2023
Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI
Aklilu A, Kumar S, Yamamoto Y, Moledina D, Sinha F, Testani J, Wilson F. Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI. Kidney360 2023, 4: 1371-1381. PMID: 37644648, PMCID: PMC10615381, DOI: 10.34067/kid.0000000000000250.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryGlucoseHeart FailureHospitalizationHumansSodiumSodium-Glucose Transporter 2 InhibitorsConceptsAcute kidney injuryHeart failure hospitalizationSodium-glucose cotransporter-2 inhibitor useSodium-glucose cotransporter 2 inhibitorsAcute heart failure hospitalizationCotransporter 2 inhibitorsCox regression analysisRenal recoveryFailure hospitalizationAKI diagnosisKidney injuryInhibitor useLower riskStage 5 chronic kidney diseaseTime-varying Cox regression analysisKidney Disease Improving Global OutcomesInverse probability-weighted analysisMulticenter retrospective cohort studyMultivariable Cox regression analysisStage 5 CKDAcute heart failureRetrospective cohort studyChronic kidney diseaseKidney function recoveryGlomerular filtration rateEffect of Sotagliflozin on Early Mortality and Heart Failure-Related Events A Post Hoc Analysis of SOLOIST-WHF
Pitt B, Bhatt D, Szarek M, Cannon C, Leiter L, McGuire D, Lewis J, Riddle M, Voors A, Metra M, Lund L, Komajda M, Testani J, Wilcox C, Ponikowski P, Lopes R, Ezekowitz J, Sun F, Davies M, Verma S, Kosiborod M, Steg P, Investigators S. Effect of Sotagliflozin on Early Mortality and Heart Failure-Related Events A Post Hoc Analysis of SOLOIST-WHF. JACC Heart Failure 2023, 11: 879-889. PMID: 37558385, DOI: 10.1016/j.jchf.2023.05.026.Peer-Reviewed Original ResearchMeSH KeywordsDiabetes Mellitus, Type 2Heart FailureHospitalizationHumansStroke VolumeVentricular Function, LeftConceptsMain endpointCardiovascular deathHeart failureN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideEffect of sotagliflozinDate of dischargeGlomerular filtration rateVentricular ejection fractionType 2 diabetesProportional hazards modelPost Hoc AnalysisAgonist useCause mortalityIndex hospitalizationStudy drugEjection fractionEarly mortalityNatriuretic peptideStudy treatmentHF eventsSubgroup analysisFiltration rateHoc AnalysisHazards modelEffect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure
Mentz R, Anstrom K, Eisenstein E, Sapp S, Greene S, Morgan S, Testani J, Harrington A, Sachdev V, Ketema F, Kim D, Desvigne-Nickens P, Pitt B, Velazquez E, Adams K, Bhatt K, DeWald T, Axsom K, Murthy S, Rich J, Testani J, Smith B, Vader J, McCulloch M, Skopicki H, Psotka M, Heroux A, Lala-Trindade A, Stevens G, Tang W, Lev Y, William P, Eberly A, Gottleib S, Haught W, Grafton G, Larned J, Tejwani L, Mody F, Krim S, Robinson M, Fang J, Adler A, Bell A, Banerjee D, Ruiz Duque E, Mizyed A, Rommel J, Arhinful J, Goyal P, Hall M, Hummel S, Shetty S, Haas D, Vilaro J, Alexy T, Herre J, Clark J, Ambrosy A, Gaglianello N, Ramasubbu K, Meadows J, Tabtabai S, Sherwood M, Hasni S, D'Urso M, Muneer B, Dunlap S, Davis W, Friedman D, Guglin M, Ferguson A, Abbate A, Smart F. Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure. JAMA 2023, 329: 214-223. PMID: 36648467, PMCID: PMC9857435, DOI: 10.1001/jama.2022.23924.Peer-Reviewed Original ResearchConceptsCause mortalityHeart failureTorsemide groupFurosemide groupTotal hospitalizationsCause hospitalizationEffects of torsemideDiuretic strategyPrespecified subgroupsSecondary outcomesEjection fractionMedian agePrimary outcomeHospitalizationMAIN OUTCOMEPatientsFurosemideMortalityMonthsTorsemidePrimary hypothesisSignificant differencesFinal dateOutcomesTrials
2022
