Search

Your search keyword '"Ezekowitz, J."' showing total 124 results
Start Over Author "Ezekowitz, J." Search Limiters Full Text
124 results on '"Ezekowitz, J."'

1. Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes

Author

Kosiborod, M, Petrie, M, Borlaug, B, Butler, J, Davies, M, Hovingh, G, Kitzman, D, Moller, D, Treppendahl, M, Verma, S, Jensen, T, Liisberg, K, Lindegaard, M, Abhayaratna, W, Ahmed, F, Ben-Gal, T, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Melenovsky, V, Merkely, B, Nunez, J, Perna, E, Schou, M, Senni, M, Sharma, K, van der Meer, P, Von Lewinski, D, Wolf, D, Shah, S, Kosiborod M. N., Petrie M. C., Borlaug B. A., Butler J., Davies M. J., Hovingh G. K., Kitzman D. W., Moller D. V., Treppendahl M. B., Verma S., Jensen T. J., Liisberg K., Lindegaard M. L., Abhayaratna W., Ahmed F. Z., Ben-Gal T., Chopra V., Ezekowitz J. A., Fu M., Ito H., Lelonek M., Melenovsky V., Merkely B., Nunez J., Perna E., Schou M., Senni M., Sharma K., van der Meer P., Von Lewinski D., Wolf D., Shah S. J., Kosiborod, M, Petrie, M, Borlaug, B, Butler, J, Davies, M, Hovingh, G, Kitzman, D, Moller, D, Treppendahl, M, Verma, S, Jensen, T, Liisberg, K, Lindegaard, M, Abhayaratna, W, Ahmed, F, Ben-Gal, T, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Melenovsky, V, Merkely, B, Nunez, J, Perna, E, Schou, M, Senni, M, Sharma, K, van der Meer, P, Von Lewinski, D, Wolf, D, Shah, S, Kosiborod M. N., Petrie M. C., Borlaug B. A., Butler J., Davies M. J., Hovingh G. K., Kitzman D. W., Moller D. V., Treppendahl M. B., Verma S., Jensen T. J., Liisberg K., Lindegaard M. L., Abhayaratna W., Ahmed F. Z., Ben-Gal T., Chopra V., Ezekowitz J. A., Fu M., Ito H., Lelonek M., Melenovsky V., Merkely B., Nunez J., Perna E., Schou M., Senni M., Sharma K., van der Meer P., Von Lewinski D., Wolf D., and Shah S. J.

Abstract

BACKGROUND Obesity and type 2 diabetes are prevalent in patients with heart failure with preserved ejection fraction and are characterized by a high symptom burden. No approved therapies specifically target obesity-related heart failure with preserved ejection fraction in persons with type 2 diabetes. METHODS We randomly assigned patients who had heart failure with preserved ejection fraction, a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or more, and type 2 diabetes to receive once-weekly semaglutide (2.4 mg) or placebo for 52 weeks. The primary end points were the change from baseline in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; scores range from 0 to 100, with higher scores indicating fewer symptoms and physical limitations) and the change in body weight. Confirmatory secondary end points included the change in 6-minute walk distance; a hierarchical composite end point that included death, heart failure events, and differences in the change in the KCCQ-CSS and 6-minute walk distance; and the change in the C-reactive protein (CRP) level. RESULTS A total of 616 participants underwent randomization. The mean change in the KCCQ-CSS was 13.7 points with semaglutide and 6.4 points with placebo (estimated difference, 7.3 points; 95% confidence interval [CI], 4.1 to 10.4; P<0.001), and the mean percentage change in body weight was −9.8% with semaglutide and −3.4% with placebo (estimated difference, −6.4 percentage points; 95% CI, −7.6 to −5.2; P<0.001). The results for the confirmatory secondary end points favored semaglutide over placebo (estimated between-group difference in change in 6-min-ute walk distance, 14.3 m [95% CI, 3.7 to 24.9; P=0.008]; win ratio for hierarchical composite end point, 1.58 [95% CI, 1.29 to 1.94; P<0.001]; and estimated treatment ratio for change in CRP level, 0.67 [95% CI, 0.55 to 0.80; P<0.001]). Serious adverse events were reported in 55 parti

Published
2024

2. Patiromer Facilitates Angiotensin Inhibitor and Mineralocorticoid Antagonist Therapies in Patients With Heart Failure and Hyperkalemia

Author

Pitt, B, Anker, S, Lund, L, Coats, A, Filippatos, G, Rossignol, P, Weir, M, Friede, T, Kosiborod, M, Metra, M, Bohm, M, Ezekowitz, J, Bayes-Genis, A, Mentz, R, Ponikowski, P, Senni, M, Pina, I, Pinto, F, van der Meer, P, Bahit, C, Belohlavek, J, Brugts, J, Perrin, A, Waechter, S, Budden, J, Butler, J, Pitt B., Anker S. D., Lund L. H., Coats A. J. S., Filippatos G., Rossignol P., Weir M. R., Friede T., Kosiborod M. N., Metra M., Bohm M., Ezekowitz J. A., Bayes-Genis A., Mentz R. J., Ponikowski P., Senni M., Pina I. L., Pinto F. J., van der Meer P., Bahit C., Belohlavek J., Brugts J. J., Perrin A., Waechter S., Budden J., Butler J., Pitt, B, Anker, S, Lund, L, Coats, A, Filippatos, G, Rossignol, P, Weir, M, Friede, T, Kosiborod, M, Metra, M, Bohm, M, Ezekowitz, J, Bayes-Genis, A, Mentz, R, Ponikowski, P, Senni, M, Pina, I, Pinto, F, van der Meer, P, Bahit, C, Belohlavek, J, Brugts, J, Perrin, A, Waechter, S, Budden, J, Butler, J, Pitt B., Anker S. D., Lund L. H., Coats A. J. S., Filippatos G., Rossignol P., Weir M. R., Friede T., Kosiborod M. N., Metra M., Bohm M., Ezekowitz J. A., Bayes-Genis A., Mentz R. J., Ponikowski P., Senni M., Pina I. L., Pinto F. J., van der Meer P., Bahit C., Belohlavek J., Brugts J. J., Perrin A., Waechter S., Budden J., and Butler J.

