Journal of Cardiac Failure
Volume 13, Issue 5 , Pages 360-364 , June 2007

Prognostic Value of Blood Urea Nitrogen in Patients Hospitalized With Worsening Heart Failure: Insights From the Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Chronic Heart Failure (ACTIV in CHF) Study

  • Gerasimos Filippatos, MD

      Affiliations

    • From the Department of Cardiology, Athens University, Athens, Greece
    • ,
  • Joseph Rossi, MD

      Affiliations

    • Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • ,
  • Donald M. Lloyd-Jones, MD, ScM

      Affiliations

    • Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • ,
  • Wendy Gattis Stough, PharmD

      Affiliations

    • Division of Cardiology, Duke University Medical Center, Durham, North Carolina
    • Campbell University School of Pharmacy Department of Clinical Research, Research Triangle Park, North Carolina
    • ,
  • John Ouyang, PhD

      Affiliations

    • Otsuka Maryland Research Institute, Rockville, Maryland
    • ,
  • David D. Shin

      Affiliations

    • Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • ,
  • Christopher O'Connor, MD

      Affiliations

    • Division of Cardiology, Duke University Medical Center, Durham, North Carolina
    • ,
  • Kirkwood F. Adams, MD

      Affiliations

    • Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina
    • ,
  • Cesare Orlandi, MD

      Affiliations

    • Otsuka Maryland Research Institute, Rockville, Maryland
    • ,
  • Mihai Gheorghiade, MD

      Affiliations

    • Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • Corresponding Author InformationReprint requests: Mihai Gheorghiade, MD, Division of Cardiology, Northwestern University, Feinberg School of Medicine, Galter 10-240, 201 E Huron Street, Chicago, IL 60611.

Received 30 June 2006 ,Revised 12 January 2007 ,Accepted 21 February 2007.

References 

  1. Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. Heart disease and stroke statistics—2007 update. A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69–e171
  2. Cuffe MS, Califf RM, Adams KF, Benza R, Bourge R, Colucci WS, et al. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002;287:1541–1547
  3. Gattis WA, O'Connor CM, Gallup DS, Hasselblad V, Gheorghiade M. Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure: results of the Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy in Heart Failure (IMPACT-HF) trial. J Am Coll Cardiol. 2004;43:1534–1541
  4. Fonarow GC, Abraham WT, Albert NM, Gattis WA, Gheorghiade M, Greenberg B, et al. Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design. Am Heart J. 2004;148:43–51
  5. Adams KF, Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2005;149:209–216
  6. Bongartz LG, Cramer MJ, Doevendans PA, Joles JA, Braam B. The severe cardiorenal syndrome: ‘Guyton revisited.’. Eur Heart J. 2005;26:11–17
  7. Shlipak MG, Massie BM. The clinical challenge of cardiorenal syndrome. Circulation. 2004;110:1514–1517
  8. Akhter MW, Aronson D, Bitar F, Khan S, Singh H, Singh RP, et al. Effect of elevated admission serum creatinine and its worsening on outcome in hospitalized patients with decompensated heart failure. Am J Cardiol. 2004;94:957–960
  9. Dries DL, Exner DV, Domanski MJ, Greenberg B, Stevenson LW. The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction. J Am Coll Cardiol. 2000;35:681–689
  10. Gottlieb SS, Abraham W, Butler J, Forman DE, Loh E, Massie BM, et al. The prognostic importance of different definitions of worsening renal function in congestive heart failure. J Card Fail. 2002;8:136–141
  11. Aronson D, Mittleman MA, Burger AJ. Elevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure. Am J Med. 2004;116:466–473
  12. Felker GM, Leimberger JD, Califf RM, Cuffe MS, Massie BM, Adams KF, et al. Risk stratification after hospitalization for decompensated heart failure. J Card Fail. 2004;10:460–466
  13. Fonarow GC, Adams KF, Abraham WT, Yancy CW, Boscardin WJ. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA. 2005;293:572–580
  14. Lee DS, Austin PC, Rouleau JL, Liu PP, Naimark D, Tu JV. Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA. 2003;290:2581–2587
  15. Gheorghiade M, Gattis WA, Barbagelata A, Adams KF, Elkayam U, Orlandi C, et al. Rationale and study design for a multicenter, randomized, double-blind, placebo-controlled study of the effects of tolvaptan on the acute and chronic outcomes of patients hospitalized with worsening congestive heart failure. Am Heart J. 2003;145:S51–S54
  16. Gheorghiade M, Gattis WA, O'Connor CM, Adams KF, Elkayam U, Barbagelata A, et al. Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trial. JAMA. 2004;291:1963–1971
  17. Cohn JN, Levine TB, Francis GS, Goldsmith S. Neurohumoral control mechanisms in congestive heart failure. Am Heart J. 1981;102:509–514
  18. Schrier RW, Abraham WT. Hormones and hemodynamics in heart failure. N Engl J Med. 1999;341:577–585

 The ACTIV in CHF trial and this analysis were funded by Otsuka Maryland Research Institute, Rockville, Maryland.

PII: S1071-9164(07)00051-6

doi: 10.1016/j.cardfail.2007.02.005

Journal of Cardiac Failure
Volume 13, Issue 5 , Pages 360-364 , June 2007

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