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Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department

BACKGROUND: Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of this study was to evaluate the clinical effects of bolus enalaprilat when admi...

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Autores principales: Ayaz, Syed Imran, Sharkey, Craig M., Kwiatkowski, Gregory M., Wilson, Suprat Saely, John, Reba S., Tolomello, Rosa, Mahajan, Arushi, Millis, Scott, Levy, Phillip D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5195922/
https://www.ncbi.nlm.nih.gov/pubmed/28032307
http://dx.doi.org/10.1186/s12245-016-0125-4
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author Ayaz, Syed Imran
Sharkey, Craig M.
Kwiatkowski, Gregory M.
Wilson, Suprat Saely
John, Reba S.
Tolomello, Rosa
Mahajan, Arushi
Millis, Scott
Levy, Phillip D.
author_facet Ayaz, Syed Imran
Sharkey, Craig M.
Kwiatkowski, Gregory M.
Wilson, Suprat Saely
John, Reba S.
Tolomello, Rosa
Mahajan, Arushi
Millis, Scott
Levy, Phillip D.
author_sort Ayaz, Syed Imran
collection PubMed
description BACKGROUND: Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of this study was to evaluate the clinical effects of bolus enalaprilat when administered to patients with acute hypertensive heart failure. FINDINGS: We performed an IRB-approved retrospective cohort study of patients who presented to the emergency department of a large urban academic hospital. Patients were identified by pharmacy record and included if they received enalaprilat intravenous (IV) bolus in the setting of acute hypertensive HF. A total of 103 patients were included. Patients were hypertensive on presentation (systolic blood pressure [SBP] = 195.2 [SD ± 32.3] mmHg) with significantly elevated mean NT-proBNP levels (3797.8 [SD ± 6523.2] pg/ml). The mean dose of enalaprilat was 1.3 [SD ± 0.7] mg, with most patients (76.7%) receiving a single 1.25 mg bolus. By 3 h post­enalaprilat, SBP had decreased substantially (−30.5 mmHg) with only 2 patients (1.9%) developing hypotension. Renal function was unaffected, with no significant change in serum creatinine by 72 h. In the 30 days post-admission, patients spent an average of 23 [SD ± 7.5] days alive and out of hospital. CONCLUSIONS: In this retrospective cohort of acute hypertensive HF patients, bolus IV enalaprilat resulted in a substantial reduction in systolic BP without adverse effect.
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spelling pubmed-51959222017-01-13 Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department Ayaz, Syed Imran Sharkey, Craig M. Kwiatkowski, Gregory M. Wilson, Suprat Saely John, Reba S. Tolomello, Rosa Mahajan, Arushi Millis, Scott Levy, Phillip D. Int J Emerg Med Brief Research Report BACKGROUND: Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of this study was to evaluate the clinical effects of bolus enalaprilat when administered to patients with acute hypertensive heart failure. FINDINGS: We performed an IRB-approved retrospective cohort study of patients who presented to the emergency department of a large urban academic hospital. Patients were identified by pharmacy record and included if they received enalaprilat intravenous (IV) bolus in the setting of acute hypertensive HF. A total of 103 patients were included. Patients were hypertensive on presentation (systolic blood pressure [SBP] = 195.2 [SD ± 32.3] mmHg) with significantly elevated mean NT-proBNP levels (3797.8 [SD ± 6523.2] pg/ml). The mean dose of enalaprilat was 1.3 [SD ± 0.7] mg, with most patients (76.7%) receiving a single 1.25 mg bolus. By 3 h post­enalaprilat, SBP had decreased substantially (−30.5 mmHg) with only 2 patients (1.9%) developing hypotension. Renal function was unaffected, with no significant change in serum creatinine by 72 h. In the 30 days post-admission, patients spent an average of 23 [SD ± 7.5] days alive and out of hospital. CONCLUSIONS: In this retrospective cohort of acute hypertensive HF patients, bolus IV enalaprilat resulted in a substantial reduction in systolic BP without adverse effect. Springer Berlin Heidelberg 2016-12-28 /pmc/articles/PMC5195922/ /pubmed/28032307 http://dx.doi.org/10.1186/s12245-016-0125-4 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Brief Research Report
Ayaz, Syed Imran
Sharkey, Craig M.
Kwiatkowski, Gregory M.
Wilson, Suprat Saely
John, Reba S.
Tolomello, Rosa
Mahajan, Arushi
Millis, Scott
Levy, Phillip D.
Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
title Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
title_full Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
title_fullStr Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
title_full_unstemmed Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
title_short Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
title_sort intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department
topic Brief Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5195922/
https://www.ncbi.nlm.nih.gov/pubmed/28032307
http://dx.doi.org/10.1186/s12245-016-0125-4
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