Abstract

Background: Hyperkalemia (HK) is associated with suboptimal renin–angiotensin system (RAS) inhibitor and mineralocorticoid receptor antagonist (MRA) use in heart failure with reduced ejection fraction (HFrEF). Objectives: This study sought to assess characteristics and RAS inhibitor/MRA use in patients receiving patiromer during the DIAMOND (Patiromer for the Management of Hyperkalemia in Subjects Receiving RAASi Medications for the Treatment of Heart Failure) run-in phase. Methods: Patients with HFrEF and HK or past HK entered a run-in phase of ≤12 weeks with patiromer-facilitated RAS inhibitor/MRA optimization to achieve ≥50% recommended RAS inhibitor dose, 50 mg/d MRA, and normokalemia. Patients achieving these criteria (randomized group) were compared with the run-in failure group (patients not meeting the randomization criteria). Results: Of 1,038 patients completing the run-in, 878 (84.6%) were randomized and 160 (15.4%) were run-in failures. Overall, 422 (40.7%) had HK entering run-in with a similar frequency in the randomized and run-in failure groups (40.3% vs 42.5%; P = 0.605). From start to the end of run-in, in the randomized group, an increase was observed in target RAS inhibitor and MRA use in patients with HK (RAS inhibitor: 76.8% to 98.6%; MRA: 35.9% to 98.6%) and past HK (RAS inhibitor: 60.5% to 98.1%; MRA: 15.6% to 98.7%). Despite not meeting the randomization criteria, an increase after run-in was observed in the run-in failure group in target RAS inhibitor (52.5% to 70.6%) and MRA use (15.0% to 48.1%). This increase was observed in patients with HK (RAS inhibitor: 51.5% to 64.7%; MRA: 19.1% to 39.7%) and past HK (RAS inhibitor: 53.3% to 75.0%; MRA: 12.0% to 54.3%). Conclusions: In patients with HFrEF and HK or past HK receiving suboptimal RAS inhibitor/MRA therapy, RAS inhibitor/MRA optimization increased during patiromer-facilitated run-in.

Published
2024

3. Vericiguat Global Study in Participants with Chronic Heart Failure: Design of the VICTOR trial

Author

Reddy, Y, Butler, J, Anstrom, K, Blaustein, R, Bonaca, M, Corda, S, Ezekowitz, J, Lam, C, Lewis, E, Lindenfeld, J, Mcmullan, C, Mentz, R, O'Connor, C, Patel, M, Ponikowski, P, Rosano, G, Saldarriaga, C, Senni, M, Udelson, J, Voors, A, Zannad, F, Reddy Y. N. V., Butler J., Anstrom K. J., Blaustein R. O., Bonaca M. P., Corda S., Ezekowitz J. A., Lam C. S. P., Lewis E. F., Lindenfeld J., McMullan C. J., Mentz R. J., O'Connor C., Patel M., Ponikowski P., Rosano G. M. C., Saldarriaga C. I., Senni M., Udelson J., Voors A. A., Zannad F., Reddy, Y, Butler, J, Anstrom, K, Blaustein, R, Bonaca, M, Corda, S, Ezekowitz, J, Lam, C, Lewis, E, Lindenfeld, J, Mcmullan, C, Mentz, R, O'Connor, C, Patel, M, Ponikowski, P, Rosano, G, Saldarriaga, C, Senni, M, Udelson, J, Voors, A, Zannad, F, Reddy Y. N. V., Butler J., Anstrom K. J., Blaustein R. O., Bonaca M. P., Corda S., Ezekowitz J. A., Lam C. S. P., Lewis E. F., Lindenfeld J., McMullan C. J., Mentz R. J., O'Connor C., Patel M., Ponikowski P., Rosano G. M. C., Saldarriaga C. I., Senni M., Udelson J., Voors A. A., and Zannad F.

Abstract

Aims: In the VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction) trial, the soluble guanylate cyclase stimulator vericiguat reduced the risk of hospitalization for heart failure (HHF) or cardiovascular death in patients with heart failure (HF) and reduced ejection fraction (HFrEF) with recent worsening HF. The effect of vericiguat in patients with HFrEF without recent worsening HF remains unknown. The VICTOR (Vericiguat Global Study in Participants with Chronic Heart Failure) trial was designed to assess the efficacy and safety of vericiguat in patients with ejection fraction ≤40% without recent worsening HF on a background of current foundational HFrEF therapy. Methods: The primary endpoint for VICTOR is time to first event for the composite of HHF or cardiovascular death. The trial will also assess the effect of vericiguat on time to cardiovascular death, time to HHF, total HHF, and all-cause death. As an event-driven trial, at least 1080 primary events are expected, but follow-up will continue until the targeted number of at least 590 cardiovascular deaths has been reached. Approximately 6000 participants will be randomized to vericiguat or placebo. Conclusion: VICTOR is the first large event-driven HFrEF trial performed in the contemporary era of quadruple foundational guideline-directed medical therapy, in a compensated ambulatory HF population. VICTOR will add important information to the evidence of the effects of vericiguat across the spectrum of patients with HFrEF.

