1. Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)
- Author
-
Etienne Gayat, Fábio Vilas-Boas, Nigel Burrows, John Parissis, Alexandre Mebazaa, Juan F. Delgado, Raphaël Porcher, Mehmet Yilmaz, Anthony S. McLean, Ferenc Follath, [Follath, F.] Univ Zurich Hosp, Dept Internal Med, Off HAL 18 D2, CH-8091 Zurich, Switzerland -- [Yilmaz, M. B.] Cumhuriyet Univ, Sch Med, Dept Cardiol, Sivas, Turkey -- [Yilmaz, M. B.] Hosp Lariboisiere, INSERM, U942, Paris, France -- [Delgado, J. F.] Hosp Doce de Octubre, Heart Failure & Transplant Unit, Dept Cardiol, Madrid, Spain -- [Parissis, J. T.] Attikon Univ Hosp, Heart Failure Clin, Athens, Greece -- [Parissis, J. T.] Attikon Univ Hosp, Cardiol Dept 2, Athens, Greece -- [Porcher, R. -- Gayat, E.] Univ Paris 07, Dept Biostat & Informat Med, Hop St Louis, AP HP,INSERM,UMR S 717, Paris, France -- [Burrows, Nigel] IMS Hlth SpA, Milan, Italy -- [Mclean, A.] Univ Sydney, Dept Intens Care Med, Nepean Hosp, Penrith, NSW, Australia -- [Vilas-Boas, F.] Hosp Espanhol, Div Cardiol, Salvador, BA, Brazil -- [Vilas-Boas, F.] Hosp Espanhol, Heart Failure & Transplantat Program, Salvador, BA, Brazil -- [Mebazaa, A.] Hosp Lariboisiere, AP HP, Dept Anesthesiol & Crit Care Med, Paris, France -- [Mebazaa, A.] Univ Paris 07, INSERM, U942, Paris, France, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Delgado, Juan F. -- 0000-0002-5401-8324, Porcher, Raphael -- 0000-0002-5277-4679, GAYAT, Etienne -- 0000-0002-3334-3849, Mebazaa, Alexandre -- 0000-0001-8715-7753, University of Zurich, and Follath, F
- Subjects
Male ,medicine.medical_specialty ,Internationality ,Acute heart failure syndromes ,610 Medicine & health ,Critical Care and Intensive Care Medicine ,law.invention ,law ,Intensive care ,Internal medicine ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Medicine ,Humans ,Hospital Mortality ,Aged ,Aged, 80 and over ,Heart Failure ,Ejection fraction ,business.industry ,Standard treatment ,Cardiogenic shock ,Levosimendan ,Middle Aged ,medicine.disease ,Classification ,Prognosis ,Intensive care unit ,Surgery ,Management ,Intensive Care Units ,Heart failure ,Acute Disease ,Dobutamine ,Female ,Therapy ,10029 Clinic and Policlinic for Internal Medicine ,2706 Critical Care and Intensive Care Medicine ,business ,medicine.drug - Abstract
WOS: 000289305700010, PubMed ID: 21210078, Purpose: We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results: Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) (p = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) (p < 0.0001). Conclusions: Our data demonstrated the existence of different subgroups based on de novo or pre-existing episode(s) of AHF and the site of hospitalization. Recognition of these subgroups might improve management and outcome by defining specific therapeutic requirements., TUBITAK (Turkey); Abbott, All coauthors would like to thank Patrick Cepon, Helen Smith, Ches Manly and Melinda Swan for their support. MB Yilmaz received a grant from TUBITAK (Turkey).; Abbott funded the ALARM-HF survey; data were acquired by IMS. Analyses were performed by Departement de Biostatistique et Informatique Medicale, Hopital Saint-Louis, APHP; Universite Paris 7; INSERM - UMR-S 717, Paris France by RP and EG. AM, JP, FVB, JFD and FF received honorarium from Abbott for lectures and/or consulting.
- Published
- 2009