Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF

Adriaan A. Voors; Beth A. Davison; G. Michael Felker; Piotr Ponikowski; Elaine Unemori; Gadi Cotter; John R. Teerlink; Barry H. Greenberg; Gerasimos Filippatos; Sam L. Teichman; Marco Metra; M. Metra; J. R. Teerlink; G. M. Felker; A. A. Voors; B. Greenberg; B. A. Davison; S. L. Teichman; E. Unemori; G. Cotter; B. M. Massie; S. Goldstein; M. Bohm; Gary S Francis; C. E. Davis; S. Boldueva; V. Moiseev; Z. Shogenov; M. Ruda; A. Vishnevsky; M. Boyarkin; V. Simanenkov; S. Tereschenko; Y. Shwartz; O. Orlikova; M. Arkhipov; I. Libov; R. Sardinov; A. Suvorov; A. Marmor; A. Katz; R. Zimlichman; M. Omary; R. Hershkoviz; S. Goland; A. Keren; D. Aronson; J. Grzybowski; W. Musial; D. Apró; G. Lupkovics; M. Metra; C. Stamate; A. Salajan; A. Matei; P. Levy; P. Pang; S. Collins; D. Gupta; W. Van Mieghem; L. Muyldermans; G. Vervoort

doi:10.1093/eurjhf/hfr060

Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF

Adriaan A. Voors, Beth A. Davison, G. Michael Felker, Piotr Ponikowski, Elaine Unemori, Gadi Cotter, John R. Teerlink, Barry H. Greenberg, Gerasimos Filippatos, Sam L. Teichman, Marco Metra, M. Metra, J. R. Teerlink, G. M. Felker, A. A. Voors, B. Greenberg, B. A. Davison, S. L. Teichman, E. Unemori, G. CotterB. M. Massie, S. Goldstein, M. Bohm, Gary S Francis, C. E. Davis, S. Boldueva, V. Moiseev, Z. Shogenov, M. Ruda, A. Vishnevsky, M. Boyarkin, V. Simanenkov, S. Tereschenko, Y. Shwartz, O. Orlikova, M. Arkhipov, I. Libov, R. Sardinov, A. Suvorov, A. Marmor, A. Katz, R. Zimlichman, M. Omary, R. Hershkoviz, S. Goland, A. Keren, D. Aronson, J. Grzybowski, W. Musial, D. Apró, G. Lupkovics, M. Metra, C. Stamate, A. Salajan, A. Matei, P. Levy, P. Pang, S. Collins, D. Gupta, W. Van Mieghem, L. Muyldermans, G. Vervoort

Medicine - Cardiology Division

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Abstract

Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of <0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P 0.01), and Day 180 (P 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP.

Original language	English (US)
Pages (from-to)	961-967
Number of pages	7
Journal	European Journal of Heart Failure
Volume	13
Issue number	9
DOIs	https://doi.org/10.1093/eurjhf/hfr060
State	Published - Sep 1 2011

Keywords

Acute heart failure
Blood pressure
Creatinine
Mortality
Renal function

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Voors, A. A., Davison, B. A., Felker, G. M., Ponikowski, P., Unemori, E., Cotter, G., Teerlink, J. R., Greenberg, B. H., Filippatos, G., Teichman, S. L., Metra, M., Metra, M., Teerlink, J. R., Felker, G. M., Voors, A. A., Greenberg, B., Davison, B. A., Teichman, S. L., Unemori, E., ... Vervoort, G. (2011). Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF. European Journal of Heart Failure, 13(9), 961-967. https://doi.org/10.1093/eurjhf/hfr060

Voors, AA, Davison, BA, Felker, GM, Ponikowski, P, Unemori, E, Cotter, G, Teerlink, JR, Greenberg, BH, Filippatos, G, Teichman, SL, Metra, M, Metra, M, Teerlink, JR, Felker, GM, Voors, AA, Greenberg, B, Davison, BA, Teichman, SL, Unemori, E, Cotter, G, Massie, BM, Goldstein, S, Bohm, M, Francis, GS, Davis, CE, Boldueva, S, Moiseev, V, Shogenov, Z, Ruda, M, Vishnevsky, A, Boyarkin, M, Simanenkov, V, Tereschenko, S, Shwartz, Y, Orlikova, O, Arkhipov, M, Libov, I, Sardinov, R, Suvorov, A, Marmor, A, Katz, A, Zimlichman, R, Omary, M, Hershkoviz, R, Goland, S, Keren, A, Aronson, D, Grzybowski, J, Musial, W, Apró, D, Lupkovics, G, Metra, M, Stamate, C, Salajan, A, Matei, A, Levy, P, Pang, P, Collins, S, Gupta, D, Van Mieghem, W, Muyldermans, L & Vervoort, G 2011, 'Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF', European Journal of Heart Failure, vol. 13, no. 9, pp. 961-967. https://doi.org/10.1093/eurjhf/hfr060