Published
2024

4. Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials

Author

Butler, J, Shah, S, Petrie, M, Borlaug, B, Abildstrom, S, Davies, M, Hovingh, G, Kitzman, D, Moller, D, Verma, S, Einfeldt, M, Lindegaard, M, Rasmussen, S, Abhayaratna, W, Ahmed, F, Ben-Gal, T, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Melenovsky, V, Merkely, B, Nunez, J, Perna, E, Schou, M, Senni, M, Sharma, K, van der Meer, P, Von Lewinski, D, Wolf, D, Kosiborod, M, Butler J., Shah S. J., Petrie M. C., Borlaug B. A., Abildstrom S. Z., Davies M. J., Hovingh G. K., Kitzman D. W., Moller D. V., Verma S., Einfeldt M. N., Lindegaard M. L., Rasmussen S., Abhayaratna W., Ahmed F. Z., Ben-Gal T., Chopra V., Ezekowitz J. A., Fu M., Ito H., Lelonek M., Melenovsky V., Merkely B., Nunez J., Perna E., Schou M., Senni M., Sharma K., van der Meer P., Von Lewinski D., Wolf D., Kosiborod M. N., Butler, J, Shah, S, Petrie, M, Borlaug, B, Abildstrom, S, Davies, M, Hovingh, G, Kitzman, D, Moller, D, Verma, S, Einfeldt, M, Lindegaard, M, Rasmussen, S, Abhayaratna, W, Ahmed, F, Ben-Gal, T, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Melenovsky, V, Merkely, B, Nunez, J, Perna, E, Schou, M, Senni, M, Sharma, K, van der Meer, P, Von Lewinski, D, Wolf, D, Kosiborod, M, Butler J., Shah S. J., Petrie M. C., Borlaug B. A., Abildstrom S. Z., Davies M. J., Hovingh G. K., Kitzman D. W., Moller D. V., Verma S., Einfeldt M. N., Lindegaard M. L., Rasmussen S., Abhayaratna W., Ahmed F. Z., Ben-Gal T., Chopra V., Ezekowitz J. A., Fu M., Ito H., Lelonek M., Melenovsky V., Merkely B., Nunez J., Perna E., Schou M., Senni M., Sharma K., van der Meer P., Von Lewinski D., Wolf D., and Kosiborod M. N.

Abstract

Background: In the STEP-HFpEF (NCT04788511) and STEP-HFpEF DM (NCT04916470) trials, the GLP-1 receptor agonist semaglutide improved symptoms, physical limitations, bodyweight, and exercise function in people with obesity-related heart failure with preserved ejection fraction. In this prespecified pooled analysis of the STEP-HFpEF and STEP-HFpEF DM trials, we aimed to provide a more definitive assessment of the effects of semaglutide across a range of outcomes and to test whether these effects were consistent across key patient subgroups. Methods: We conducted a prespecified pooled analysis of individual patient data from STEP-HFpEF and STEP-HFpEF DM, randomised, double-blind, placebo-controlled trials at 129 clinical research sites in 18 countries. In both trials, eligible participants were aged 18 years or older, had heart failure with a left ventricular ejection fraction of at least 45%, a BMI of at least 30 kg/m2, New York Heart Association class II–IV symptoms, and a Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS; a measure of heart failure-related symptoms and physical limitations) of less than 90 points. In STEP-HFpEF, people with diabetes or glycated haemoglobin A1c concentrations of at least 6·5% were excluded, whereas for inclusion in STEP-HFpEF DM participants had to have been diagnosed with type 2 diabetes at least 90 days before screening and to have an HbA1c of 10% or lower. In both trials, participants were randomly assigned to either 2·4 mg semaglutide once weekly or matched placebo for 52 weeks. The dual primary endpoints were change from baseline to week 52 in KCCQ-CSS and bodyweight in all randomly assigned participants. Confirmatory secondary endpoints included change from baseline to week 52 in 6-min walk distance, a hierarchical composite endpoint (all-cause death, heart failure events, and differences in changes in KCCQ-CSS and 6-min walk distance); and C-reactive protein (CRP) concentrations. Heterogeneity in treatme

Published
2024

5. Patiromer-Facilitated Renin-Angiotensin-Aldosterone System Inhibitor Utilization in Patients with Heart Failure with or without Comorbid Chronic Kidney Disease: Subgroup Analysis of DIAMOND Randomized Trial

Author

Weir, M, Rossignol, P, Pitt, B, Lund, L, Coats, A, Filippatos, G, Perrin, A, Waechter, S, Budden, J, Kosiborod, M, Metra, M, Boehm, M, Ezekowitz, J, Bayes-Genis, A, Mentz, R, Ponikowski, P, Senni, M, Castro-Montes, E, Nicolau, J, Parkhomenko, A, Seferovic, P, Cohen-Solal, A, Anker, S, Butler, J, Weir M. R., Rossignol P., Pitt B., Lund L. H., Coats A. J. S., Filippatos G., Perrin A., Waechter S., Budden J., Kosiborod M., Metra M., Boehm M., Ezekowitz J. A., Bayes-Genis A., Mentz R. J., Ponikowski P., Senni M., Castro-Montes E., Nicolau J. C., Parkhomenko A., Seferovic P., Cohen-Solal A., Anker S. D., Butler J., Weir, M, Rossignol, P, Pitt, B, Lund, L, Coats, A, Filippatos, G, Perrin, A, Waechter, S, Budden, J, Kosiborod, M, Metra, M, Boehm, M, Ezekowitz, J, Bayes-Genis, A, Mentz, R, Ponikowski, P, Senni, M, Castro-Montes, E, Nicolau, J, Parkhomenko, A, Seferovic, P, Cohen-Solal, A, Anker, S, Butler, J, Weir M. R., Rossignol P., Pitt B., Lund L. H., Coats A. J. S., Filippatos G., Perrin A., Waechter S., Budden J., Kosiborod M., Metra M., Boehm M., Ezekowitz J. A., Bayes-Genis A., Mentz R. J., Ponikowski P., Senni M., Castro-Montes E., Nicolau J. C., Parkhomenko A., Seferovic P., Cohen-Solal A., Anker S. D., and Butler J.

