Is addition of vasodilators to loop diuretics of value in the care of hospitalized acute heart failure patients? Real-world evidence from a retrospective analysis of a large United States hospital database.

•Hospital billing records for 82,808 USA patients with acute heart failure are analyzed.•Treatments with IV loop diuretics alone or with nitrates or nesiritide are compared.•IV vasodilators + IV loop diuretics do not lower inpatient mortality.•IV vasodilators + IV loop diuretics do not lower rehospitalization rates.•IV vasodilators + IV loop diuretics are associated with higher inpatient costs.