heart and vessels, 2017-04, Vol.32 (4), p.419-427</ispartof><rights>Springer Japan 2016</rights><rights>Heart and Vessels is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c429t-f351450beddbaa2445280daf9c87ebe6b32effd48d569b71d5a4e50f53d2dc8e3</citedby><cites>FETCH-LOGICAL-c429t-f351450beddbaa2445280daf9c87ebe6b32effd48d569b71d5a4e50f53d2dc8e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-016-0883-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-016-0883-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27469321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okuhara, Yoshitaka</creatorcontrib><creatorcontrib>Hirotani, Shinichi</creatorcontrib><creatorcontrib>Ando, Tomotaka</creatorcontrib><creatorcontrib>Nishimura, Koichi</creatorcontrib><creatorcontrib>Orihara, Yoshiyuki</creatorcontrib><creatorcontrib>Komamura, Kazuo</creatorcontrib><creatorcontrib>Naito, Yoshiro</creatorcontrib><creatorcontrib>Mano, Toshiaki</creatorcontrib><creatorcontrib>Masuyama, Tohru</creatorcontrib><title>Comparison of salt with low-dose furosemide and carperitide for treating acute decompensated heart failure: a single-center retrospective cohort study</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Hypertonic saline with furosemide has been proposed for a long time as an effective therapeutic option for the treatment of acute decompensated heart failure (ADHF). We previously reported the efficacy of continuous infusion of 1.7 % hypertonic saline plus low-dose furosemide in treatment for ADHF. Although this therapeutic strategy can be a useful option for effective decongestion in treatment for ADHF, there is no study that assesses the effect and safety of saline supplementation compared with standard therapy in Japan. The aim of this study was to investigate the efficacy, safety, and cost-effectiveness of 1.7 % hypertonic saline plus low-dose furosemide infusion compared with carperitide. We compared clinical outcomes, adverse events, and cost for patients receiving carperitide (carperitide group) with those for patients receiving 1.7 % hypertonic saline plus low-dose furosemide (salt group) during the initial hospitalization for ADHF. The cost analysis was performed on the basis of the previous report about cost-effectiveness of acute heart failure. A total of 175 ADHF patients received either carperitide (
n
= 111) or 1.7 % hypertonic saline plus low-dose furosemide infusion (
n
= 64) as initial treatment. There were no differences in length of hospital stay (27 ± 19 vs. 25 ± 16 day,
p
= 0.170) and infusion period (7.2 ± 6.1 vs. 8.4 ± 7.5 day,
p
= 0.474) between the two groups. The incidence of rehospitalization did not differ at 1 month (7.6 vs. 6.6 %,
p
= 1.000) and 1 year (36.8 vs. 37.7 %,
p
= 0.907) between the two groups. The Kaplan–Meier curves revealed no significant difference for 1 year all-cause mortality between the two groups (log-rank,
p
= 0.724). The single hospitalization cost was 95,314 yen lower and the yearly hospitalization cost 125,628 yen lower in the salt group compared with the carperitide group. Thus, intravenous 1.7 % hypertonic saline plus low-dose furosemide infusion is as effective as carperitide in terms of clinical outcome and is a cost-effective therapeutic strategy for the treatment of ADHF.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrial Natriuretic Factor - administration & dosage</subject><subject>Atrial Natriuretic Factor - economics</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Costs and Cost Analysis</subject><subject>Diuretics - administration & dosage</subject><subject>Diuretics - economics</subject><subject>Drug therapy</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Furosemide - administration & dosage</subject><subject>Furosemide - economics</subject><subject>Heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - mortality</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Japan</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Saline Solution, Hypertonic - administration & dosage</subject><subject>Saline Solution, Hypertonic - economics</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc-KFDEQh4Mo7rj6AF4k4MVLNH86ncSbDKu7sOBFz006qexk6e60SdplX8TnNcOsIoJ4KkJ99RWpH0IvGX3LKFXvCqVCU0JZT6jWgrBHaMd6JgmXSjxGO2oYJVpwdYaelXJLKZOGmafojKuuN4KzHfqxT_NqcyxpwSngYqeK72I94CndEZ8K4LDlVuboAdvFY2fzCjnW4zukjGsGW-Nyg63bKmAPrglhKbaCxwewueJg47RleI8tLo2cgDhYKmScoTb3Cq7G74BdOqRGl7r5--foSbBTgRcP9Rx9_XjxZX9Jrj9_utp_uCau46aSICTrJB3B-9Fa3nWSa-ptME4rGKEfBYcQfKe97M2omJe2A0mDFJ57p0Gcozcn75rTtw1KHeZYHEyTXSBtZWDaMK04b9f6P8p7JZShXUNf_4Xepi0v7SON0sxIY5hqFDtRrh2hZAjDmuNs8_3A6HDMdzjlO7R8h2O-A2szrx7M2ziD_z3xK9AG8BNQWmu5gfzH6n9afwKj47O9</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Okuhara, Yoshitaka</creator><creator>Hirotani, Shinichi</creator><creator>Ando, Tomotaka</creator><creator>Nishimura, Koichi</creator><creator>Orihara, Yoshiyuki</creator><creator>Komamura, Kazuo</creator><creator>Naito, Yoshiro</creator><creator>Mano, Toshiaki</creator><creator>Masuyama, Tohru</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Comparison of salt with low-dose furosemide and carperitide for treating acute decompensated heart failure: a single-center retrospective cohort study</title><author>Okuhara, Yoshitaka ; Hirotani, Shinichi ; Ando, Tomotaka ; Nishimura, Koichi ; Orihara, Yoshiyuki ; Komamura, Kazuo ; Naito, Yoshiro ; Mano, Toshiaki ; Masuyama, Tohru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c429t-f351450beddbaa2445280daf9c87ebe6b32effd48d569b71d5a4e50f53d2dc8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atrial Natriuretic Factor - administration & dosage</topic><topic>Atrial Natriuretic Factor - economics</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Costs and Cost Analysis</topic><topic>Diuretics - administration & dosage</topic><topic>Diuretics - economics</topic><topic>Drug therapy</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Furosemide - administration & dosage</topic><topic>Furosemide - economics</topic><topic>Heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - mortality</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Japan</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Saline Solution, Hypertonic - administration & dosage</topic><topic>Saline Solution, Hypertonic - economics</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okuhara, Yoshitaka</creatorcontrib><creatorcontrib>Hirotani, Shinichi</creatorcontrib><creatorcontrib>Ando, Tomotaka</creatorcontrib><creatorcontrib>Nishimura, Koichi</creatorcontrib><creatorcontrib>Orihara, Yoshiyuki</creatorcontrib><creatorcontrib>Komamura, Kazuo</creatorcontrib><creatorcontrib>Naito, Yoshiro</creatorcontrib><creatorcontrib>Mano, Toshiaki</creatorcontrib><creatorcontrib>Masuyama, Tohru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okuhara, Yoshitaka</au><au>Hirotani, Shinichi</au><au>Ando, Tomotaka</au><au>Nishimura, Koichi</au><au>Orihara, Yoshiyuki</au><au>Komamura, Kazuo</au><au>Naito, Yoshiro</au><au>Mano, Toshiaki</au><au>Masuyama, Tohru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of salt with low-dose furosemide and carperitide for treating acute decompensated heart failure: a single-center retrospective cohort study</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>32</volume><issue>4</issue><spage>419</spage><epage>427</epage><pages>419-427</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><coden>HEVEEO</coden><abstract>Hypertonic saline with furosemide has been proposed for a long time as an effective therapeutic option for the treatment of acute decompensated heart failure (ADHF). We previously reported the efficacy of continuous infusion of 1.7 % hypertonic saline plus low-dose furosemide in treatment for ADHF. Although this therapeutic strategy can be a useful option for effective decongestion in treatment for ADHF, there is no study that assesses the effect and safety of saline supplementation compared with standard therapy in Japan. The aim of this study was to investigate the efficacy, safety, and cost-effectiveness of 1.7 % hypertonic saline plus low-dose furosemide infusion compared with carperitide. We compared clinical outcomes, adverse events, and cost for patients receiving carperitide (carperitide group) with those for patients receiving 1.7 % hypertonic saline plus low-dose furosemide (salt group) during the initial hospitalization for ADHF. The cost analysis was performed on the basis of the previous report about cost-effectiveness of acute heart failure. A total of 175 ADHF patients received either carperitide (
n
= 111) or 1.7 % hypertonic saline plus low-dose furosemide infusion (
n
= 64) as initial treatment. There were no differences in length of hospital stay (27 ± 19 vs. 25 ± 16 day,
p
= 0.170) and infusion period (7.2 ± 6.1 vs. 8.4 ± 7.5 day,
p
= 0.474) between the two groups. The incidence of rehospitalization did not differ at 1 month (7.6 vs. 6.6 %,
p
= 1.000) and 1 year (36.8 vs. 37.7 %,
p
= 0.907) between the two groups. The Kaplan–Meier curves revealed no significant difference for 1 year all-cause mortality between the two groups (log-rank,
p
= 0.724). The single hospitalization cost was 95,314 yen lower and the yearly hospitalization cost 125,628 yen lower in the salt group compared with the carperitide group. Thus, intravenous 1.7 % hypertonic saline plus low-dose furosemide infusion is as effective as carperitide in terms of clinical outcome and is a cost-effective therapeutic strategy for the treatment of ADHF.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>27469321</pmid><doi>10.1007/s00380-016-0883-1</doi><tpages>9</tpages></addata></record> |
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| ispartof | Heart and vessels, 2017-04, Vol.32 (4), p.419-427 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Acute Disease Aged Aged, 80 and over Atrial Natriuretic Factor - administration & dosage Atrial Natriuretic Factor - economics Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Costs and Cost Analysis Diuretics - administration & dosage Diuretics - economics Drug therapy Echocardiography Female Follow-Up Studies Furosemide - administration & dosage Furosemide - economics Heart failure Heart Failure - drug therapy Heart Failure - mortality Hospitalization - economics Humans Infusions, Intravenous Japan Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Original Article Retrospective Studies Saline Solution, Hypertonic - administration & dosage Saline Solution, Hypertonic - economics Treatment Outcome Vascular Surgery |
| title | Comparison of salt with low-dose furosemide and carperitide for treating acute decompensated heart failure: a single-center retrospective cohort study |
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