Rates of In-Hospital Decongestion and Association with Mortality and Cardiovascular Outcomes Among Patients Admitted for Acute Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Rates of In-Hospital Decongestion and Association with Mortality and Cardiovascular Outcomes Among Patients Admitted for Acute Heart Failure. The American Journal Of Medicine 2022, 135: e337-e352. PMID: 35472391, PMCID: PMC10767835, DOI: 10.1016/j.amjmed.2022.04.003.Peer-Reviewed Original ResearchMeSH KeywordsBiomarkersHeart FailureHospitalizationHospitalsHumansNatriuretic Peptide, BrainPeptide FragmentsPrognosisConceptsB-type natriuretic peptideAcute heart failureHeart failure hospitalizationComposite outcomeHeart failureFailure hospitalizationCardiovascular outcomesCardiovascular mortalityNatriuretic peptideN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideHeart Failure Outcome StudyMultivariable Cox regression modelsResistant heart failureLower hazardCox regression modelRisk of mortalityPropensity-score matchingTolvaptan (EVEREST) trialCause mortalityCardiovascular benefitsVasopressin AntagonismVolume overloadReduced riskOutcome studies
2021
Effect of Sotagliflozin on Total Hospitalizations in Patients With Type 2 Diabetes and Worsening Heart Failure : A Randomized Trial.
Szarek M, Bhatt DL, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Banks P, Tesfaye E, Ezekowitz JA, Verma S, Pitt B. Effect of Sotagliflozin on Total Hospitalizations in Patients With Type 2 Diabetes and Worsening Heart Failure : A Randomized Trial. Annals Of Internal Medicine 2021, 174: 1065-1072. PMID: 34152828, DOI: 10.7326/m21-0651.Peer-Reviewed Original ResearchConceptsHeart failurePlacebo groupType 2 diabetesSotagliflozin groupRate of daysSodium-glucose cotransporter 2 inhibitorsEffect of sotagliflozinPrespecified efficacy outcomeWorsening Heart FailureDuration of admissionPlacebo-controlled trialCotransporter 2 inhibitorsPatient-centered outcomesSodium-glucose cotransporter 1Poisson regression modelsCardiovascular deathEfficacy outcomesTotal hospitalizationsUrgent visitsEjection fractionPatients' qualityDisease burdenSotagliflozinHospitalizationPatientsSodium-Glucose Cotransporter-2 Inhibitors in Heart Failure
Morris AA, Testani JM, Butler J. Sodium-Glucose Cotransporter-2 Inhibitors in Heart Failure. Circulation 2021, 143: 2329-2331. PMID: 34125562, PMCID: PMC8210466, DOI: 10.1161/circulationaha.120.052821.Peer-Reviewed Original ResearchEarly diuretic strategies and the association with In-hospital and Post-discharge outcomes in acute heart failure
Fudim M, Spates T, Sun JL, Kittipibul V, Testani JM, Starling RC, Tang WHW, Hernandez AF, Felker GM, O'Connor CM, Mentz RJ. Early diuretic strategies and the association with In-hospital and Post-discharge outcomes in acute heart failure. American Heart Journal 2021, 239: 110-119. PMID: 34052212, DOI: 10.1016/j.ahj.2021.05.011.Peer-Reviewed Original ResearchMeSH KeywordsCreatinineDiureticsDrug MonitoringFemaleFurosemideHeart FailureHospitalizationHumansInfusions, IntravenousInjections, IntravenousMaleMiddle AgedMortalityNatriuretic Peptide, BrainOutcome and Process Assessment, Health CarePatient ReadmissionPeptide FragmentsTime-to-TreatmentUnited StatesConceptsIntermittent bolus administrationAcute heart failureDecompensated heart failureHeart failurePost-discharge outcomesDiuretic strategyDay mortalityBolus administrationDays/dischargeHigher baseline creatinineIntermittent bolus groupTotal urine outputBaseline creatinineDiuretic regimenHigh NTproBNPCause mortalityHF readmissionHF rehospitalizationHospital outcomesBaseline characteristicsCardiovascular mortalityIn-HospitalRenal functionBolus groupContinuous therapy
2020
Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients
Biegus J, Zymliński R, Testani J, Marciniak D, Zdanowicz A, Jankowska EA, Banasiak W, Ponikowski P. Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients. European Journal Of Heart Failure 2020, 23: 729-739. PMID: 33190378, DOI: 10.1002/ejhf.2053.Peer-Reviewed Original ResearchConceptsAcute heart failureGlomerular filtration rateHeart failureFiltration rateDay 1Acute heart failure patientsHospital heart failureSpot urine sodiumHeart failure patientsUrinary sodium concentrationAHF patientsInotrope useTherapeutic profilingUrine sodiumFailure patientsIndependent prognosticatorRenal functionDay 2PatientsEGFRConcomitant assessmentWater handlingSodium concentrationPrognosticatorExcretersSotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure