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title = "Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF",

abstract = "Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of <0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P 0.01), and Day 180 (P 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP.",

keywords = "Acute heart failure, Blood pressure, Creatinine, Mortality, Renal function",

author = "Voors, {Adriaan A.} and Davison, {Beth A.} and Felker, {G. Michael} and Piotr Ponikowski and Elaine Unemori and Gadi Cotter and Teerlink, {John R.} and Greenberg, {Barry H.} and Gerasimos Filippatos and Teichman, {Sam L.} and Marco Metra and M. Metra and Teerlink, {J. R.} and Felker, {G. M.} and Voors, {A. A.} and B. Greenberg and Davison, {B. A.} and Teichman, {S. L.} and E. Unemori and G. Cotter and Massie, {B. M.} and S. Goldstein and M. Bohm and Francis, {Gary S} and Davis, {C. E.} and S. Boldueva and V. Moiseev and Z. Shogenov and M. Ruda and A. Vishnevsky and M. Boyarkin and V. Simanenkov and S. Tereschenko and Y. Shwartz and O. Orlikova and M. Arkhipov and I. Libov and R. Sardinov and A. Suvorov and A. Marmor and A. Katz and R. Zimlichman and M. Omary and R. Hershkoviz and S. Goland and A. Keren and D. Aronson and J. Grzybowski and W. Musial and D. Apr{\'o} and G. Lupkovics and M. Metra and C. Stamate and A. Salajan and A. Matei and P. Levy and P. Pang and S. Collins and D. Gupta and {Van Mieghem}, W. and L. Muyldermans and G. Vervoort",

year = "2011",

month = sep,

day = "1",

doi = "10.1093/eurjhf/hfr060",

language = "English (US)",

volume = "13",

pages = "961--967",

journal = "European Journal of Heart Failure",

issn = "1388-9842",

publisher = "Oxford University Press",

number = "9",

}

TY - JOUR

T1 - Early drop in systolic blood pressure and worsening renal function in acute heart failure

T2 - Renal results of Pre-RELAX-AHF

AU - Voors, Adriaan A.

AU - Davison, Beth A.

AU - Felker, G. Michael

AU - Ponikowski, Piotr

AU - Unemori, Elaine

AU - Cotter, Gadi

AU - Teerlink, John R.

AU - Greenberg, Barry H.

AU - Filippatos, Gerasimos

AU - Teichman, Sam L.

AU - Metra, Marco

AU - Metra, M.

AU - Teerlink, J. R.

AU - Felker, G. M.

AU - Voors, A. A.

AU - Greenberg, B.

AU - Davison, B. A.

AU - Teichman, S. L.

AU - Unemori, E.

AU - Cotter, G.

AU - Massie, B. M.

AU - Goldstein, S.

AU - Bohm, M.

AU - Francis, Gary S

AU - Davis, C. E.

AU - Boldueva, S.

AU - Moiseev, V.

AU - Shogenov, Z.

AU - Ruda, M.

AU - Vishnevsky, A.

AU - Boyarkin, M.

AU - Simanenkov, V.

AU - Tereschenko, S.

AU - Shwartz, Y.

AU - Orlikova, O.

AU - Arkhipov, M.

AU - Libov, I.

AU - Sardinov, R.

AU - Suvorov, A.

AU - Marmor, A.

AU - Katz, A.

AU - Zimlichman, R.

AU - Omary, M.

AU - Hershkoviz, R.

AU - Goland, S.

AU - Keren, A.

AU - Aronson, D.

AU - Grzybowski, J.

AU - Musial, W.

AU - Apró, D.

AU - Lupkovics, G.

AU - Metra, M.

AU - Stamate, C.

AU - Salajan, A.

AU - Matei, A.

AU - Levy, P.

AU - Pang, P.

AU - Collins, S.

AU - Gupta, D.

AU - Van Mieghem, W.

AU - Muyldermans, L.

AU - Vervoort, G.

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of <0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P 0.01), and Day 180 (P 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP.

AB - Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of <0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P 0.01), and Day 180 (P 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP.

KW - Acute heart failure

KW - Blood pressure

KW - Creatinine

KW - Mortality

KW - Renal function

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U2 - 10.1093/eurjhf/hfr060

DO - 10.1093/eurjhf/hfr060

M3 - Article

C2 - 21622980

AN - SCOPUS:80052016600

SN - 1388-9842

VL - 13

SP - 961

EP - 967

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

IS - 9

ER -

Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF

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