RESEARCH ARTICLE The effect of intravenous isosorbide dinitrate in acute decompensated heart failure in hospital Je ´re ´my Chambord 1 • David Attivi 1 • Ve ´ronique Thuus 2 • Claire Zeghmouli 1 • Ste ´phane Gibaud 1,3,4 Received: 3 November 2016 / Accepted: 25 March 2017 Ó Springer International Publishing 2017 Abstract Background According to new recommenda- tions for the management of acute decompensated heart failure (ADHF) in 2015, intravenous vasodilator therapy might be given as an early therapy when systolic blood pressure is normal to high (C110 mmHg). Only 29% of patients with ADHF are treated with vasodilators without medical contraindication. Objective To evaluate the effect of the systematic use of ISDN on ADHF without con- traindication especially on rehospitalization rate. Settings The 600-bed hospital (Centre Hospitalier de l’Ouest Vosgien, Neufcha ˆteau, France). Methods This is a ret- rospective study with data analysed from medical records. Patients with ADHF episodes and hospitalization in the cardiology department or intensive care unit (ICU) between November 2013 and December 2015 were included resulting in 199 hospitalizations in the analysis (37 were treated by ISDN, and 162 were not). Main outcome measure Effects of ISDN on 180-day hospital readmission for ADHF or acute myocardial infarction (AMI), in-hospital mortality, length of stay, number of ICU admissions, and ICU length of stay. Results Patients who received ISDN required more ICU admissions than the other patients (54.1 vs 33.3%, p = 0.02). Neverthe- less 180-day hospital readmission was lower for patients who were receiving ISDN (8.1 vs 22.8%, p = 0.04). ISDN did not influence other clinical outcomes tested. Conclusion ISDN may minimize or prevent the conse- quences of altered haemodynamics. Lower rehospitaliza- tion rate with ISDN was seen in this study. Keywords Acute decompensated heart failure Á France Á Guidelines Á Isosorbide dinitrate Á Rehospitalisation Á Vasodilator Impacts on practice • Rehospitalization rate for ADHF and AMI could be decreased when patients with acute decompensated heart failure are treated with intravenous isosorbide dinitrate, but this finding has to be confirmed in sub- sequent studies. • If there is no contraindication, acute decompensated heart failure should be treated early with intravenous isosorbide dinitrate, following 2015 European recommendations Introduction Heart failure (HF) is a major public health problem, with a prevalence of more than 5.8 million in the United States and more than 23 million worldwide [1]. In 2008, 2–3% of European people also suffered heart failure [2]. The & Ste ´phane Gibaud stephane.gibaud@univ-lorraine.fr 1 Department of Pharmacy, Centre hospitalier de l’Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300 Neufcha ˆteau, France 2 Department of Cardiology, Centre hospitalier de l’Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300 Neufcha ˆteau, France 3 EA3452/CITHEFOR, Faculte ´ de pharmacie, Universite ´ de Lorraine, 5, rue Albert Lebrun, 54000 Nancy, France 4 Pharmacie Clinique, Faculte ´ de Pharmacie, Universite ´ de Lorraine, 5, rue Albert Lebrun, 54000 Nancy, France 123 Int J Clin Pharm DOI 10.1007/s11096-017-0459-x