Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan

Abstract Within no definite diuretic protocol for acute heart failure (AHF) patients and its variation in regional clinical guidelines, the latest national guidelines in Japan commends use of tolvaptan in diuretic-resistant patients. This study aimed to examine trends in tolvaptan usage and associat...

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Autores principales:	Yusuke Yamazaki, Yasuyuki Shiraishi, Shun Kohsaka, Yuji Nagatomo, Keiichi Fukuda, Takashi Kohno, Tsutomu Yoshikawa
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8394f492d760442b96a973386f29ce2e
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spelling	oai:doaj.org-article:8394f492d760442b96a973386f29ce2e2021-12-02T17:37:35ZTemporal trends in tolvaptan use after revision of national heart failure guidelines in Japan10.1038/s41598-021-98173-82045-2322https://doaj.org/article/8394f492d760442b96a973386f29ce2e2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98173-8https://doaj.org/toc/2045-2322Abstract Within no definite diuretic protocol for acute heart failure (AHF) patients and its variation in regional clinical guidelines, the latest national guidelines in Japan commends use of tolvaptan in diuretic-resistant patients. This study aimed to examine trends in tolvaptan usage and associated outcomes of AHF patients requiring hospitalization. Between April, 2018 and October, 2019, 1343 consecutive AHF patients (median 78 [69–85] year-old) were enrolled in a prospective, multicenter registry in Japan. Trends over time in tolvaptan usage, along with the severity of heart failure status based on the Get With The Guideline-Heart Failure [GWTG-HF] risk score, and in-hospital outcomes were investigated. During the study period, tolvaptan usage has increased from 13.0 to 28.7% over time (p for trend = 0.07), and 49.4% started tolvaptan within 3 days after admission. The GWTG-HF risk score in the tolvaptan group has significantly decreased over time, while that in the non-tolvaptan group has unchanged. There were no differences in the in-hospital mortality rate between the patients with and without tolvaptan (6.7% vs. 5.8%). After revision of the Japanese clinical practice guidelines for AHF in March 2018, tolvaptan usage for AHF patients has steadily increased. However, in-hospital outcomes including mortality do not seem to be affected.Yusuke YamazakiYasuyuki ShiraishiShun KohsakaYuji NagatomoKeiichi FukudaTakashi KohnoTsutomu YoshikawaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yusuke Yamazaki Yasuyuki Shiraishi Shun Kohsaka Yuji Nagatomo Keiichi Fukuda Takashi Kohno Tsutomu Yoshikawa Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan
description	Abstract Within no definite diuretic protocol for acute heart failure (AHF) patients and its variation in regional clinical guidelines, the latest national guidelines in Japan commends use of tolvaptan in diuretic-resistant patients. This study aimed to examine trends in tolvaptan usage and associated outcomes of AHF patients requiring hospitalization. Between April, 2018 and October, 2019, 1343 consecutive AHF patients (median 78 [69–85] year-old) were enrolled in a prospective, multicenter registry in Japan. Trends over time in tolvaptan usage, along with the severity of heart failure status based on the Get With The Guideline-Heart Failure [GWTG-HF] risk score, and in-hospital outcomes were investigated. During the study period, tolvaptan usage has increased from 13.0 to 28.7% over time (p for trend = 0.07), and 49.4% started tolvaptan within 3 days after admission. The GWTG-HF risk score in the tolvaptan group has significantly decreased over time, while that in the non-tolvaptan group has unchanged. There were no differences in the in-hospital mortality rate between the patients with and without tolvaptan (6.7% vs. 5.8%). After revision of the Japanese clinical practice guidelines for AHF in March 2018, tolvaptan usage for AHF patients has steadily increased. However, in-hospital outcomes including mortality do not seem to be affected.
format	article
author	Yusuke Yamazaki Yasuyuki Shiraishi Shun Kohsaka Yuji Nagatomo Keiichi Fukuda Takashi Kohno Tsutomu Yoshikawa
author_facet	Yusuke Yamazaki Yasuyuki Shiraishi Shun Kohsaka Yuji Nagatomo Keiichi Fukuda Takashi Kohno Tsutomu Yoshikawa
author_sort	Yusuke Yamazaki
title	Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan
title_short	Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan
title_full	Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan
title_fullStr	Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan
title_full_unstemmed	Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan
title_sort	temporal trends in tolvaptan use after revision of national heart failure guidelines in japan
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8394f492d760442b96a973386f29ce2e
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Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan

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