EFFECTIVENESS AND OUTCOMES OF H-ISDN IN ADDITION TO CONVENTIONAL THERAPY IN ACUTE HEART FAILURE PATIENTS WITH RENAL IMPAIRMENT

Objective:The primary objective of the study is todetermine whether the addition of H-ISDN to conventional therapy improves the cardiovascular outcomes and also to assess both short term(1 and 3 months) and long term outcomes(1 year).

Materials and Methods:This is a prospective observational study.A total of 82 acute heart failure patients with renal impairment were divided into two groups based on exposure to H-ISDNGroup I-Patients on H-ISDN plus conventional therapyGroup II-Patients on conventional therapy. Followup of all the subjects to study the outcomes of improvement in NYHA class,rehospitalisation and mortality rate at 1 month,3 months and 1 year was done for both the groups.

Results:We observed that out of the 82 acute heart failure patients with renal impairment,43 patients were receiving H-ISDN in addition to conventional therapy(Group I) and 39 patients were receiving conventional therapy(Group II) .The length of stay(6.03± 2.906 vs 6.93± 3.845) was shorter in the treated group when compared to the non treated group.A greater difference in reduced hospitalisation was seen at 3 months(2.32% vs 12.82%).The treated group had higher improvement in NYHA class at 1 month(67.44% vs 46.15%), 3 months(51.16% vs 41.02%) and 1 year (44.18% vs 20.51%P=0.023).

Conclusion:Acute heart failure patients with renal impairment have poor prognosis. Randomised controlled trials are required to validate if the use of H-ISDN is associated with better outcomes in AHF patients.