TY - JOUR
T1 - Plasma Volume Status and Its Association With In-Hospital and Postdischarge Outcomes in Decompensated Heart Failure
AU - Fudim, Marat
AU - Lerman, Joseph B.
AU - Page, Courtney
AU - Alhanti, Brooke
AU - Califf, Robert M.
AU - Ezekowitz, Justin A.
AU - Girerd, Nicolas
AU - Grodin, Justin L.
AU - Miller, Wayne L.
AU - Pandey, Ambarish
AU - Rossignol, Patrick
AU - Starling, Randall C.
AU - Tang, W. H.Wilson
AU - Zannad, Faiez
AU - Hernandez, Adrian F.
AU - O'connor, Christopher M.
AU - Mentz, Robert J.
N1 - Funding Information:
The ASCEND-HF study was supported by Scios Inc.
Funding Information:
Dr Fudim is supported by an American Heart Association Grant, 17MCPRP33460225; Mario Family Award, Consulting fees/honoraria from Coridea, AxonTherapies, Galvani, and Daxor. Dr Grodin has received research support from the Texas Health Resources Clinical Scholars fund and reports consulting fees/honoraria from Pfizer. Dr Rossignol reports consulting for G3P and Idorsia; honoraria from Ablative Solutions, AstraZeneca, Bayer, CVRx, Fresenius, Grunenthal, Novartis, NovoNordisk, Relypsa, Servier, Stealth Peptides, and Vifor Fresenius Medical Care Renal Pharma; and travel grants from AstraZeneca, Bayer, CVRx, Novartis, and Vifor Fresenius Medical Care Renal Pharma; Cofounder: CardioRenal.
Funding Information:
Dr O'Connor Received grant support from the NIH and Roche Diagnostics. Dr Metz reports research support from the National Institutes of Health (U01HL125511-01A1 and R01AG045551-01A1), Akros, Amgen, AstraZeneca, Bayer, GlaxoSmithKline, Gilead, InnoLife, Luitpold/American Regent, Medtronic, Merck, Novartis, and Sanofi; honoraria from Abbott, Amgen, AstraZeneca, Bayer, Boston Scientific, Janssen, Luitpold Pharmaceuticals, Medtronic, Merck, Novartis, and Sanofi; and has served on an advisory board for Amgen, AstraZeneca, Luitpold, Merck, Novartis and Boehringer Ingelheim. All other authors reports no relevant conflicts.
Funding Information:
PR, NG, and FZ are supported by the RHU Fight-HF, a public grant overseen by the French National Research Agency (ANR) as part of the second “Investissements d'Avenir” program (reference: ANR-15-RHUS-0004), by the French PIA project “Lorraine Université d'Excellence” (reference: ANR-15-IDEX-04-LUE).
Funding Information:
PR, NG, and FZ are supported by the RHU Fight-HF, a public grant overseen by the French National Research Agency (ANR) as part of the second ?Investissements d'Avenir? program (reference: ANR-15-RHUS-0004), by the French PIA project ?Lorraine Universit? d'Excellence? (reference: ANR-15-IDEX-04-LUE). Dr Fudim is supported by an American Heart Association Grant, 17MCPRP33460225; Mario Family Award, Consulting fees/honoraria from Coridea, AxonTherapies, Galvani, and Daxor. Dr Grodin has received research support from the Texas Health Resources Clinical Scholars fund and reports consulting fees/honoraria from Pfizer. Dr Rossignol reports consulting for G3P and Idorsia; honoraria from Ablative Solutions, AstraZeneca, Bayer, CVRx, Fresenius, Grunenthal, Novartis, NovoNordisk, Relypsa, Servier, Stealth Peptides, and Vifor Fresenius Medical Care Renal Pharma; and travel grants from AstraZeneca, Bayer, CVRx, Novartis, and Vifor Fresenius Medical Care Renal Pharma; Cofounder: CardioRenal. Dr Califf was the Commissioner of Food and Drugs for the U.S. Food and Drug Administration from February 2016 to January 2017 and Deputy Commissioner for Medical Products and Tobacco for the U.S. Food and Drug Administration from February 2015 to January 2016; serves on the corporate board for Cytokinetics; is the Board Chair for the People-Centered Research Foundation; has received consulting fees from Merck, Biogen, Genentech, Eli Lilly, and Boehringer Ingelheim; and is employed as a scientific advisor by Verily Life Sciences (Alphabet). Dr. Zanand reports personal fees from Janssen, Bayer, Novartis, Boston Scientific, Resmed, Amgen, CVRx, Quantum Genomics, General Electric, Boehringer, AstraZeneca, Vifor Fresenius, and Cardior, outside the submitted work. Dr Hernandez received consulting fees from AstraZeneca, Bayer, Boston Scientific, Merck, Novartis, and Sanofi; and research support from AstraZeneca, GlaxoSmithKline, Luitpold, Merck, and Novartis. Dr O'Connor Received grant support from the NIH and Roche Diagnostics. Dr Metz reports research support from the National Institutes of Health (U01HL125511-01A1 and R01AG045551-01A1), Akros, Amgen, AstraZeneca, Bayer, GlaxoSmithKline, Gilead, InnoLife, Luitpold/American Regent, Medtronic, Merck, Novartis, and Sanofi; honoraria from Abbott, Amgen, AstraZeneca, Bayer, Boston Scientific, Janssen, Luitpold Pharmaceuticals, Medtronic, Merck, Novartis, and Sanofi; and has served on an advisory board for Amgen, AstraZeneca, Luitpold, Merck, Novartis and Boehringer Ingelheim. All other authors reports no relevant conflicts. The ASCEND-HF study was supported by Scios Inc.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/3
