Expanding the Definition of Worsening Heart Failure and Recognizing the Importance of Outpatient Escalation of Oral Diuretics

HomeCirculationVol. 148, No. 22Expanding the Definition of Worsening Heart Failure and Recognizing the Importance of Outpatient Escalation of Oral Diuretics No AccessEditorialRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessEditorialRequest AccessFull TextExpanding the Definition of Worsening Heart Failure and Recognizing the Importance of Outpatient Escalation of Oral Diuretics Stephen J. Greene and Javed Butler Stephen J. GreeneStephen J. Greene https://orcid.org/0000-0001-6912-7374 Division of Cardiology, Duke University School of Medicine, Durham, NC (S.J.G.). Duke Clinical Research Institute, Durham, NC (S.J.G.). Search for more papers by this author and Javed ButlerJaved Butler Correspondence to: Javed Butler, MD, MPH, MBA, Baylor Scott and White Research Institute, 3434 Oak St, Suite 501, Dallas, TX 75204. Email E-mail Address: [email protected] https://orcid.org/0000-0001-7683-4720 Baylor Scott and White Research Institute, Dallas, TX (J.B.). Department of Medicine, University of Mississippi Medical Center, Jackson (J.B.). Search for more papers by this author Originally published27 Nov 2023https://doi.org/10.1161/CIRCULATIONAHA.123.066915Circulation. 2023;148:1746–1749This article is a commentary on the followingOutpatient Worsening Among Patients With Mildly Reduced and Preserved Ejection Fraction Heart Failure in the DELIVER TrialFootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Disclosures, see page 1748.Circulation is available at www.ahajournals.org/journal/circCorrespondence to: Javed Butler, MD, MPH, MBA, Baylor Scott and White Research Institute, 3434 Oak St, Suite 501, Dallas, TX 75204. Email javed.butler@bswhealth.orgREFERENCES1. Butler J, Braunwald E, Gheorghiade M. Recognizing worsening chronic heart failure as an entity and an end point in clinical trials.JAMA. 2014; 312:789–790. doi: 10.1001/jama.2014.6643CrossrefMedlineGoogle Scholar2. Greene SJ, Fonarow GC, Butler J. Risk profiles in heart failure: baseline, residual, worsening, and advanced heart failure risk.Circ Heart Fail. 2020; 13:e007132. doi: 10.1161/CIRCHEARTFAILURE.120.007132LinkGoogle Scholar3. Greene SJ, Mentz RJ, Felker GM. Outpatient worsening heart failure as a target for therapy: a review.JAMA Cardiol. 2018; 3:252–259. doi: 10.1001/jamacardio.2017.5250CrossrefMedlineGoogle Scholar4. Greene SJ, Bauersachs J, Brugts JJ, Ezekowitz JA, Lam CSP, Lund LH, Ponikowski P, Voors AA, Zannad F, Zieroth S, et al. Worsening heart failure: nomenclature, epidemiology, and future directions: JACC review topic of the week.J Am Coll Cardiol. 2023; 81:413–424. doi: 10.1016/j.jacc.2022.11.023CrossrefMedlineGoogle Scholar5. 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Khan MS, Greene SJ, Hellkamp AS, DeVore AD, Shen X, Albert NM, Patterson JH, Spertus JA, Thomas LE, Williams FB, et al. Diuretic changes, health care resource utilization, and clinical outcomes for heart failure with reduced ejection fraction: from the change the management of patients with heart failure registry.Circ Heart Fail. 2021; 14:e008351. doi: 10.1161/CIRCHEARTFAILURE.121.008351LinkGoogle Scholar9. Chatur S, Vaduganathan M, Claggett BL, Cunningham JW, Docherty KF, Desai AS, Jhund PS, de Boer RA, Hernandez AF, Inzucchi SE, et al. Outpatient worsening among patients with mildly reduced and preserved ejection fraction heart failure in the DELIVER trial.Circulation. 2023; 148:1735–1745. doi: 10.1161/CIRCULATIONAHA.123.066506LinkGoogle Scholar10. Docherty KF, Jhund PS, Anand I, Bengtsson O, Bohm M, de Boer RA, DeMets DL, Desai AS, Drozdz J, Howlett J, et al. Effect of dapagliflozin on outpatient worsening of patients with heart failure and reduced ejection fraction: a prespecified analysis of DAPA-HF.Circulation. 2020; 142:1623–1632. doi: 10.1161/CIRCULATIONAHA.120.047480LinkGoogle Scholar11. Vaduganathan M, Cunningham JW, Claggett BL, Causland FM, Barkoudah E, Finn P, Zannad F, Pfeffer MA, Rizkala AR, Sabarwal S, et al. Worsening heart failure episodes outside a hospital setting in heart failure with preserved ejection fraction: the PARAGON-HF trial.JACC Heart Fail. 2021; 9:374–382. doi: 10.1016/j.jchf.2021.01.014CrossrefMedlineGoogle Scholar12. Greene SJ, Butler J, Fonarow GC. Contextualizing risk among patients with heart failure.JAMA. 2021; 326:2261–2262. doi: 10.1001/jama.2021.20739CrossrefMedlineGoogle Scholar13. Tardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, Pinto FJ, Ibrahim R, Gamra H, Kiwan GS, et al. Efficacy and safety of low-dose colchicine after myocardial infarction.N Engl J Med. 2019; 381:2497–2505. doi: 10.1056/NEJMoa1912388CrossrefMedlineGoogle Scholar14. Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, Neumann FJ, Ardissino D, De Servi S, Murphy SA, et al; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes.N Engl J Med. 2007; 357:2001–2015. doi: 10.1056/NEJMoa0706482CrossrefMedlineGoogle Scholar15. Okumura N, Jhund PS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Swedberg K, Zile MR, Solomon SD, et al; PARADIGM-HF Investigators and Committees. Importance of clinical worsening of heart failure treated in the outpatient setting: evidence from the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial (PARADIGM-HF).Circulation. 2016; 133:2254–2262. doi: 10.1161/CIRCULATIONAHA.115.020729LinkGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesOutpatient Worsening Among Patients With Mildly Reduced and Preserved Ejection Fraction Heart Failure in the DELIVER TrialSafia Chatur, et al. Circulation. 2023;148:1735-1745 November 28, 2023Vol 148, Issue 22 Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.123.066915PMID: 38011247 Originally publishedNovember 27, 2023 KeywordsEditorialsdiureticsheart failuretherapeuticsPDF download Advertisement SubjectsHeart Failure