title: Early vasoactive drugs improve heart failure outcomes.
abstract: Vasoactive therapy is often used to treat acute decompensated heart failure (ADHF). The authors sought to determine whether clinical outcomes are temporally associated with time to vasoactive therapy (vasoactive time) in ADHF. Using the Acute Decompensated Heart Failure (ADHERE) Registry, the authors examined the relationship between vasoactive time and inpatient mortality within 48 hours of hospitalization. Vasoactive agents were used early (defined as <6 hours) in 22,788 (63.8%) patients and late in 12,912 (36.2%). Median vasoactive time was 1.7 and 14.7 hours in the early and late groups, respectively. In-hospital mortality was significantly lower in the early group (odds ratio, 0.87; 95% confidence interval, 0.79-0.96; P=.006), and the adjusted odds of death increased 6.8% for every 6 hours of treatment delay (95% confidence interval, 4.2-9.6; P<.0001). Early vasoactive initiation is associated with improved outcomes in patients hospitalized for ADHF.
authors.affiliation: Department of Emergency Medicine, The Cleveland Clinic, Cleveland, OH 44195, USA. peacocw@ccf.org
authors.forename: William Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Charles
authors.initials: C
authors.lastname: Emerman
authors.forename: Maria R
authors.initials: MR
authors.lastname: Costanzo
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Diercks
authors.forename: Margarita
authors.initials: M
authors.lastname: Lopatin
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D016001:Confidence Intervals; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D002316:Cardiotonic Agents; D014665:Vasodilator Agents