Background Loop diuretics are commonly prescribed in the community, not always to patients with a recorded diagnosis of heart failure (HF). The rate of HF events in patients prescribed loop diuretics without a diagnosis of HF is unknown. Methods This was a propensity-matched cohort study using data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office of National Statistics in the UK. Patients prescribed a loop diuretic without a diagnosis of HF (loop diuretic group) between 1 January 2010 and 31 December 2015 were compared with patients with HF (HF group)—analysis A, and patients with risk factors for HF (either ischaemic heart disease, or diabetes and hypertension—at-risk group)—analysis B. The primary endpoint was an HF event (a composite of presentation with HF symptoms, HF hospitalisation, HF diagnosis (analysis B only) and all-cause mortality). Results From a total population of 180 384 patients (78 968 in the loop diuretic group, 28 177 in the HF group and 73 239 in the at-risk group), there were 59 694 patients, 22 352 patients and 57 219 patients in the loop diuretic, HF and at-risk groups, respectively, after exclusion criteria were applied. After propensity matching for age, sex and comorbidities, patients in the loop diuretic group had a similar rate of HF events as those in the HF group (71.9% vs 72.1%; HR=0.92 (95% CI 0.90 to 0.94); p<0.001), and twice as those in the at-risk group (59.2% vs 35.7%; HR=2.04 (95% CI 2.00 to 2.08); p<0.001). Conclusions Patients prescribed a loop diuretic without a recorded diagnosis of HF experience HF events at a rate comparable with that of patients with a recorded diagnosis of HF; many of these patients may have undiagnosed HF. Data may be obtained from a third party and are not publicly available. Data provided by CPRD.

中文翻译：

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未诊断心力衰竭而接受袢利尿剂治疗的患者的结果：一项回顾性队列研究

背景 袢利尿剂通常在社区中使用，但并不总是针对有心力衰竭 (HF) 诊断记录的患者。未诊断心力衰竭而服用袢利尿剂的患者心力衰竭事件发生率尚不清楚。方法 这是一项倾向匹配队列研究，使用来自临床实践研究数据链、医院事件统计和英国国家统计办公室的数据。将 2010 年 1 月 1 日至 2015 年 12 月 31 日期间未诊断为心力衰竭而服用袢利尿剂的患者（袢利尿剂组）与心力衰竭患者（心力衰竭组）进行比较——分析 A，以及有心力衰竭危险因素的患者（缺血性心脏病、主要终点是心力衰竭事件（心力衰竭症状、心力衰竭住院、心力衰竭诊断（仅分析 B）和全因死亡率的复合表现）。结果 总共 180 384 名患者（袢利尿剂组 78 968 名患者、心力衰竭组 28 177 名患者、高危组 73 239 名患者）中，有 59 694 名患者、22 352 名患者和 57 219 名患者应用排除标准后，分别使用袢利尿剂、心衰组和高危组。对年龄、性别和合并症进行倾向匹配后，袢利尿剂组患者的心力衰竭事件发生率与心力衰竭组相似（71.9% vs 72.1%；HR=0.92（95% CI 0.90 至 0.94）；p< 0.001），是高危组的两倍（59.2% vs 35.7%；HR=2.04（95% CI 2.00 至 2.08）；p<0.001）。结论 在未记录心力衰竭诊断的情况下服用袢利尿剂的患者发生心力衰竭事件的发生率与有心力衰竭诊断记录的患者相当。其中许多患者可能患有未确诊的心力衰竭。数据可能从第三方获得，并且不公开。数据由CPRD提供。