Isosorbide dinitrate bolus for heart failure in elderly emergency patients: a retrospective study

Eur J Emerg Med. 2011 Oct;18(5):272-5. doi: 10.1097/MEJ.0b013e328345d72a.

Abstract

In this study we aimed to determine whether isosorbide dinitrate (ISDN) bolus is associated with hypotension in patients aged at least 75 years presenting to an emergency department (ED) with acute heart failure (AHF) syndrome. This is a retrospective study, and all patients with AHF presenting in our ED during 2007 were included. We included 136 patients: 25 (18%) of them received ISDN in bolus (group B) among other treatments, and 111 (82%) did not (group O). Baseline characteristics of the two groups were not similar, with a higher rate of hypertension in group B. The mean lower systolic blood pressure after treatment was similar: 116±18 mmHg in group O compared with 116±19 mmHg in group B+, and was less than 90 mmHg in 0% cases in group B+ versus 3% in group O (P=0.5). Secondary endpoints were not significant, with mortality in group B of 4% versus 10% in group O (P=0.32). ISDN is not associated with more hypotension when used in bolus for elderly patients treated in the ED for AHF.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • France
  • Geriatric Assessment / methods*
  • Heart Failure, Systolic / drug therapy*
  • Heart Failure, Systolic / mortality
  • Hospital Mortality
  • Humans
  • Hypotension / chemically induced*
  • Intensive Care Units
  • Isosorbide Dinitrate / administration & dosage
  • Isosorbide Dinitrate / adverse effects*
  • Isosorbide Dinitrate / therapeutic use
  • Length of Stay / statistics & numerical data
  • Male
  • Retrospective Studies
  • Statistics as Topic
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / adverse effects*
  • Vasodilator Agents / therapeutic use

Substances

  • Vasodilator Agents
  • Isosorbide Dinitrate