Abstract

Introduction: Renin-angiotensin-aldosterone system inhibitor (RAASi; including mineralocorticoid receptor antagonists [MRAs]) benefits are greatest in patients with heart failure with reduced ejection fraction (HFrEF) and chronic kidney disease (CKD); however, the risk of hyperkalemia (HK) is high. Methods: The DIAMOND trial (NCT03888066) assessed the ability of patiromer to control serum potassium (sK+) in patients with HFrEF with/without CKD. Prior to randomization (double-blind withdrawal, 1:1), patients on patiromer had to achieve .50% recommended doses of RAASi and 50 mg/day of MRA with normokalemia during a run-in period. The present analysis assessed the effect of baseline estimated glomerular filtration rate (eGFR) in subgroups of ≥/<60, ≥/<45 (prespecified), and ≥/<30 mL/min/1.73 m2 (added post hoc). Results: In total, 81.3, 78.9, and 81.1% of patients with eGFR <60, <45, and <30 mL/min/1.73 m2 at screening achieved RAASi/MRA targets. A greater efficacy of patiromer versus placebo to control sK+ in patients with more advanced CKD was reported (p-interaction ≤0.027 for all eGFR subgroups). Greater effects on secondary endpoints were observed with patiromer versus placebo in patients with eGFR <60 and <45 mL/min/1.73 m2. Adverse effects were similar between patiromer and placebo across subgroups. Conclusion: Patiromer enabled use of RAASi, controlled sK+, and minimized HK risk in patients with HFrEF, with greater effect sizes for most endpoints noted in patient subgroups with lower eGFR. Patiromer was well tolerated by patients in all eGFR subgroups.

Published
2024

6. Patiromer for Heart Failure Medication Optimization in Patients With Current or Past Hyperkalemia: DIAMOND Subanalysis

Author

Coats, A, Anker, S, Lund, L, Filippatos, G, Rossignol, P, Pitt, B, Weir, M, Kosiborod, M, Metra, M, Bohm, M, Ezekowitz, J, Bayes-Genis, A, Mentz, R, Ponikowski, P, Senni, M, Cleland, J, Goudev, A, Khintibidze, I, Lindenfeld, J, Merkely, B, Waechter, S, Budden, J, Perrin, A, Butler, J, Coats A. J. S., Anker S. D., Lund L. H., Filippatos G., Rossignol P., Pitt B., Weir M. R., Kosiborod M. N., Metra M., Bohm M., Ezekowitz J. A., Bayes-Genis A., Mentz R. J., Ponikowski P., Senni M., Cleland J. G. F., Goudev A., Khintibidze I., Lindenfeld J., Merkely B., Waechter S., Budden J., Perrin A., Butler J., Coats, A, Anker, S, Lund, L, Filippatos, G, Rossignol, P, Pitt, B, Weir, M, Kosiborod, M, Metra, M, Bohm, M, Ezekowitz, J, Bayes-Genis, A, Mentz, R, Ponikowski, P, Senni, M, Cleland, J, Goudev, A, Khintibidze, I, Lindenfeld, J, Merkely, B, Waechter, S, Budden, J, Perrin, A, Butler, J, Coats A. J. S., Anker S. D., Lund L. H., Filippatos G., Rossignol P., Pitt B., Weir M. R., Kosiborod M. N., Metra M., Bohm M., Ezekowitz J. A., Bayes-Genis A., Mentz R. J., Ponikowski P., Senni M., Cleland J. G. F., Goudev A., Khintibidze I., Lindenfeld J., Merkely B., Waechter S., Budden J., Perrin A., and Butler J.

Abstract

Background: For heart failure with reduced ejection fraction (HFrEF), suboptimal use of renin-angiotensin-aldosterone system inhibitors (RAASis), including mineralocorticoid receptor antagonists (MRAs), due to hyperkalemia, may be improved by potassium binders. Objectives: This prespecified analysis of the phase 3 DIAMOND (Patiromer for the Management of Hyperkalemia in Subjects Receiving RAASi Medications for the Treatment of Heart Failure) trial assessed the effect of patiromer in patients with HFrEF and either current or past hyperkalemia. Methods: Patients with HFrEF and current or past (within 1 year before enrollment) hyperkalemia (serum potassium [sK+] >5.0 mmol/L) entered a single-blind, run-in phase to optimize RAASis while receiving patiromer. They were subsequently randomized, double-blind, to continue patiromer or change to placebo. Results: Of the 1,038 patients who completed run-in, 354 (83.9%) of 422 with current hyperkalemia and 524 (85.1%) of 616 with past hyperkalemia achieved RAASi optimization and were randomized to treatment. During the double-blind phase, patiromer lowered sK+ levels compared with placebo in both the current and past hyperkalemia subgroups: difference in adjusted mean change from baseline: –0.12 (95% CI: –0.17 to –0.07) and –0.08 (95% CI: –0.12 to –0.05), respectively; Pinteraction = 0.166. Patiromer was more effective than placebo in maintaining MRA at target dose in patients with current vs past hyperkalemia (HR: 0.45 [95% CI: 0.26-0.76] vs HR: 0.85 [95% CI: 0.54-1.32]; Pinteraction = 0.031). Adverse events were similar between subgroups. Conclusions: The use of patiromer facilitates achieving target doses of RAASis in patients with HFrEF with either current or past hyperkalemia. For those with current hyperkalemia before RAASi optimization, use of patiromer may be more beneficial in helping to maintain sK+ control and achieve MRA target dose. (Patiromer for the Management of Hyperkalemia in Subjects Receiving RAASi Medica

