Subcutaneous furosemide pump sends heart failure patients home sooner, with more readmissions

The edition in brief

SUBCUT-HF II randomised 172 UK patients hospitalised with heart failure to an early discharge strategy using subcutaneous furosemide from a wearable minipump, or usual care. Early discharge gave 4.0 more days alive and out of hospital at 30 days (95% CI 2.1 to 5.8) and a hospital stay 5.5 days shorter, with more heart failure readmissions (14% vs 6%, OR 2.45, 95% CI 0.81 to 7.43). A PRO-TAVI substudy found that deferring PCI before transcatheter aortic valve replacement reduced bleeding, but in patients with a SYNTAX score above 17 the ischaemic composite was higher with deferral (30.9% vs 14.8%, adjusted HR 2.43), a post hoc finding. An EAPCI and European Bifurcation Club consensus statement sets out how to use intravascular ultrasound or optical coherence tomography in left main bifurcation PCI. TARTAN-HF randomised 706 people with diabetes and heart failure risk factors to NT-proBNP screening or usual care; heart failure was diagnosed in 24.6% vs 1% at 6 months, mostly with preserved ejection fraction, with a number needed to screen of 5. A pearl covers early follow-up after heart failure discharge.