Get started
Work

Continuation of Chronic Heart Failure Therapies During Heart Failure Hospitalization - a Review

Year: 2019
Type: review
Abstract: Randomized controlled trials have demonstrated the benefits of guideline-directed medical therapy in the outpatient setting for treatment of chronic heart failure. However, the benefits of continuation (or discontinuation) of major chronic heart failure therapies when treating acute heart failure during hospitalization are less clear. Real and anticipated worsening renal function, hyperkalemia and hypotension are the three major reasons for discontinuation of renin-angiotensin-aldosterone system inhibitors during hospitalization, and a failure to resume renin-angiotensin-aldosterone system inhibitors before discharge could worsen cardiovascular outcomes. Available data, mostly observational, shows that continuation or initiation of renin-angiotensin-aldosterone system inhibitors appears efficacious, safe, and well tolerated in majority of acute heart failure patients during hospitalization. Worsening renal function portends poor prognosis only if associated with congestion in acute heart failure, and clinicians should not de-escalate diuretic therapy routinely for worsening renal function.
DOI: 10.31083/j.rcm.2019.03.562
Authors: Girish Singhania, Abutaleb A. Ejaz, Peter A. McCullough, Aaron Y. Kluger, Saravanan Balamuthusamy, Bhagwan Dass, Namrata Singhania, Adhish Agarwal
Institutions: CHI St. Vincent, University of Florida, Baylor University Medical Center, Baylor Scott & White Research Institute, University of North Texas, Texas Christian University, Mount Carmel East, University of Utah
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,200
OpenAlex ID: W2977742019
FWCI: 0.725
Cites: 25
Cited by: 19
Related to: 10