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Latest & greatest articles for heart failure
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on heart failure or other clinical topics then use Trip today.
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Association of genetically predicted testosterone with thromboembolism, heartfailure, and myocardial infarction: mendelian randomisation study in UK Biobank. To determine whether endogenous testosterone has a causal role in thromboembolism, heartfailure, and myocardial infarction.Two sample mendelian randomisation study using genetic variants as instrumental variables, randomly allocated at conception, to infer causality as additional randomised evidence.Reduction by Dutasteride of Prostate (...) Cancer Events (REDUCE) randomised controlled trial, UK Biobank, and CARDIoGRAMplusC4D 1000 Genomes based genome wide association study.3225 men of European ancestry aged 50-75 in REDUCE; 392 038 white British men and women aged 40-69 from the UK Biobank; and 171 875 participants of about 77% European descent, from CARDIoGRAMplusC4D 1000 Genomes based study for validation.Thromboembolism, heartfailure, and myocardial infarction based on self reports, hospital episodes, and death.Of the UK Biobank
Prospective Validation of the Emergency HeartFailure Mortality Risk Grade for Acute HeartFailure Improved risk stratification of acute heartfailure in the emergency department may inform physicians' decisions regarding patient admission or early discharge disposition. We aimed to validate the previously-derived Emergency Heartfailure Mortality Risk Grade for 7-day (EHMRG7) and 30-day (EHMRG30-ST) mortality.We conducted a multicenter, prospective validation study of patients with acute heart (...) failure at 9 hospitals. We surveyed physicians for their estimates of 7-day mortality risk, obtained for each patient before knowledge of the model predictions, and compared these with EHMRG7 for discrimination and net reclassification improvement. We also prospectively examined discrimination of the EHMRG30-ST model, which incorporates all components of EHMRG7 as well as the presence of ST-depression on the 12-lead ECG.We recruited 1983 patients seeking emergency department care for acute heart
Anti-Inflammatory Therapy with Canakinumab for the Prevention of Hospitalization for HeartFailure Subclinical inflammation is associated with an increased risk of heartfailure and with adverse prognosis in patients with established heartfailure. Yet, treatments specifically directed at reducing inflammation in patients with heartfailure have not yet shown improved clinical outcomes. We tested the hypothesis that the interleukin-1β inhibitor canakinumab would prevent hospitalization (...) for heartfailure (HHF) and the composite of HHF or heartfailure-related mortality.We randomized 10 061 patients with prior myocardial infarction and high-sensitivity C-reactive protein ≥2 mg/L to canakinumab 50, 150, or 300 mg or placebo, given subcutaneously once every 3 months. In total, 2173 (22%) reported a history of heartfailure at baseline. We tested the hypothesis that canakinumab prevents prospectively collected HHF events and the composite of HHF or heartfailure-related mortality.A total
Effect of Barthel Index on the Risk of Thirty-Day Mortality in Patients With Acute HeartFailure Attending the Emergency Department: A Cohort Study of Nine Thousand Ninety-Eight Patients From the Epidemiology of Acute HeartFailure in Emergency Department We assess the value of the Barthel Index (BI) in predicting 30-day mortality risk among patients with acute heartfailure who are attending the emergency department (ED).We selected 9,098 acute heartfailure patients from the Acute Heart (...) . In comparison with baseline BI score, ED BI score consistently provided greater discrimination. Neither baseline BI score nor the change in BI score from baseline to the ED visit added further prognostic value to the ED BI score.Functional status assessed by the BI score at the ED visit is a strong predictor of 30-day mortality in acute heartfailure patients, with higher predictive value than baseline BI score and acute functional decline. Routine recording of BI score at the ED visit may help
the prespecified secondary end
points cardiovascular death and the composite of all-cause death and
hospitalization for heart failure.In this pragmatic, registry-based randomized clinical trial, we
used a nationwide quality registry for coronary care for trial procedures
and evaluated end points through the Swedish population registry
(mortality), the Swedish inpatient registry (heartfailure), and cause of
death registry (cardiovascular death). Patients with suspected acute
myocardial infarction and oxygen (...) saturation of ≥90% were randomly
assigned to receive either supplemental oxygen at 6 L/min for 6 to 12
hours delivered by open face mask or ambient air.A total of 6629 patients were enrolled. Acute heartfailure
treatment, left ventricular systolic function assessed by echocardiography, and
infarct size measured by high-sensitive cardiac troponin T were similar in the
2 groups during the hospitalization period. All-cause death or hospitalization
