2026-04-29T23:04:17Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/231922024-11-28T17:31:34Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16961col_20.500.12105_16967col_20.500.12105_16969
Repisalud
author
Miro, Oscar
author
Llorens, Pere
author
Freund, Yonathan
author
Davison, Beth
author
Takagi, Koji
author
Herrero-Puente, Pablo
author
Jacob, Javier
author
Martin-Sanchez, Francisco Javier
author
Gil, Victor
author
Rosselló, Xavier
author
Alquezar-Arbe, Aitor
author
Jimenez-Fabrega, Francesc X
author
Masip, Josep
author
Mebazaa, Alexandre
author
Cotter, Gad
author
EAHFE Res Group
2024-09-18T06:42:20Z
2024-09-18T06:42:20Z
2021-12-01
Miro O, Llorens P, Freund Y, Davison B, Takagi K, Herrero-Puente P, et al. 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. Int J Cardiol. 2021 Dec 1;344:127-34.
10.1016/j.ijcard.2021.09.031
1874-1754
0167-5273
International Journal of Cardiology
https://hdl.handle.net/20.500.13003/19550
34543690
L2014723315
2-s2.0-85115644341
https://hdl.handle.net/20.500.12105/23192
757375800024
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. Conclusions: Early prehospital IV NTG administration was associated with lower mortality and post-discharge events, while IV NTG initiated in ED only improved post-discharge event rate. Further studies are needed to assess the role of early prehospital administration of IV NTG to patients with AHF.
eng
Acute heart failure
Nitrates
Nitroglycerine
Outcome
Mortality
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
research article