Y1 - 2021/3
N2 - Background: Prior analyses suggest an association between formula-based plasma volume (PV) estimates and outcomes in heart failure (HF). We assessed the association between estimated PV status by the Duarte-ePV and Kaplan Hakim (KH-ePVS) formulas, and in-hospital and postdischarge clinical outcomes, in the ASCEND-HF trial. Methods and Results: The KH-ePVS and Duarte-ePV were calculated on admission. We assessed associations with in-hospital worsening HF, 30-day composite cardiovascular mortality or HF rehospitalization and 180-day all-cause mortality. There were 6373 (89.2%), and 6354 (89.0%) patients who had necessary characteristics to calculate KH-ePVS and Duarte-ePV, respectively. There was no association between PV by either formula with in-hospital worsening HF. KH-ePVS showed a weak correlation with N-terminal prohormone BNP, and with measures of decongestion such as body weight change and urine output (r < 0.3 for all). Duarte-ePV was trending toward an association with worse 30-day (adjusted odds ratio 1.07, 95% confidence interval [CI] 1.00–1.15, P = .058), but not 180-day outcomes (adjusted hazard ratio 1.03, 95% CI 0.97–1.09, P =. 289). A continuous KH-ePVS of >0 (per 10-unit increase) was associated with improved 30-day outcomes (adjusted odds ratio 0.75, 95% CI 0.62–0.91, P = .004). The continuous KH-ePVS was not associated with 180-day outcomes (adjusted hazard ratio 1.05, 95% CI 0.98–1.12, P =. 139). Conclusions: Baseline PV estimates had a weak association with in-hospital measures of decongestion. The Duarte-ePV trended toward an association with early clinical outcomes in decompensated HF, and may improve risk stratification in HF.
AB - Background: Prior analyses suggest an association between formula-based plasma volume (PV) estimates and outcomes in heart failure (HF). We assessed the association between estimated PV status by the Duarte-ePV and Kaplan Hakim (KH-ePVS) formulas, and in-hospital and postdischarge clinical outcomes, in the ASCEND-HF trial. Methods and Results: The KH-ePVS and Duarte-ePV were calculated on admission. We assessed associations with in-hospital worsening HF, 30-day composite cardiovascular mortality or HF rehospitalization and 180-day all-cause mortality. There were 6373 (89.2%), and 6354 (89.0%) patients who had necessary characteristics to calculate KH-ePVS and Duarte-ePV, respectively. There was no association between PV by either formula with in-hospital worsening HF. KH-ePVS showed a weak correlation with N-terminal prohormone BNP, and with measures of decongestion such as body weight change and urine output (r < 0.3 for all). Duarte-ePV was trending toward an association with worse 30-day (adjusted odds ratio 1.07, 95% confidence interval [CI] 1.00–1.15, P = .058), but not 180-day outcomes (adjusted hazard ratio 1.03, 95% CI 0.97–1.09, P =. 289). A continuous KH-ePVS of >0 (per 10-unit increase) was associated with improved 30-day outcomes (adjusted odds ratio 0.75, 95% CI 0.62–0.91, P = .004). The continuous KH-ePVS was not associated with 180-day outcomes (adjusted hazard ratio 1.05, 95% CI 0.98–1.12, P =. 139). Conclusions: Baseline PV estimates had a weak association with in-hospital measures of decongestion. The Duarte-ePV trended toward an association with early clinical outcomes in decompensated HF, and may improve risk stratification in HF.
KW - Heart failure
KW - congestion
KW - plasma volume
UR - http://www.scopus.com/inward/record.url?scp=85095588075&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095588075&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2020.09.478
DO - 10.1016/j.cardfail.2020.09.478
M3 - Article
C2 - 33038532
AN - SCOPUS:85095588075
SN - 1071-9164
VL - 27
SP - 297
EP - 308
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 3
ER -