for heartfailure within 1 year after randomization
Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for HeartFailure: The PACT-HF Randomized Clinical Trial. Health care services that support the hospital-to-home transition can improve outcomes in patients with heartfailure (HF).To test the effectiveness of the Patient-Centered Care Transitions in HF transitional care model in patients hospitalized for HF.Stepped-wedge cluster randomized trial of 2494 adults hospitalized for HF across 10 (...) hospitals in Ontario, Canada, from February 2015 to March 2016, with follow-up until November 2016.Hospitals were randomized to receive the intervention (n = 1104 patients), in which nurse-led self-care education, a structured hospital discharge summary, a family physician follow-up appointment less than 1 week after discharge, and, for high-risk patients, structured nurse homevisits and heart function clinic care were provided to patients, or usual care (n = 1390 patients), in which transitional care
Trends in survival after a diagnosis of heartfailure in the United Kingdom 2000-2017: population based cohort study. To report reliable estimates of short term and long term survival rates for people with a diagnosis of heartfailure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group.Population based cohort study.Primary care, United Kingdom.Primary care data for 55 959 patients aged 45 and overwith a new diagnosis of heartfailure and 278 679 age (...) and sex matched controls in the Clinical Practice Research Datalink from 1 January 2000 to 31 December 2017 and linked to inpatient Hospital Episode Statistics and Office for National Statistics mortality data.Survival rates at one, five, and 10 years and cause of death for people with and without heartfailure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group.Overall, one, five, and 10 year survival rates increased by 6.6% (from 74.2% in 2000 to 80.8
Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With HeartFailure. Heartfailure is an established risk factor for postoperative mortality, but how left ventricular ejection fraction and heartfailure symptoms affect surgical outcomes is not fully described.To determine the risk of postoperative mortality among patients with heartfailure at various levels of echocardiographic (left ventricular systolic dysfunction (...) ) and clinical (symptoms) severity compared with those without heartfailure and to evaluate how risk varies across levels of surgical complexity.US multisite retrospective cohort study of all adult patients receiving elective, noncardiac surgery in the Veterans Affairs Surgical Quality Improvement Project database from 2009 through 2016. A total of 609 735 patient records were identified and analyzed with 1 year of follow-up after having surgery (final study follow-up: September 1, 2017).Heartfailure, left
Repetitive levosimendan infusions for patients with advanced chronic heartfailure in the vulnerable post-discharge period. Hospitalization for acute heartfailure (HF) is associated with a substantial morbidity burden and with associated healthcare costs and an increased mortality risk. However, few if any major medical innovations have been witnessed in this area in recent times. Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management (...) of acute HF. Experience in several clinical studies has indicated that administration of intravenous levosimendan in intermittent cycles may reduce hospitalization and mortality rates in patients with advanced HF; however, none of those trials were designed or powered to give conclusive insights into that possibility. This paper describes the rationale and protocol of LeoDOR (levosimendan infusions for patients with advanced chronic heartfailure), a randomized, double-blind, placebo-controlled
Liraglutide and weight loss among patients with advanced heartfailure and a reduced ejection fraction: insights from the FIGHT trial. Obesity is present in up to 45% of patients with heartfailure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with HF and reduced ejection fraction (HFrEF) and a recent acute HF hospitalization remains unknown.The Functional (...) Impact of GLP-1 for HeartFailure Treatment study randomized 300 patients with HFrEF (ejection fraction ≤ 40%), both with and without diabetes and a recent HF hospitalization to liraglutide or placebo. The primary outcome for this post hoc analysis was the change in weight from baseline to last study visit. We conducted an 'on-treatment' analysis of patients with at least one follow-up visit on study drug (123 on liraglutide and 124 on placebo). The median age was 61 years, 21% were female, and 69
