Effects of Nesiritide and Predictors of Urine Output in Acute Decompensated Heart Failure Results From ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure)

摘要: Objectives This study sought to determine if nesiritide increases diuresis in congestive heart failure patients. Background In the ASCEND-HF (Acute Study of Clinical Effectiveness Nesiritide and Decompensated Heart Failure), 7,141 patients hospitalized with acute decompensated (ADHF) were randomized receive or placebo for 24 to 168 h, addition standard care. There minimal effects on survival, future hospitalizations, symptoms. However, whether not ADHF is unknown. Methods Urine output was measured 5,864 subjects; these, 5,320 received loop diuretics had dose data recorded. Loop other than furosemide converted equivalent doses. A total 4,881 complete data. We used logistic regression models identify impact urine factors associated high output. Results Median (25th, 75th percentiles) 24-h 2,280 (1,550, 3,280) ml 2,200 3,200) (p = NS). diuretic (furosemide equivalent) 80 (40, 140) mg both placebo. Diuretic a strong predictor Other independent predictors included: male sex, greater body mass index, higher diastolic blood pressure, elevated jugular venous recent weight gain, lower urea nitrogen. The did change None interaction terms between affected prediction. Conclusions increase ADHF. Higher output, but neurohormonal activation (as evidenced by nitrogen concentration) pressure limited diuresis.