title: The effect of intravenous isosorbide dinitrate in acute decompensated heart failure in hospital.
abstract: Background According to new recommendations for the management of acute decompensated heart failure (ADHF) in 2015, intravenous vasodilator therapy might be given as an early therapy when systolic blood pressure is normal to high (≥110 mmHg). Only 29% of patients with ADHF are treated with vasodilators without medical contraindication. Objective To evaluate the effect of the systematic use of ISDN on ADHF without contraindication especially on rehospitalization rate. Settings The 600-bed hospital (Centre Hospitalier de l'Ouest Vosgien, Neufchâteau, France). Methods This is a retrospective study with data analysed from medical records. Patients with ADHF episodes and hospitalization in the cardiology department or intensive care unit (ICU) between November 2013 and December 2015 were included resulting in 199 hospitalizations in the analysis (37 were treated by ISDN, and 162 were not). Main outcome measure Effects of ISDN on 180-day hospital readmission for ADHF or acute myocardial infarction (AMI), in-hospital mortality, length of stay, number of ICU admissions, and ICU length of stay. Results Patients who received ISDN required more ICU admissions than the other patients (54.1 vs 33.3%, p = 0.02). Nevertheless 180-day hospital readmission was lower for patients who were receiving ISDN (8.1 vs 22.8%, p = 0.04). ISDN did not influence other clinical outcomes tested. Conclusion ISDN may minimize or prevent the consequences of altered haemodynamics. Lower rehospitalization rate with ISDN was seen in this study.
authors.affiliation: Department of Pharmacy, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France.
authors.forename: Jérémy
authors.initials: J
authors.lastname: Chambord
authors.affiliation: Department of Pharmacy, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France.
authors.forename: David
authors.initials: D
authors.lastname: Attivi
authors.affiliation: Department of Cardiology, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Thuus
authors.affiliation: Department of Pharmacy, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Zeghmouli
authors.affiliation: Department of Pharmacy, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France. stephane.gibaud@univ-lorraine.fr.|EA3452/CITHEFOR, Faculté de pharmacie, Université de Lorraine, 5, rue Albert Lebrun, 54000, Nancy, France. stephane.gibaud@univ-lorraine.fr.|Pharmacie Clinique, Faculté de Pharmacie, Université de Lorraine, 5, rue Albert Lebrun, 54000, Nancy, France. stephane.gibaud@univ-lorraine.fr.
authors.forename: Stéphane
authors.identifier: http://orcid.org/0000-0003-3594-0601
authors.initials: S
authors.lastname: Gibaud
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005602:France; D006333:Heart Failure / Q000188:drug therapy*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage*; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate
keywords: Acute decompensated heart failure; France; Guidelines; Isosorbide dinitrate; Rehospitalisation; Vasodilator