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

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

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Department of Emergency Medicine and Surgery, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie Paris, Paris, France.


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.

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