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Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan.
- Source :
-
Scientific reports [Sci Rep] 2021 Sep 29; Vol. 11 (1), pp. 19360. Date of Electronic Publication: 2021 Sep 29. - Publication Year :
- 2021
-
Abstract
- Within no definite diuretic protocol for acute heart failure (AHF) patients and its variation in regional clinical guidelines, the latest national guidelines in Japan commends use of tolvaptan in diuretic-resistant patients. This study aimed to examine trends in tolvaptan usage and associated outcomes of AHF patients requiring hospitalization. Between April, 2018 and October, 2019, 1343 consecutive AHF patients (median 78 [69-85] year-old) were enrolled in a prospective, multicenter registry in Japan. Trends over time in tolvaptan usage, along with the severity of heart failure status based on the Get With The Guideline-Heart Failure [GWTG-HF] risk score, and in-hospital outcomes were investigated. During the study period, tolvaptan usage has increased from 13.0 to 28.7% over time (p for trend = 0.07), and 49.4% started tolvaptan within 3 days after admission. The GWTG-HF risk score in the tolvaptan group has significantly decreased over time, while that in the non-tolvaptan group has unchanged. There were no differences in the in-hospital mortality rate between the patients with and without tolvaptan (6.7% vs. 5.8%). After revision of the Japanese clinical practice guidelines for AHF in March 2018, tolvaptan usage for AHF patients has steadily increased. However, in-hospital outcomes including mortality do not seem to be affected.<br /> (© 2021. The Author(s).)
- Subjects :
- Aged
Aged, 80 and over
Female
Humans
Japan epidemiology
Male
Prospective Studies
Risk Factors
Acute Disease epidemiology
Acute Disease therapy
Antidiuretic Hormone Receptor Antagonists adverse effects
Heart Failure drug therapy
Heart Failure mortality
Hospital Mortality trends
Tolvaptan adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 34588492
- Full Text :
- https://doi.org/10.1038/s41598-021-98173-8