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Effectiveness of early administration of Tolvaptan for cardiac prognosis in acute decompensated heart failure

Session Poster Session 3

Speaker Toshio Kaneda

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : T Kaneda (Yokohama,JP), M Suzuki (Yokohama,JP), K Hara (Yokohama,JP), M Omori (Yokohama,JP), Y Taomoto (Yokohama,JP), M Iya (Yokohama,JP), Y Yamakami (Yokohama,JP), H Shimada (Yokohama,JP), T Manno (Yokohama,JP), A Isshiki (Yokohama,JP), S Kimura (Yokohama,JP), M Shimizu (Yokohama,JP), H Fujii (Yokohama,JP)

T Kaneda1 , M Suzuki1 , K Hara1 , M Omori1 , Y Taomoto1 , M Iya1 , Y Yamakami1 , H Shimada1 , T Manno1 , A Isshiki1 , S Kimura1 , M Shimizu1 , H Fujii1 , 1Yokohama Minami Kyosai Hospital, Cardiology - Yokohama - Japan ,


Backgrounds: Tolvaptan is recognized to have effects on acute decompensated heart failure (ADHF). However, the prognostic value of the timing of Tolvaptan administration in hospitalization was not elucidated.

Methods: We enrolled consecutive 155 patients with ADHF (81.7±10.5 years, 83 males) who took Tolvaptan treatment in hospitalization, and observed them for max 60 days retrospectively. The patients were assigned into two groups: patients taking Tolvaptan within 48 hours or over after hospitalization (Early group vs Non-early group). Cardiac death was set as primary endpoint.

Results: Twenty-one patients died for observation period. The mortality rate was better in Early groups (Early:3, Non-early:10, P=0.002). Multivariate Cox regression analysis showed the early administration was a significant negative predictor of cardiac death (hazard ratio:0.237, P=0.029). Kaplan-Meier curve analysis revealed the survival curve was significantly better in Early group (log rank P=0.018)

Conclusion: Early administration (within 48 hours) of Tolvaptan after hospitalization was a significant negative predictor of cardiac death in patients with ADHF.

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