The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure

Jin Joo Park, Sun Hwa Kim, Il Young Oh, Dong Ju Choi, Hyun Ah Park, Hyun Jai Cho, Hae Young Lee, Jae Yeong Cho, Kye Hun Kim, Jung Woo Son, Byung Su Yoo, Jaewon Oh, Seok Min Kang, Sang Hong Baek, Ga Yeon Lee, Jin Oh Choi, Eun Seok Jeon, Sang Eun Lee, Jae Joong Kim, Ju Hee LeeMyeong Chan Cho, Se Yong Jang, Shung Chull Chae, Byung Hee Oh

Research output: Contribution to journalArticle

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Abstract

Objectives: This study sought to examine the impact of door-to-diuretic (D2D) time on mortality in patients with acute heart failure (AHF) who were presenting to an emergency department (ED). Background: Most patients with AHF present with congestion. Early decongestion with diuretic agents could improve their clinical outcomes. Methods: The Korea Acute Heart Failure registry enrolled 5,625 consecutive patients hospitalized for AHF. For this analysis, the study included patients who received intravenous diuretic agents within 24 h after ED arrival. Early and delayed groups were defined as D2D time ≤60 min and D2D time >60 min, respectively. The primary outcomes were in-hospital death and post-discharge death at 1 month and 1 year on the basis of D2D time. Results: A total of 2,761 patients met the inclusion criteria. The median D2D time was 128 min (interquartile range: 63 to 243 min), and 663 (24%) patients belonged to the early group. The baseline characteristics were similar between the groups. The rate of in-hospital death did not differ between the groups (5.0% vs. 5.1%; p > 0.999), nor did the post-discharge 1-month (4.0% vs. 3.0%; log-rank p = 0.246) and 1-year (20.6% vs. 19.3%; log-rank p = 0.458) mortality rates. Get With the Guidelines-Heart Failure risk score was calculated for each patient. In multivariate analyses with adjustment for Get With the Guidelines-Heart Failure risk score and other significant clinical covariates and propensity-matched analyses, D2D time was not associated with clinical outcomes. Conclusions: The D2D time was not associated with clinical outcomes in a large prospective cohort of patients with AHF who were presenting to an ED. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843)

Original languageEnglish
Pages (from-to)286-294
Number of pages9
JournalJACC: Heart Failure
Volume6
Issue number4
DOIs
Publication statusPublished - 2018 Apr

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Diuretics
Heart Failure
Hospital Emergency Service
Korea
Registries
Guidelines
Mortality
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, J. J., Kim, S. H., Oh, I. Y., Choi, D. J., Park, H. A., Cho, H. J., ... Oh, B. H. (2018). The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure. JACC: Heart Failure, 6(4), 286-294. https://doi.org/10.1016/j.jchf.2017.12.017
Park, Jin Joo ; Kim, Sun Hwa ; Oh, Il Young ; Choi, Dong Ju ; Park, Hyun Ah ; Cho, Hyun Jai ; Lee, Hae Young ; Cho, Jae Yeong ; Kim, Kye Hun ; Son, Jung Woo ; Yoo, Byung Su ; Oh, Jaewon ; Kang, Seok Min ; Baek, Sang Hong ; Lee, Ga Yeon ; Choi, Jin Oh ; Jeon, Eun Seok ; Lee, Sang Eun ; Kim, Jae Joong ; Lee, Ju Hee ; Cho, Myeong Chan ; Jang, Se Yong ; Chae, Shung Chull ; Oh, Byung Hee. / The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure. In: JACC: Heart Failure. 2018 ; Vol. 6, No. 4. pp. 286-294.
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abstract = "Objectives: This study sought to examine the impact of door-to-diuretic (D2D) time on mortality in patients with acute heart failure (AHF) who were presenting to an emergency department (ED). Background: Most patients with AHF present with congestion. Early decongestion with diuretic agents could improve their clinical outcomes. Methods: The Korea Acute Heart Failure registry enrolled 5,625 consecutive patients hospitalized for AHF. For this analysis, the study included patients who received intravenous diuretic agents within 24 h after ED arrival. Early and delayed groups were defined as D2D time ≤60 min and D2D time >60 min, respectively. The primary outcomes were in-hospital death and post-discharge death at 1 month and 1 year on the basis of D2D time. Results: A total of 2,761 patients met the inclusion criteria. The median D2D time was 128 min (interquartile range: 63 to 243 min), and 663 (24{\%}) patients belonged to the early group. The baseline characteristics were similar between the groups. The rate of in-hospital death did not differ between the groups (5.0{\%} vs. 5.1{\%}; p > 0.999), nor did the post-discharge 1-month (4.0{\%} vs. 3.0{\%}; log-rank p = 0.246) and 1-year (20.6{\%} vs. 19.3{\%}; log-rank p = 0.458) mortality rates. Get With the Guidelines-Heart Failure risk score was calculated for each patient. In multivariate analyses with adjustment for Get With the Guidelines-Heart Failure risk score and other significant clinical covariates and propensity-matched analyses, D2D time was not associated with clinical outcomes. Conclusions: The D2D time was not associated with clinical outcomes in a large prospective cohort of patients with AHF who were presenting to an ED. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843)",
author = "Park, {Jin Joo} and Kim, {Sun Hwa} and Oh, {Il Young} and Choi, {Dong Ju} and Park, {Hyun Ah} and Cho, {Hyun Jai} and Lee, {Hae Young} and Cho, {Jae Yeong} and Kim, {Kye Hun} and Son, {Jung Woo} and Yoo, {Byung Su} and Jaewon Oh and Kang, {Seok Min} and Baek, {Sang Hong} and Lee, {Ga Yeon} and Choi, {Jin Oh} and Jeon, {Eun Seok} and Lee, {Sang Eun} and Kim, {Jae Joong} and Lee, {Ju Hee} and Cho, {Myeong Chan} and Jang, {Se Yong} and Chae, {Shung Chull} and Oh, {Byung Hee}",
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Park, JJ, Kim, SH, Oh, IY, Choi, DJ, Park, HA, Cho, HJ, Lee, HY, Cho, JY, Kim, KH, Son, JW, Yoo, BS, Oh, J, Kang, SM, Baek, SH, Lee, GY, Choi, JO, Jeon, ES, Lee, SE, Kim, JJ, Lee, JH, Cho, MC, Jang, SY, Chae, SC & Oh, BH 2018, 'The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure', JACC: Heart Failure, vol. 6, no. 4, pp. 286-294. https://doi.org/10.1016/j.jchf.2017.12.017

The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure. / Park, Jin Joo; Kim, Sun Hwa; Oh, Il Young; Choi, Dong Ju; Park, Hyun Ah; Cho, Hyun Jai; Lee, Hae Young; Cho, Jae Yeong; Kim, Kye Hun; Son, Jung Woo; Yoo, Byung Su; Oh, Jaewon; Kang, Seok Min; Baek, Sang Hong; Lee, Ga Yeon; Choi, Jin Oh; Jeon, Eun Seok; Lee, Sang Eun; Kim, Jae Joong; Lee, Ju Hee; Cho, Myeong Chan; Jang, Se Yong; Chae, Shung Chull; Oh, Byung Hee.

In: JACC: Heart Failure, Vol. 6, No. 4, 04.2018, p. 286-294.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure

AU - Park, Jin Joo

AU - Kim, Sun Hwa

AU - Oh, Il Young

AU - Choi, Dong Ju

AU - Park, Hyun Ah

AU - Cho, Hyun Jai

AU - Lee, Hae Young

AU - Cho, Jae Yeong

AU - Kim, Kye Hun

AU - Son, Jung Woo

AU - Yoo, Byung Su

AU - Oh, Jaewon

AU - Kang, Seok Min

AU - Baek, Sang Hong

AU - Lee, Ga Yeon

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Lee, Sang Eun

AU - Kim, Jae Joong

AU - Lee, Ju Hee

AU - Cho, Myeong Chan

AU - Jang, Se Yong

AU - Chae, Shung Chull

AU - Oh, Byung Hee

PY - 2018/4

Y1 - 2018/4

N2 - Objectives: This study sought to examine the impact of door-to-diuretic (D2D) time on mortality in patients with acute heart failure (AHF) who were presenting to an emergency department (ED). Background: Most patients with AHF present with congestion. Early decongestion with diuretic agents could improve their clinical outcomes. Methods: The Korea Acute Heart Failure registry enrolled 5,625 consecutive patients hospitalized for AHF. For this analysis, the study included patients who received intravenous diuretic agents within 24 h after ED arrival. Early and delayed groups were defined as D2D time ≤60 min and D2D time >60 min, respectively. The primary outcomes were in-hospital death and post-discharge death at 1 month and 1 year on the basis of D2D time. Results: A total of 2,761 patients met the inclusion criteria. The median D2D time was 128 min (interquartile range: 63 to 243 min), and 663 (24%) patients belonged to the early group. The baseline characteristics were similar between the groups. The rate of in-hospital death did not differ between the groups (5.0% vs. 5.1%; p > 0.999), nor did the post-discharge 1-month (4.0% vs. 3.0%; log-rank p = 0.246) and 1-year (20.6% vs. 19.3%; log-rank p = 0.458) mortality rates. Get With the Guidelines-Heart Failure risk score was calculated for each patient. In multivariate analyses with adjustment for Get With the Guidelines-Heart Failure risk score and other significant clinical covariates and propensity-matched analyses, D2D time was not associated with clinical outcomes. Conclusions: The D2D time was not associated with clinical outcomes in a large prospective cohort of patients with AHF who were presenting to an ED. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843)

AB - Objectives: This study sought to examine the impact of door-to-diuretic (D2D) time on mortality in patients with acute heart failure (AHF) who were presenting to an emergency department (ED). Background: Most patients with AHF present with congestion. Early decongestion with diuretic agents could improve their clinical outcomes. Methods: The Korea Acute Heart Failure registry enrolled 5,625 consecutive patients hospitalized for AHF. For this analysis, the study included patients who received intravenous diuretic agents within 24 h after ED arrival. Early and delayed groups were defined as D2D time ≤60 min and D2D time >60 min, respectively. The primary outcomes were in-hospital death and post-discharge death at 1 month and 1 year on the basis of D2D time. Results: A total of 2,761 patients met the inclusion criteria. The median D2D time was 128 min (interquartile range: 63 to 243 min), and 663 (24%) patients belonged to the early group. The baseline characteristics were similar between the groups. The rate of in-hospital death did not differ between the groups (5.0% vs. 5.1%; p > 0.999), nor did the post-discharge 1-month (4.0% vs. 3.0%; log-rank p = 0.246) and 1-year (20.6% vs. 19.3%; log-rank p = 0.458) mortality rates. Get With the Guidelines-Heart Failure risk score was calculated for each patient. In multivariate analyses with adjustment for Get With the Guidelines-Heart Failure risk score and other significant clinical covariates and propensity-matched analyses, D2D time was not associated with clinical outcomes. Conclusions: The D2D time was not associated with clinical outcomes in a large prospective cohort of patients with AHF who were presenting to an ED. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843)

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