Published
2024

7. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity

Author

Kosiborod, M, Abildstrom, S, Borlaug, B, Butler, J, Rasmussen, S, Davies, M, Hovingh, G, Kitzman, D, Lindegaard, M, Moller, D, Shah, S, Treppendahl, M, Verma, S, Abhayaratna, W, Ahmed, F, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Melenovsky, V, Merkely, B, Nunez, J, Perna, E, Schou, M, Senni, M, Sharma, K, Van Der Meer, P, Von Lewinski, D, Wolf, D, Petrie, M, Kosiborod M. N., Abildstrom S. Z., Borlaug B. A., Butler J., Rasmussen S., Davies M., Hovingh G. K., Kitzman D. W., Lindegaard M. L., Moller D. V., Shah S. J., Treppendahl M. B., Verma S., Abhayaratna W., Ahmed F. Z., Chopra V., Ezekowitz J., Fu M., Ito H., Lelonek M., Melenovsky V., Merkely B., Nunez J., Perna E., Schou M., Senni M., Sharma K., Van Der Meer P., Von Lewinski D., Wolf D., Petrie M. C., Kosiborod, M, Abildstrom, S, Borlaug, B, Butler, J, Rasmussen, S, Davies, M, Hovingh, G, Kitzman, D, Lindegaard, M, Moller, D, Shah, S, Treppendahl, M, Verma, S, Abhayaratna, W, Ahmed, F, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Melenovsky, V, Merkely, B, Nunez, J, Perna, E, Schou, M, Senni, M, Sharma, K, Van Der Meer, P, Von Lewinski, D, Wolf, D, Petrie, M, Kosiborod M. N., Abildstrom S. Z., Borlaug B. A., Butler J., Rasmussen S., Davies M., Hovingh G. K., Kitzman D. W., Lindegaard M. L., Moller D. V., Shah S. J., Treppendahl M. B., Verma S., Abhayaratna W., Ahmed F. Z., Chopra V., Ezekowitz J., Fu M., Ito H., Lelonek M., Melenovsky V., Merkely B., Nunez J., Perna E., Schou M., Senni M., Sharma K., Van Der Meer P., Von Lewinski D., Wolf D., and Petrie M. C.

Abstract

Background Heart failure with preserved ejection fraction is increasing in prevalence and is associated with a high symptom burden and functional impairment, especially in persons with obesity. No therapies have been approved to target obesity-related heart failure with preserved ejection fraction. Methods We randomly assigned 529 patients who had heart failure with preserved ejection fraction and a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or higher to receive once-weekly semaglutide (2.4 mg) or placebo for 52 weeks. The dual primary end points were the change from baseline in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; scores range from 0 to 100, with higher scores indicating fewer symptoms and physical limitations) and the change in body weight. Confirmatory secondary end points included the change in the 6-minute walk distance; a hierarchical composite end point that included death, heart failure events, and differences in the change in the KCCQ-CSS and 6-minute walk distance; and the change in the C-reactive protein (CRP) level. Results The mean change in the KCCQ-CSS was 16.6 points with semaglutide and 8.7 points with placebo (estimated difference, 7.8 points; 95% confidence interval [CI], 4.8 to 10.9; P<0.001), and the mean percentage change in body weight was -13.3% with semaglutide and -2.6% with placebo (estimated difference, -10.7 percentage points; 95% CI, -11.9 to -9.4; P<0.001). The mean change in the 6-minute walk distance was 21.5 m with semaglutide and 1.2 m with placebo (estimated difference, 20.3 m; 95% CI, 8.6 to 32.1; P<0.001). In the analysis of the hierarchical composite end point, semaglutide produced more wins than placebo (win ratio, 1.72; 95% CI, 1.37 to 2.15; P<0.001). The mean percentage change in the CRP level was -43.5% with semaglutide and -7.3% with placebo (estimated treatment ratio, 0.61; 95% CI, 0.51 to 0.72; P<0.001). Serious ad

Published
2023

8. Semaglutide in Patients With Obesity and Heart Failure Across Mildly Reduced or Preserved Ejection Fraction

Author

Butler, J, Abildstrom, S, Borlaug, B, Davies, M, Kitzman, D, Petrie, M, Shah, S, Verma, S, Abhayaratna, W, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Nunez, J, Perna, E, Schou, M, Senni, M, van der Meer, P, von Lewinski, D, Wolf, D, Altschul, R, Rasmussen, S, Kosiborod, M, Butler J., Abildstrom S. Z., Borlaug B. A., Davies M. J., Kitzman D. W., Petrie M. C., Shah S. J., Verma S., Abhayaratna W. P., Chopra V., Ezekowitz J. A., Fu M., Ito H., Lelonek M., Nunez J., Perna E., Schou M., Senni M., van der Meer P., von Lewinski D., Wolf D., Altschul R. L., Rasmussen S., Kosiborod M. N., Butler, J, Abildstrom, S, Borlaug, B, Davies, M, Kitzman, D, Petrie, M, Shah, S, Verma, S, Abhayaratna, W, Chopra, V, Ezekowitz, J, Fu, M, Ito, H, Lelonek, M, Nunez, J, Perna, E, Schou, M, Senni, M, van der Meer, P, von Lewinski, D, Wolf, D, Altschul, R, Rasmussen, S, Kosiborod, M, Butler J., Abildstrom S. Z., Borlaug B. A., Davies M. J., Kitzman D. W., Petrie M. C., Shah S. J., Verma S., Abhayaratna W. P., Chopra V., Ezekowitz J. A., Fu M., Ito H., Lelonek M., Nunez J., Perna E., Schou M., Senni M., van der Meer P., von Lewinski D., Wolf D., Altschul R. L., Rasmussen S., and Kosiborod M. N.

