Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/183883
Title: Early intravenous nitroglycerin use in prehospital setting and in the emergency department to treat patients with acute heart failure: Insights from the EAHFE Spanish registry
Author: Miró i Andreu, Òscar
Llorens, Pere
Freund, Yonathan
Davison, Beth
Takagi, Koji
Herrero Puente, Pablo
Jacob, Javier
Martín Sánchez, Francisco Javier
Gil, Víctor
Rosselló, Xavier
Alquézar Arbé, Aitor
Jiménez Fábrega, Francesc X.
Masip, Josep
Mebazaa, Alexandre
Cotter, Gad
The EAHFE Spanish registry
Keywords: Serveis d'urgències mèdiques
Insuficiència cardíaca
Mortalitat
Medicina d'urgència
Emergency medical services
Heart failure
Mortality
Emergency medicine
Issue Date: 1-Dec-2021
Publisher: Elsevier B.V.
Abstract: Background and objective: Although recommended for the treatment of acute heart failure (AHF), the use of intravenous (IV) nitroglycerin (NTG) is supported by scarce and contradicting evidence. In the current analysis, we have assessed the impact of IV NTG administration by EMS or in emergency department (ED) on outcomes of AHF patients. Methods: We analyze AHF patients included by 45 hospitals that were delivered to ED by EMS. Patients were grouped according to whether treatment with IV NTG was started by EMS before ED admission (preED-NTG), during the ED stay (ED-NTG) or were untreated with IV NTG (no-NTG, control group). In-hospital, 30-day and 365-day all-cause mortality, prolonged hospitalization (>7 days) and 90-day post-discharge combined adverse events (ED revisit, hospitalization or death) were compared in EMS-NTG and ED-NTG respect to control group. Results: We included 8424 patients: preED-NTG = 292 (3.5%), ED-NTG = 1159 (13.8%) and no-NTG = 6973 (82.7%). preED-NTG group had the most severely decompensated cases of AHF (p < 0.001) but it had lower inhospital (OR = 0.724, 95%CI = 0.459-1.114), 30-day (HR = 0.818, 0.576-1.163) and 365-day mortality (HR = 0.692, 0.551-0.869) and 90-day post-discharge events (HR = 0.795, 0.643-0.984) than control group. ED-NTG group had mortalities similar to control group (in-hospital: OR = 1.164, 0.936-1.448; 30-day: HR = 0.980, 0.819-1.174; 365-day: HR = 0.929, 0.830-1.039) but significantly decreased 90-day post-discharge events (HR = 0.870, 0.780-0.970). Prolonged hospitalization rate did not differ among groups. Five different analyses confirmed these findings.
Note: Reproducció del document publicat a: https://doi.org/10.1016/j.ijcard.2021.09.031
It is part of: International Journal of Cardiology, 2021, vol. 344, p. 127-134
URI: http://hdl.handle.net/2445/183883
Related resource: https://doi.org/10.1016/j.ijcard.2021.09.031
ISSN: 0167-5273
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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