Title: The Prognosis in Refractory Heart Failure Patients Requiring Continuous Administration of Tolvaptan
Abstract: Background: Tolvaptan, V2-receptor antagonist, is an important drug of heart failure(HF)management in Japan. It is useful for treatment of HF patients with fluid overload who are refractory to previous diuretic therapies in short period. However, the prognosis and characteristics of the patients who were long-term administration of tolvaptan are not well known. Methods and Results: We investigated 803 hospitalizedHF patients from Jan 2011 through March 2015. 18 patients were required continuous administration of tolvaptan after discharge. The initial dose of tolvaptan of 15 cases (83%) was 7.5 mg/day. The increase of tolvaptan was required for treatment of HF in 10 cases (56%). The frequency of HF readmission was 11 cases (61%) and all-cause death was 9 cases (50%) within one year. In the group which was not survived throughout the year, hypoalbuminemia and NYHA3 at discharge were significantly higher more than the survived group (P < .05, respectively). Conclusion: The prognosis of the HF patients who were needed long-term continuation of tolvaptan was not long, especially the patients with hypoalbuminemia or heavy symptoms at discharge. It may to be necessary to consider palliative care in cases of long-term use of tolvaptan. Background: Tolvaptan, V2-receptor antagonist, is an important drug of heart failure(HF)management in Japan. It is useful for treatment of HF patients with fluid overload who are refractory to previous diuretic therapies in short period. However, the prognosis and characteristics of the patients who were long-term administration of tolvaptan are not well known. Methods and Results: We investigated 803 hospitalizedHF patients from Jan 2011 through March 2015. 18 patients were required continuous administration of tolvaptan after discharge. The initial dose of tolvaptan of 15 cases (83%) was 7.5 mg/day. The increase of tolvaptan was required for treatment of HF in 10 cases (56%). The frequency of HF readmission was 11 cases (61%) and all-cause death was 9 cases (50%) within one year. In the group which was not survived throughout the year, hypoalbuminemia and NYHA3 at discharge were significantly higher more than the survived group (P < .05, respectively). Conclusion: The prognosis of the HF patients who were needed long-term continuation of tolvaptan was not long, especially the patients with hypoalbuminemia or heavy symptoms at discharge. It may to be necessary to consider palliative care in cases of long-term use of tolvaptan.
Publication Year: 2016
Publication Date: 2016-08-29
Language: en
Type: article
Indexed In: ['crossref']
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