Abstract

Background: Many therapies for heart failure (HF) have shown differential impact across the spectrum of left ventricular ejection fraction (LVEF). Objectives: In this prespecified analysis, the authors assessed the effects of semaglutide across the baseline LVEF strata in patients with the obesity phenotype of HF with preserved ejection fraction (HFpEF) in the STEP-HFpEF (Semaglutide Treatment Effect in People with obesity and HFpEF) trial. Methods: STEP-HFpEF randomized 529 patients (263 semaglutide; 266 placebo). For this prespecified analysis, patients were categorized into 3 groups based on LVEF: 45% to 49% (n = 85), 50% to 59% (n = 215), and ≥60% (n = 229). Results: At 52 weeks, semaglutide improved the dual primary endpoints of Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (estimated treatment difference: EF [ejection fraction] 45%-49%: 5.0 points [95% CI: −2.7 to 12.8 points], EF 50%-59%: 9.8 points [95% CI: 5.0 to 14.6 points], and EF ≥60%: 7.4 points [95% CI: 2.8 to 12.0 points]; P interaction = 0.56) and body weight (EF: 45%-49%: −7.6 [95% CI: −10.7 to −4.4], EF 50%-59%: −10.6 [95% CI: −12.6 to −8.6] and EF ≥60%: −11.9 [95% CI: −13.8 to −9.9]; P interaction = 0.08), to a similar extent across LVEF categories. Likewise, LVEF did not influence the benefit of semaglutide on confirmatory secondary endpoints: 6-minute walk distance (P interaction = 0.19), hierarchal composite endpoint (P interaction = 0.43), and high-sensitivity C-reactive protein (P interaction = 0.26); or exploratory endpoint of N-terminal pro-brain natriuretic peptide (P interaction = 0.96). Semaglutide was well-tolerated across LVEF categories. Conclusions: In patients with HFpEF and obesity, semaglutide 2.4 mg improved symptoms, physical limitations, and exercise function, and reduced inflammation and body weight to a similar extent across LVEF categories. These data support treatment with semaglutide in patients with the obesity phenotype of HFpEF regardless of LVEF. (Re

Published
2023

9. Management of Worsening Heart Failure With Reduced Ejection Fraction: JACC Focus Seminar 3/3

Author

Greene, S, Bauersachs, J, Brugts, J, Ezekowitz, J, Filippatos, G, Gustafsson, F, Lam, C, Lund, L, Mentz, R, Pieske, B, Ponikowski, P, Senni, M, Skopicki, N, Voors, A, Zannad, F, Zieroth, S, Butler, J, Greene S. J., Bauersachs J., Brugts J. J., Ezekowitz J. A., Filippatos G., Gustafsson F., Lam C. S. P., Lund L. H., Mentz R. J., Pieske B., Ponikowski P., Senni M., Skopicki N., Voors A. A., Zannad F., Zieroth S., Butler J., Greene, S, Bauersachs, J, Brugts, J, Ezekowitz, J, Filippatos, G, Gustafsson, F, Lam, C, Lund, L, Mentz, R, Pieske, B, Ponikowski, P, Senni, M, Skopicki, N, Voors, A, Zannad, F, Zieroth, S, Butler, J, Greene S. J., Bauersachs J., Brugts J. J., Ezekowitz J. A., Filippatos G., Gustafsson F., Lam C. S. P., Lund L. H., Mentz R. J., Pieske B., Ponikowski P., Senni M., Skopicki N., Voors A. A., Zannad F., Zieroth S., and Butler J.

Abstract

Despite worsening heart failure (HF) being extremely common, expensive, and associated with substantial risk of death, there remain no dedicated clinical practice guidelines for the specific management of these patients. The lack of a management guideline is despite a rapidly evolving evidence-base, as a number of recent clinical trials have demonstrated multiple therapies to be safe and efficacious in this high-risk population. Herein, we propose a framework for treating worsening HF with reduced ejection fraction with the sense of urgency it deserves. This includes treating congestion; managing precipitants; and establishing a foundation of rapid-sequence, simultaneous, and/or in-hospital initiation of quadruple medical therapy for HF with reduced ejection fraction, with the top priority being at least low doses of all 4 medications. Moreover, to maximally reduce residual clinical risk, we further propose consideration of upfront simultaneous use of vericiguat (ie, quintuple medical therapy) and administration of intravenous iron for those who are iron deficient.

