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Fuentes Prado, MireyaAuthorAguirre, AlfonsAuthorPerello Carbonell, RafaelAuthorVazquez-Alvarez, JAuthorMiro, OAuthorMartinez-Zapico, AAuthor

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August 1, 2016
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Influence of Intravenous Nitrate Treatment on Early Mortality Among Patients With Acute Heart Failure. NITRO-EAHFE Study

Publicated to: Rev Esp Cardiol. 68 (11): 959-967 - 2015-11-01 68(11), DOI: 10.1016/j.rec.2014.12.016

Authors:

Herrero-Puente, Pablo; Jacob, Javier; Martin-Sanchez, Francisco Javier; Vazquez-Alvarez, Joaquin; Martinez-Camblor, Pablo; Miro, Oscar; Javier Lucas-Imbernon, Francisco; Martinez-Zapico, Aleida; Llorens, Pere
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Affiliations

Hosp Clin Barcelona, Grp Invest Urgencias Proc & Patol, Area Urgencias, IDIBAPS, Barcelona, Spain - Author
Hosp Clin San Carlos, Serv Urgencias, Madrid, Spain - Author
Hosp Clin San Carlos, UCE, Madrid, Spain - Author
Hosp Gen Univ Alicante, Hospitalizac Domicilio, Alicante, Spain - Author
Hosp Gen Univ Alicante, Serv Urgencias UCE, Alicante, Spain - Author
Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain - Author
Hosp Univ Cent Asturias, Area Gest Clin Med Interna, Oviedo 33011, Asturias, Spain - Author
Hosp Univ Cent Asturias, Unidad Gest Clin Urgencias, Grp Invest Urgencias, Oviedo 33011, Asturias, Spain - Author
Oficina Invest Biosanit Asturias OIB FICYT, Asturias, Spain - Author
Univ Albacete, Gen Hosp, Serv Urgencias, Albacete, Spain - Author
Univ Autonoma Chile, Temuco, Chile - Author
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Abstract

There is little evidence on the prognostic influence of intravenous nitrates in patients with acute heart failure. Our purpose was to determine the influence of this treatment on early mortality and new visits.Prospective, multicenter cohort study of patients with acute heart failure in an emergency room during 2 periods (May 2009 and November-December 2011). Patients with systolic blood pressure > 110mmHg were included, grouped according to whether they received intravenous nitroglycerin or not. Endpoints were mortality at 3, 7, 14, and 30 days and new visits at 30 days. The propensity score was estimated by logistic regression to determine the prognostic influence of the treatment.We included 3178 of 4897 individuals. A total of 308 (9.7%) had died within 30 days and 465 (17%) attended new visits. The mean (standard deviation) age was 79.5 (10.0) years, and 796 (25%) patients received intravenous nitrates. After matching, there were 685 individuals in each group. The hazard ratio for 30-day mortality with nitrates was 1.21 (95% confidence interval, 0.87-1.70) and was 0.93 for new visits (95% confidence interval, 0.71-1.22). The results were similar for mortality at 3, 7, and 14 days (hazard ratio = 1.05 [95% confidence interval, 0.56-1.96], hazard ratio = 1.20 [95% confidence interval, 0.74-1.94], and hazard ratio = 1.23 [95% confidence interval, 0.82-1.84], respectively). In the presence of hypertensive pulmonary edema, the nitrates group showed a hazard ratio of 0.88 (95% confidence interval, 0.47-1.63) for 30-day mortality.Intravenous nitrates do not influence early mortality or new visits in patients with acute heart failure.Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
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Keywords

acute heart failureepidemiologyguidelineshospital emergency roomsinsuficiencia cardiaca agudaintravenous nitratesmortalidadmortalitynitratos intravenososprognostic valuepropensity scorestrategiesAcute heart failureAgedAged, 80 and overCohort studiesEmergency service, hospitalFemaleHeart failureHospital emergency roomsHumansInfusions, intravenousInsuficiencia cardiaca agudaIntravenous nitratesMaleMortalidadMortalityNatriuretic peptideNitratesNitratos intravenososNitroglycerinPrognosisPropensity scoreProportional hazards modelsProspective studiesServicios de urgencias hospitalariosVasodilator agents

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Rev Esp Cardiol due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2015, it was in position 22/124, thus managing to position itself as a Q1 (Primer Cuartil), in the category Cardiac & Cardiovascular Systems.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-05:

  • WoS: 15
  • Scopus: 15
  • Europe PMC: 5
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-05:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 14.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 14 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 9.
  • The number of mentions on the social network X (formerly Twitter): 2 (Altmetric).
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Chile.

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Awards linked to the item

This study was conducted as part of the 2008-2011 National R&D Plan projects PI10/01918 and PI11/01021 of the Instituto de Salud Carlos III and was supported by ERDF (European Regional Development Fund) funds. The IDIBAPS (Institut d'Investigacions Biomediques August Pi i Sunyer) Emergency Rooms: Processes and Pathologies'' research group was supported by a grant from the Generalitat de Catalunya for consolidated research groups (GRC 2009/1385).
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