Pro-gastrin-releasing peptide and outcome in patients with heartfailure and anaemia: results from the RED-HF study. Neuroendocrine activation is associated with poor outcome in heartfailure (HF). The neuropeptide gastrin-releasing peptide (GRP), derived from the precursor proGRP1-125 (proGRP), has recently been implicated in inflammation and wound repair. We investigated the predictive value of proGRP on clinical outcomes in HF patients with reduced ejection fraction.The association between (...) plasma proGRP (time-resolved immunofluorometric assay) and the primary endpoint of death from any cause or first hospitalization for worsening of HF was evaluated using multivariable Cox proportional hazard models in 1541 patients with systolic HF and mild to moderate anaemia, enrolled in the Reduction of Events by Darbepoetin alfa in HeartFailure (RED-HF) trial. Median proGRP levels in the RED-HF cohort were markedly increased [95 ng/L (25th, 75th percentile, 69-129 ng/L)] with 64% patients above
External Validation of the MEESSI Acute HeartFailure Risk Score: A Cohort Study. The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) score was developed to predict 30-day mortality in patients presenting with acute heartfailure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown.To externally validate the MEESSI-AHF score in another country.Prospective cohort study (...) for missing values in the overall cohort of 1572 patients.External validation was done using a reduced model. Findings are specific to patients with AHF who present to the ED and are clinically stable enough to provide informed consent. Performance in patients with terminal kidney failure who are receiving long-term dialysis cannot be commented on.External validation of the MEESSI-AHF risk score showed excellent discrimination. Recalibration may be needed when the score is introduced to new
Cost-Effectiveness of a Home Visit Program for Patients with HeartFailure in Brazil: Evidence from a Randomized Clinical Trial. Estimate the cost-effectiveness of a nurse-led home visit (HV) intervention as compared with the standard HF management, within a randomized clinical trial in Brazil.Cost-effectiveness study within a randomized trial.To assess the cost-effectiveness of four home visits and four telephone calls by nurses in the management of patients with HF within a randomized
Chronic congestive heartfailure Chronic congestive heartfailure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Chronic congestive heartfailure Last reviewed: February 2019 Last updated: January 2019 Summary A complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. It is a major and growing public health (...) problem. It is the only cardiovascular disease that is increasing in incidence and prevalence, partly because the population is ageing, but also because of improved cardiovascular interventions for disease processes that reduce early mortality but may result in cardiac changes that lead to heartfailure. The key manifestations are dyspnoea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary congestion and peripheral oedema. Diagnosis is largely clinical
(CABG) or percutaneous coronary intervention (PCI)) should be considered in patients with HF and suitable coronary anatomy. Key message 7: Asymptomatic LV Dysfunction ? Identify patients who are at high risk of developing LV dysfunction and treat the underlying disease appropriately. ? ACE-I and ß-blockers (post MI) have been shown to slow down the onset of symptoms and reduce cardiac morbidity. Key message 8:HeartFailure with Preserved LV Function (HFpEF) ? HFpEF is a common cause of HF (...) bypass graft (CABG) or percutaneous coronary intervention (PCI)) should be considered in patients with HF and suitable coronary anatomy. Key message 7: Asymptomatic LV Dysfunction ? Identify patients who are at high risk of developing LV dysfunction and treat the underlying disease appropriately. ? ACE-I and ß-blockers (post MI) have been shown to slow down the onset of symptoms and reduce cardiac morbidity. Key message 8:HeartFailure with Preserved LV Function (HFpEF) ? HFpEF is a common cause
Motivational interviewing can support physical activity in elderly patients with diastolic heartfailure: results from a pilot study. Patients suffering from heartfailure with preserved ejection fraction (HFpEF) report similar symptoms and reduction in quality of life to those with reduced ejection fraction but remain largely untreated. We conducted a preliminary evaluation of the acceptance, feasibility, and efficacy of a motivational interviewing (MI) intervention to support elderly patients (...) suffering from HFpEF in maintaining or starting physical activity.At the conclusion of the exercise training in diastolic heartfailure parent trial that examined the effects of supervised exercise, patients with HFpEF were offered participation in a two-group pilot study. Based on their preference, consenting patients were assigned to either a 6 month MI intervention group (n = 19) or their physicians' usual care (n = 20). To support participants in increasing and/or maintaining their physical activity
Association of Rivaroxaban With Thromboembolic Events in Patients With HeartFailure, Coronary Disease, and Sinus Rhythm: A Post Hoc Analysis of the COMMANDER HF Trial. Whether anticoagulation benefits patients with heartfailure (HF) in sinus rhythm is uncertain. The COMMANDER HF randomized clinical trial evaluated the effects of adding low-dose rivaroxaban to antiplatelet therapy in patients with recent worsening of chronic HF with reduced ejection fraction, coronary artery disease (CAD