Published
2023

10. Association between obesity and health-related quality of life in patients with coronary artery disease

Author

Oreopoulos, A, Padwal, R, McAlister, FA, Ezekowitz, J, Sharma, AM, Kalantar-Zadeh, K, Fonarow, GC, and Norris, CM

Subjects
Heart Disease - Coronary Heart Disease, Prevention, Clinical Research, Depression, Heart Disease, Nutrition, Cardiovascular, Atherosclerosis, Obesity, Mental Health, 2.1 Biological and endogenous factors, Aetiology, Oral and gastrointestinal, Cancer, Good Health and Well Being, Alberta, Body Mass Index, Body Weight, Coronary Angiography, Coronary Artery Disease, Cross-Sectional Studies, Female, Health Status, Humans, Male, Middle Aged, Quality of Life, Risk Factors, Surveys and Questionnaires, quality of life, epidemiology, coronary artery disease, Medical and Health Sciences, Education, Endocrinology & Metabolism
Abstract

Background and objectiveIn patients with coronary artery disease (CAD), obesity is paradoxically associated with better survival (the 'obesity paradox'). Our objective was to determine whether this counterintuitive relationship extends to health-related quality of life (HRQOL) outcomes.DesignCross-sectional observational study.SubjectsAll adults undergoing coronary angiography residing in Alberta, Canada between January 2003 and March 2006 in the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry.MethodsPatients completed self-reported questionnaires 1 year after their index cardiac catheterization, including the Seattle Angina Questionnaire (SAQ) and the EuroQol 5D (EQ-5D Index). Patients were grouped into six body mass index (BMI) categories (underweight, normal, overweight, mild obesity, moderate obesity and severe obesity). An analysis of covariance was used to create risk-adjusted scores.ResultsA total of 5362 patients were included in the analysis. Obese patients were younger than normal and overweight participants, and had a higher prevalence of depression and cardiovascular risk factors. In the adjusted models, SAQ physical function scores and the EQ Index (representing overall QOL) were significantly reduced in patients with mild, moderate and severe obesity compared with patients with a normal BMI. Patients with severe obesity had both statistically and clinically significant reductions in HRQOL scores. Depressive symptoms accounted for a large proportion in variability of all HRQOL scores.ConclusionsBMI is inversely associated with physical function and overall HRQOL in CAD patients, especially in patients with severe obesity. High body weight is a modifiable risk factor; however, given the apparent obesity paradox in patients with CAD, it is critical that future studies be conducted to fully clarify the relationships between HRQOL and body composition (body fat and lean mass), nutritional state and survival outcomes.

Published
2010

11. Diuretic use and outcomes in patients with HFrEF: Insights from the VICTORIA trial

Author

Ezekowitz, J A, primary, Alemayehu, W, additional, Edelmann, F, additional, Ponikowski, P, additional, Lam, C S P, additional, O'connor, C M, additional, Butler, J, additional, Homering, M, additional, Corda, S, additional, Mcmullan, C J, additional, Westerhout, C M, additional, Voors, A A, additional, Mentz, R J, additional, and Armstrong, P, additional

Published
2023
Full Text
View/download PDF

12. Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support-Free Days in Patients Hospitalized With COVID-19: A Randomized Clinical Trial.

Author

Lawler, P.R., Derde, L.P.G., Veerdonk, F.L. van de, McVerry, B.J., Huang, D.T., Berry, L.R., Lorenzi, E., Kimmenade, R.R.J. van, Gommans, F., Vaduganathan, M., Leaf, D.E., Baron, R.M., Kim, E.Y., Frankfurter, C., Epelman, S., Kwan, Y., Grieve, R., O'Neill, S., Sadique, Z., Puskarich, M., Marshall, J.C., Higgins, A.M., Mouncey, P.R., Rowan, K.M., Al-Beidh, F., Annane, D., Arabi, Y.M., Au, C., Beane, A., Bentum-Puijk, W. van, Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Burrell, A., Buzgau, A., Buxton, M., Cecconi, M., Cheng, A.C., Cove, M., Detry, M.A., Estcourt, L.J., Ezekowitz, J., Fitzgerald, M., Gattas, D., Godoy, L.C., Goossens, H., Haniffa, R., Harrison, D.A., Hills, T., Horvat, C.M., Ichihara, N., Lamontagne, F., Linstrum, K.M., McAuley, D.F., McGlothlin, A., McGuinness, S.P., McQuilten, Z., Murthy, S., Nichol, A.D., Owen, D.R.J., Parke, R.L., Parker, J.C., Pollock, K.M., Reyes, L.F., Saito, H., Santos, M.S., Saunders, C.T., Seymour, C.W., Shankar-Hari, M., Singh, V., Turgeon, A.F., Turner, A.M., Zarychanski, R., Green, C., Lewis, R.J., Angus, D.C., Berry, S., Gordon, A.C., McArthur, C.J., Webb, S.A., Lawler, P.R., Derde, L.P.G., Veerdonk, F.L. van de, McVerry, B.J., Huang, D.T., Berry, L.R., Lorenzi, E., Kimmenade, R.R.J. van, Gommans, F., Vaduganathan, M., Leaf, D.E., Baron, R.M., Kim, E.Y., Frankfurter, C., Epelman, S., Kwan, Y., Grieve, R., O'Neill, S., Sadique, Z., Puskarich, M., Marshall, J.C., Higgins, A.M., Mouncey, P.R., Rowan, K.M., Al-Beidh, F., Annane, D., Arabi, Y.M., Au, C., Beane, A., Bentum-Puijk, W. van, Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Burrell, A., Buzgau, A., Buxton, M., Cecconi, M., Cheng, A.C., Cove, M., Detry, M.A., Estcourt, L.J., Ezekowitz, J., Fitzgerald, M., Gattas, D., Godoy, L.C., Goossens, H., Haniffa, R., Harrison, D.A., Hills, T., Horvat, C.M., Ichihara, N., Lamontagne, F., Linstrum, K.M., McAuley, D.F., McGlothlin, A., McGuinness, S.P., McQuilten, Z., Murthy, S., Nichol, A.D., Owen, D.R.J., Parke, R.L., Parker, J.C., Pollock, K.M., Reyes, L.F., Saito, H., Santos, M.S., Saunders, C.T., Seymour, C.W., Shankar-Hari, M., Singh, V., Turgeon, A.F., Turner, A.M., Zarychanski, R., Green, C., Lewis, R.J., Angus, D.C., Berry, S., Gordon, A.C., McArthur, C.J., and Webb, S.A.

