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Brisco, Meredith A., MD, MSCE; Zile, Michael R., MD; Hanberg, Jennifer S., BA; Wilson, F. Perry, MD, MSCE; Parikh, Chirag R., MD, PhD; Coca, Steven G., DO MS; Tang, W.H. Wilson, MD; Testani, Jeffrey M., MD, MTR
Journal of cardiac failure, 10/2016, Volume: 22, Issue: 10Journal Article
Highlights • The validity of using changes in serum creatinine as surrogate endpoints for outcomes in heart failure was examined in 301 patients in the DOSE trial. • Decreases in serum creatinine, when incorrectly assumed to be linearly related to outcomes, were paradoxically associated with a substantially increased risk for adverse events. • Worsening in serum creatinine during the randomized intervention was not associated with an increase in adverse outcomes. • Improvement in renal function during the randomized intervention was strongly associated with poor outcomes. • The practice of using mild to moderate-sized changes in serum creatinine as an endpoint in heart failure clinical trials may be inappropriate.
