Outpatient diuretic intensification across the cardiovascular-kidney-metabolic spectrum
This article relates to:
-
Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials
- Safia Chatur,
- Muthiah Vaduganathan,
- Robert A. Fletcher,
- Vlado Perkovic,
- Hiddo Heerspink,
- Clare Arnott,
- Carol Pollock,
- Kenneth W. Mahaffey,
- Bruce Neal,
- Meg Jardine,
- Scott D. Solomon,
- Brendon L. Neuen,
- Volume 27Issue 6European Journal of Heart Failure
- pages: 994-1002
- First Published online: January 23, 2025
Pedro Marques
RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
Search for more papers by this authorCorresponding Author
João Pedro Ferreira
RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
Université de Lorraine, INSERM, Centre d'Investigations Cliniques 1433, CHRU de Nancy, Inserm 1116 and INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN Network, Nancy, France
Corresponding author. RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal. Tel: +351 22 5513600, Fax: +351 22 5513601, Email: [email protected]
Search for more papers by this authorPedro Marques
RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
Search for more papers by this authorCorresponding Author
João Pedro Ferreira
RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
Université de Lorraine, INSERM, Centre d'Investigations Cliniques 1433, CHRU de Nancy, Inserm 1116 and INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN Network, Nancy, France
Corresponding author. RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal. Tel: +351 22 5513600, Fax: +351 22 5513601, Email: [email protected]
Search for more papers by this authorThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology. doi: 10.1002/ejhf.3586.
References
- 1Braunwald E. Diabetes, heart failure, and renal dysfunction: The vicious circles. Prog Cardiovasc Dis 2019; 62: 298–302. https://doi.org/10.1016/j.pcad.2019.07.003
- 2Ndumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, et al. Cardiovascular-kidney-metabolic health: A presidential advisory from the American Heart Association. Circulation 2023; 148: 1606–1635. https://doi.org/10.1161/CIR.0000000000001184
- 3Agarwal R, Filippatos G, Pitt B, Anker SD, Rossing P, Joseph A, et al.; FIDELIO-DKD and FIGARO-DKD Investigators. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: The FIDELITY pooled analysis. Eur Heart J 2022; 43: 474–484. https://doi.org/10.1093/eurheartj/ehab777
- 4Friday JM, Cleland JG, Pellicori P, Wolters MK, JJV MM, Jhund PS, et al. Loop diuretic utilisation with or without heart failure: Impact on prognosis. Eur Heart J 2024; 45: 3837–3849. https://doi.org/10.1093/eurheartj/ehae345
- 5Pellicori P, Fitchett D, Kosiborod MN, Ofstad AP, Seman L, Zinman B, et al. Use of diuretics and outcomes in patients with type 2 diabetes: Findings from the EMPA-REG OUTCOME trial. Eur J Heart Fail 2021; 23: 1085–1093. https://doi.org/10.1002/ejhf.2220
- 6Greene SJ, Butler J. Expanding the definition of worsening heart failure and recognizing the importance of outpatient escalation of oral diuretics. Circulation 2023; 148: 1746–1749. https://doi.org/10.1161/CIRCULATIONAHA.123.066915
- 7Packer M, Zile MR, Kramer CM, Baum SJ, Litwin SE, Menon V, et al.; SUMMIT Trial Study Group. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2025; 392: 427–437. https://doi.org/10.1056/NEJMoa2410027
- 8Vardeny O, Claggett B, Kachadourian J, Desai AS, Packer M, Rouleau J, et al. Reduced loop diuretic use in patients taking sacubitril/valsartan compared with enalapril: The PARADIGM-HF trial. Eur J Heart Fail 2019; 21: 337–341. https://doi.org/10.1002/ejhf.1402
- 9Chatur S, Vaduganathan M, Fletcher R, Perkovic V, Heerspink H, Arnott C, et al. Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials. Eur J Heart Fail 2025; 27: 994–1002. https://doi.org/10.1002/ejhf.3586
- 10Butler J, Shah SJ, Petrie MC, Borlaug BA, Abildstrøm SZ, Davies MJ, et al.; STEP-HFpEF Trial Committees and Investigators. Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: A pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials. Lancet 2024; 403: 1635–1648. https://doi.org/10.1016/S0140-6736(24)00469-0
- 11Shah SJ, Sharma K, Borlaug BA, Butler J, Davies M, Kitzman DW, et al. Semaglutide and diuretic use in obesity-related heart failure with preserved ejection fraction: A pooled analysis of the STEP-HFpEF and STEP-HFpEF-DM trials. Eur Heart J 2024; 45: 3254–3269. https://doi.org/10.1093/eurheartj/ehae322
- 12Ferreira JP, Liu J, Claggett BL, Vardeny O, Pitt B, Pfeffer MA, et al. Outpatient diuretic intensification as endpoint in heart failure with preserved ejection fraction trials: An analysis from TOPCAT. Eur J Heart Fail 2022; 24: 378–384. https://doi.org/10.1002/ejhf.2376
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