Abstract

Item does not contain fulltext, IMPORTANCE: Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. OBJECTIVE: To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS: In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non-critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS: Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES: The primary outcome was organ support-free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS: On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support-free days among critically ill patients was 10 (-1 to 16) in the ACE inhibitor group (n = 231), 8 (-1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support-free days compared with control were 94.9% and 95.4%, respectively. Hospital surv

Published
2023

13. Ethnic-Specific Normative Reference Values for Echocardiographic LA and LV Size, LV Mass, and Systolic Function: The EchoNoRMAL Study

Author

Poppe, K.K., Doughty, R.N., Gardin, J.M., Hobbs, F.D.R., McMurray, J.J.V., Nagueh, S.F., Senior, R., Thomas, L., Whalley, G.A., Aune, E., Brown, A., Badano, L.P., Cameron, V., Chadha, D.S., Chahal, N., Chien, K.L., Daimon, M., Dalen, H., Detrano, R., Akif Duzenli, M., Ezekowitz, J., de Simone, G., Di Pasquale, P., Fukuda, S., Gill, P.S., Grossman, E., Kim, H.-K., Kuznetsova, T., Leung, N.K.W., Linhart, A., McDonagh, T.A., McGrady, M., Mill, J.G., Mogelvang, R., Muiesan, M.L., Ng, A.C.T., Ojji, D., Otterstad, J.E., Petrovic, D.J., Prendergast, B., Rietzschel, E., Schirmer, H., Schvartzman, P., Simova, I., Sliwa, K., Stewart, S., Squire, I.B., Takeuchi, M., Altman, D.G., Perera, R., Triggs, C.M., Au Yeung, H., Beans Picón, G.A., Anderson, T., Dyck, J., Ezekowitz, J.A., Chirinos, J.A., De Buyzere, M.L., Gillebert, T.C., Segers, P., Van daele, C.M., Walsh, H.A., Izzo, R., De Luca, N., Trimarco, B., Goel, K., Misra, A., Chen, P.-C., Lin, H.-J., Su, T.-C., Richards, A.M., Troughton, R., Skov Jensen, J., Paterna, S., Davies, M.K., Davis, R.C., Roalfe, A., Calvert, M., Freemantle, N., Lip, G.Y.H., Staessen, J.A., Dargie, H.J., Ford, I., Galasko, G., Lahiri, A., Carrington, M., Krum, H., Zeitz, C., Blauwet, L., Moelmen Hansen, H.E., Støylen, A., Thorstensen, A., Watanabe, H., Yoshikawa, J., Chambers, J.C., Kooner, J., Davies, J., Loke, I., Ng, L., Leung, D.Y., Arnold, L., Coffey, S., d'Arcy, J., Hammond, C., Mabbett, C., Lima, C., Loudon, M., Pinheiro, N., Reynolds, R., Muraru, D., Peluso, D., Dal Bianco, L., Petrovic, J., Fuchs, F.D., Katova, T., Kaku, K., Boyd, A., Chia, E.M., Angelo, L.C., Pereira, A.C., Krieger, J.E., Rodrigues, S.L., Paini, A., Agabiti Rosei, E., and Salvetti, M.

Published
2015
Full Text
View/download PDF

14. Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support–free days in patients hospitalized with COVID-19

Author

Writing Committee for the REMAP-CAP Investigators, Lawler, PR, Derde, LPG, Van de Veerdonk, FL, McVerry, BJ, Huang, DT, Berry, LR, Lorenzi, E, Van Kimmenade, R, Gommans, F, Vaduganathan, M, Leaf, DE, Baron, RM, Kim, EY, Frankfurter, C, Epelman, S, Kwan, Y, Grieve, R, O'Neill, S, Sadique, Z, Puskarich, M, Marshall, JC, Higgins, AM, Mouncey, PR, Rowan, KM, Al-Beidh, F, Annane, D, Arabi, YM, Au, C, Beane, A, Van Bentum-Puijk, W, Bonten, MJM, Bradbury, CA, Brunkhorst, FM, Burrell, A, Buzgau, A, Buxton, M, Cecconi, M, Cheng, AC, Cove, M, Detry, MA, Estcourt, LJ, Ezekowitz, J, Fitzgerald, M, Gattas, D, Godoy, LC, Goossens, H, Haniffa, R, Harrison, DA, Hills, T, Horvat, CM, Ichihara, N, Lamontagne, F, Linstrum, KM, McAuley, DF, McGlothlin, A, McGuinness, SP, McQuilten, Z, Murthy, S, Nichol, AD, Owen, DRJ, Parke, RL, Parker, JC, Pollock, KM, Reyes, LF, Saito, H, Santos, MS, Saunders, CT, Seymour, CW, Shankar-Hari, M, Singh, V, Turgeon, AF, Turner, AM, Zarychanski, R, Green, C, Lewis, RJ, Angus, DC, Berry, S, Gordon, AC, McArthur, CJ, and Webb, SA

Abstract

IMPORTANCE: Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. OBJECTIVE: To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS: In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non-critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS: Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES: The primary outcome was organ support-free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS: On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support-free days among critically ill patients was 10 (-1 to 16) in the ACE inhibitor group (n = 231), 8 (-1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support-free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE: In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02735707.

Published
2023

15. Geographic variation in heart failure with reduced ejection fraction: insights from the VICTORIA trial

Author

Tsutsui, H, primary, Lam, C S P, additional, Zhang, J, additional, Godoy-Palomino, A, additional, Tziakas, D, additional, