Long-term Effects and Prognosis in Heart Failure Patients Receiving Tolvaptan after Discharge

• Published in: Japanese Journal of Clinical Physiology Vol. 49; no. 1; pp. 29 - 36
• Main Authors: ITO, Chikayuki, KIDA, Keisuke, SUZUKI, Norio, KAMIJIMA, Ryo, NABETA, Takeru, MAEZAWA, Hideyuki, ISHIHARA, Shiro, OKABE, Toshitaka, ISHIKAWA, Tae, AKASHI, Yoshihiro J
• Format: Journal Article
• Language: English; Japanese
• Published: Japanese Society of Clinical Physiology 01.02.2019; Japanese Society of clinical Physiology
• ISSN: 0286-7052; 2435-1695
• DOI: 10.34363/jocp.49.1_29

Background: The short-term clinical effects of Tolvaptan (TLV) in patients hospitalized for heart failure (HF) are well known. Only a few of studies have investigated its long-term efficacy and safety in HF outpatients after discharge, however. The purpose of this study was to investigate the long-term effects, prognosis, and safety of TLV in HF outpatients after discharge.Methods: A total of 167 HF patients admitted to 8 hospitals in Kanagawa, Japan, between January 2013 and August 2015 were enrolled in the study. All were treated with TLV, even after discharge. The rates of continued administration of TLV, prognosis, and safety at 6 months were retrospectively evaluated.Results: A total of 121 patients continued to take TLV for 6 months after discharge (Treatment Continued group); 24 did not require TLV therapy due to HF stabilization (Treatment Unnecessary group); and 22 discontinued TLV therapy (Treatment Discontinued group). A comparison of patient backgrounds at discharge among these groups revealed significant differences in history of hospitalization due to HF exacerbation, B-type natriuretic peptide level, and dose of furosemide. A significant number of events were observed in the Treatment Discontinued group (p＜0.001), most of which occurred within 30 days after discharge. In this group, 55％ of the patients were readmitted within 30 days after discharge.Conclusions: The present results showing that it is possible to identify the effects of TLV in HF outpatients within 30 days after discharge suggest that long-term administration of this drug is relatively safe.