Bhatt DL, Szarek M, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Verma S, Lapuerta P, Pitt B. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure. New England Journal Of Medicine 2020, 384: 117-128. PMID: 33200892, DOI: 10.1056/nejmoa2030183.Peer-Reviewed Original ResearchConceptsPrimary end-point eventEnd-point eventsHeart failureSotagliflozin groupCardiovascular causesPlacebo groupRate of deathFirst doseUrgent visitsSodium-glucose cotransporter 2 inhibitorsType 2 diabetes mellitusWorsening Heart FailureAcute kidney injuryDecompensated heart failureDouble-blind trialPrimary end pointStable heart failureCotransporter 2 inhibitorsPercentage of patientsRisk of hospitalizationKidney injuryPrespecified subgroupsDiabetes mellitusSevere hypoglycemiaSGLT2 inhibitorsAccelerated decline in renal function after hospitalization for acute heart failure: an opportunity to intervene, or a sign of the inevitable?
McNaughton CD, Collins SP, Testani JM. Accelerated decline in renal function after hospitalization for acute heart failure: an opportunity to intervene, or a sign of the inevitable? European Journal Of Heart Failure 2020, 22: 1800-1802. PMID: 32840958, DOI: 10.1002/ejhf.1992.Commentaries, Editorials and LettersRacial Differences in Diuretic Efficiency, Plasma Renin, and Rehospitalization in Subjects With Acute Heart Failure
Morris AA, Nayak A, Ko YA, D’Souza M, Felker GM, Redfield MM, Tang WHW, Testani JM, Butler J. Racial Differences in Diuretic Efficiency, Plasma Renin, and Rehospitalization in Subjects With Acute Heart Failure. Circulation Heart Failure 2020, 13: e006827. PMID: 32635768, PMCID: PMC7474850, DOI: 10.1161/circheartfailure.119.006827.Peer-Reviewed Original ResearchConceptsPlasma renin activityAcute heart failureLevels of PRADiuretic efficiencyHeart failureBlack patientsNonblack patientsAcute heart failure clinical trialsRacial differencesBaseline plasma renin activityHeart failure clinical trialsHigher diuretic efficiencyMeasures of decongestionRisk of rehospitalizationNonischemic heart failureNet fluid balanceSubset of subjectsGreater fluid lossRace/ethnic groupsCARRESS-HFDOSE-AHFFurosemide equivalentsROSE-AHFAldosterone systemNT-proBNPAccess and Outcomes Among Hypertrophic Cardiomyopathy Patients in a Large Integrated Health System
Thomas A, Papoutsidakis N, Spatz E, Testani J, Soucier R, Chou J, Ahmad T, Darr U, Hu X, Li F, Chen ME, Bellumkonda L, Sumathipala A, Jacoby D. Access and Outcomes Among Hypertrophic Cardiomyopathy Patients in a Large Integrated Health System. Journal Of The American Heart Association 2020, 9: e014095. PMID: 31973610, PMCID: PMC7033886, DOI: 10.1161/jaha.119.014095.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCardiomyopathy, HypertrophicCause of DeathConnecticutDelivery of Health Care, IntegratedFemaleHealthcare DisparitiesHeart Disease Risk FactorsHospitalizationHumansMaleMiddle AgedOutcome and Process Assessment, Health CareReferral and ConsultationRetrospective StudiesRisk AssessmentSocial ClassSocial Determinants of HealthTreatment OutcomeConceptsSpecialty careHCM patientsCare cohortHypertrophic cardiomyopathyYale New Haven Health SystemLarge integrated health systemHealth systemBackground Hypertrophic cardiomyopathyRetrospective cohort studySocioeconomic statusPatients' socioeconomic statusHigher socioeconomic status groupsHypertrophic cardiomyopathy patientsIntegrated health systemSpecialty care accessSocioeconomic status groupsMedical insurance providersCardiomyopathy clinicCause deathLSES patientsCause hospitalizationCause mortalityNoncardiac causesCohort studySecondary outcomes
2019
Treating Heart Failure With Antihyperglycemic Medications: Is Now the Right Time?
