Article Dans Une Revue Journal of Cardiac Failure Année : 2025

The Effects of Burst Steroid Therapy on Short-term Decongestion in Acute Heart Failure Patients With Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial

1 Wrocław Medical University
2 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
3 Heart Initiative [Durham, USA]
4 MRI - Momentum Research Inc. [Durham, NC, USA]
5 CHU Pitié-Salpêtrière [AP-HP]
6 SU - Sorbonne Université
7 FHU IMPEC - FHU IMProving Emergency Care
8 UMCG - University Medical Center Groningen [Groningen]
9 University of Groningen [Groningen]
10 Department of Astronomy and Planetary Science [Flagstaff]
11 Yerevan State Medical University after Mkhitar Heratsi
12 Department of Gastroenterology and Hepatology, Mikaelyan University Hospital, Yerevan, Armenia.
13 AMC - Arabkir Medical Center [Yerevan, Armenia]
14 GHU AP-HP Nord - Université Paris Cité
15 Hôpital Lariboisière-Fernand-Widal [APHP]
16 NKUA - National and Kapodistrian University of Athens
17 “Attikon” University Hospital
18 UMPCD - University of Medicine and Pharmacy “Carol Davila”
19 Emergency Institute for Cardiovascular Diseases “Prof. Dr. C.C. Iliescu” [Bucharest, Romania]
20 UniBs - Università degli Studi di Brescia = University of Brescia
21 PASS-CRB-APHP-SU - Centre de Ressources Biologiques APHP-SU
22 ASST Spedali Civili di Brescia - Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia [Brescia]
23 Washington University School of Medicine [Saint Louis, MO]
24 Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière]
25 FHU PROMICE - Fédération Hospitalo-Universitaire PRecision medicine for cOMprehensIve care of Critically ill patiEnts
26 Beaujon Hospital, DMU Parabol, AP-HP Nord, University of Paris
Tabassome Simon

Résumé

Background: The effect of steroids on congestion in patients with acute heart failure (AHF) is not known. Methods and results: Patients with AHF, NT-proBNP levels > 1500 pg/mL and high-sensitivity C-reactive protein (hsCRP) levels > 20 mg/L were randomized to once-daily oral 40 mg prednisone for 7 days or usual care. In this post hoc analysis, congestion score was calculated on the basis of orthopnea, edema and rales (0 reflecting lack of congestion, and 9 maximal congestion) at each time point. Among 100 eligible patients randomized, those assigned to prednisone had a greater improvement in congestion score at day 31 (win odds for the prednisone group compared to usual care at day 31 was 1.77 (95% CI 1.17-2.84; P = 0.0066) in all patients and 2.41 (95% CI 1.37-5.05; P = 0.0016) in patients with IL-6 > 13 pg/mL at baseline. In patients with congestion scores ≥ 7 at baseline, the effects of prednisone therapy on the EQ-5D visual analog scale score were 4.30 (95% CI 0.77-7.83) points at day 7 and 5.40 (0.51-10.29) points at day 31, accompanied by lower heart rate and respiratory rate and higher oxygen saturation compared to usual care. Conclusions: In patients with AHF and inflammatory activation, 7-day steroid therapy was associated with reduction in signs of congestion up to day 31. These results need confirmation in larger studies examining potential effects of steroids on congestion, diuresis, fluid redistribution and vascular permeability as well as clinical effects in AHF.

Fichier principal
Vignette du fichier
PIIS1071916424003762.pdf (1.53 Mo) Télécharger le fichier
Origine Publication financée par une institution
licence

Dates et versions

inserm-05406480 , version 1 (09-12-2025)

Licence

Identifiants

Citer

Jan Biegus, Gad Cotter, Beth Davison, Yonathan Freund, Adriaan Voors, et al.. The Effects of Burst Steroid Therapy on Short-term Decongestion in Acute Heart Failure Patients With Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial. Journal of Cardiac Failure, 2025, 31 (2), pp.354-366. ⟨10.1016/j.cardfail.2024.09.002⟩. ⟨inserm-05406480⟩
0 Consultations
0 Téléchargements

Altmetric

Partager

  • More