Testani JM, Inzucchi SE, Voors AA. Treating Heart Failure With Antihyperglycemic Medications: Is Now the Right Time? Circulation 2019, 139: 2383-2385. PMID: 31107618, DOI: 10.1161/circulationaha.119.038854.Commentaries, Editorials and LettersBiomarkersBlood GlucoseDiabetes Mellitus, Type 2Disease ProgressionEvidence-Based MedicineGlucagon-Like Peptide-1 ReceptorHeart FailureHospitalizationHumansIncretinsProtective FactorsRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeUrinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure
Martens P, Dupont M, Verbrugge FH, Damman K, Degryse N, Nijst P, Reynders C, Penders J, Tang WHW, Testani J, Mullens W. Urinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure. JACC Heart Failure 2019, 7: 404-414. PMID: 31047021, DOI: 10.1016/j.jchf.2019.02.011.Peer-Reviewed Original ResearchConceptsChronic HF patientsHF patientsHeart failureSodium excretionAcute decompensated heart failureAcute heart failure hospitalizationLongitudinal changesChronic heart failureDecompensated heart failureHeart failure hospitalizationHigher sodium excretionUrinary sodium concentrationGlomerular filtration rate measurementInterindividual differencesLarge interindividual differencesFiltration rate measurementAHF hospitalizationDyspnea scoreFailure hospitalizationNT-proBNPChronic heartEjection fractionIndependent predictorsClinical endpointsPathophysiologic interactions
2018
Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study
Lawson CA, Testani JM, Mamas M, Damman K, Jones PW, Teece L, Kadam UT. Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study. International Journal Of Cardiology 2018, 267: 120-127. PMID: 29957251, PMCID: PMC6024224, DOI: 10.1016/j.ijcard.2018.04.090.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseRenal functionKidney diseasePrevalence of CKDModerate chronic kidney diseaseSevere chronic kidney diseasePresence of diabetesAdjusted risk estimatesGlomerular filtration rateCase-control studyHeart failure monitoringUK national studyHF prognosisFirst hospitalisationHF patientsRenal declineHF cohortRelated comorbiditiesHF settingFiltration rateNatural courseHospitalisationHigh riskRisk associationCommunity population
2016
Implications of Serum Chloride Homeostasis in Acute Heart Failure (from ROSE-AHF)
Grodin JL, Sun JL, Anstrom KJ, Chen HH, Starling RC, Testani JM, Tang WH. Implications of Serum Chloride Homeostasis in Acute Heart Failure (from ROSE-AHF). The American Journal Of Cardiology 2016, 119: 78-83. PMID: 27816115, PMCID: PMC5161696, DOI: 10.1016/j.amjcard.2016.09.014.Peer-Reviewed Original ResearchConceptsAcute heart failureSerum Cl levelsHeart failureClinical outcomesDiuretic responseAcute heart failure trialsRenal Optimization Strategies EvaluationShort-term clinical responseCumulative sodium excretionLoop diuretic doseHeart Failure TrialLong-term mortalitySerum chloride levelsCystatin C changesDiuretic dosePostdischarge outcomesSodium excretionCl levelsClinical responseRenal functionDiuretic efficiencyFailure TrialAdditional adjustmentCystatin CTherapeutic implicationsHypochloremia, Diuretic Resistance, and Outcome in Patients With Acute Heart Failure
Ter Maaten JM, Damman K, Hanberg JS, Givertz MM, Metra M, O'Connor CM, Teerlink JR, Ponikowski P, Cotter G, Davison B, Cleland JG, Bloomfield DM, Hillege HL, van Veldhuisen DJ, Voors AA, Testani JM. Hypochloremia, Diuretic Resistance, and Outcome in Patients With Acute Heart Failure. Circulation Heart Failure 2016, 9: e003109. PMID: 27507112, DOI: 10.1161/circheartfailure.116.003109.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overBiomarkersChloridesDisease ProgressionDiureticsDown-RegulationDrug ResistanceFemaleHeart FailureHospitalizationHumansKaplan-Meier EstimateLinear ModelsMaleMiddle AgedMultivariate AnalysisProportional Hazards ModelsRisk FactorsTime FactorsTreatment OutcomeXanthinesConceptsAcute heart failureMEq/L.Heart failureDay 14Serum chloridePoor diuretic responseHours of admissionLower serum chlorideBlood urea nitrogenSerum chloride levelsAHF therapiesDiuretic resistancePROTECT trialNeurohormonal activationMultivariable adjustmentRenal functionHospital admissionMultivariable analysisDiuretic responseDiuretic responsivenessDiuretic targetChloride levelsUrea nitrogenHypochloremiaChloride homeostasis
2015
Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial
Wilson FP, Shashaty M, Testani J, Aqeel I, Borovskiy Y, Ellenberg SS, Feldman HI, Fernandez H, Gitelman Y, Lin J, Negoianu D, Parikh CR, Reese PP, Urbani R, Fuchs B. Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial. The Lancet 2015, 385: 1966-1974. PMID: 25726515, PMCID: PMC4475457, DOI: 10.1016/s0140-6736(15)60266-5.Peer-Reviewed Original ResearchConceptsAcute kidney injuryUsual care groupKidney injuryCare groupAlert groupClinical outcomesElectronic alertsEligible participantsKidney Disease Improving Global OutcomesEnd-stage renal diseaseAcute kidney injury alertsEffective treatment optionIntensive care unitElectronic alert systemComputer-generated sequenceRandomisation strataSurgical admissionsUsual carePrimary outcomeRenal diseaseCare unitTreatment optionsCreatinine valuesCreatinine concentrationSuch injuriesIntravenous Fluids in Acute Decompensated Heart Failure
Bikdeli B, Strait KM, Dharmarajan K, Li SX, Mody P, Partovian C, Coca SG, Kim N, Horwitz LI, Testani JM, Krumholz HM. Intravenous Fluids in Acute Decompensated Heart Failure. JACC Heart Failure 2015, 3: 127-133. PMID: 25660836, PMCID: PMC4438991, DOI: 10.1016/j.jchf.2014.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFluid TherapyHeart FailureHospital MortalityHospitalizationHumansInfusions, IntravenousIntensive Care UnitsIntubation, IntratrachealIsotonic SolutionsMaleMiddle AgedRenal Replacement TherapyRetrospective StudiesRinger's SolutionSaline Solution, HypertonicSodium Potassium Chloride Symporter InhibitorsUnited StatesYoung AdultConceptsAcute decompensated heart failureDecompensated heart failureHeart failureIntravenous fluidsRetrospective cohort studyCritical care admissionRenal replacement therapyDays of hospitalizationProportion of hospitalizationsHalf-normal salineWarrants further investigationOnly diureticsCare admissionHospital deathHospital outcomesCohort studyLoop diureticsPatient groupReplacement therapyWorse outcomesNormal salineInpatient careMedian volumePatientsHospitalization
2013
Potential Effects of Digoxin on Long-Term Renal and Clinical Outcomes in Chronic Heart Failure
Testani JM, Brisco MA, Tang WH, Kimmel SE, Tiku-Owens A, Forfia PR, Coca SG. Potential Effects of Digoxin on Long-Term Renal and Clinical Outcomes in Chronic Heart Failure. Journal Of Cardiac Failure 2013, 19: 295-302. PMID: 23663810, PMCID: PMC3694335, DOI: 10.1016/j.cardfail.2013.03.002.Peer-Reviewed Original ResearchConceptsDigitalis Investigation GroupRenal dysfunctionHeart failureClinical outcomesFavorable renal responseHospitalization-free survivalLong-Term RenalChronic heart failureSerum creatinine levelsGlomerular filtration rateHypothesis-generating findingsLong-term improvementDIG trialCreatinine levelsRenal functionKidney functionRenal responseFiltration rateDigitalis glycosidesPatientsDigoxinHospitalizationDeathAdditional researchInvestigation group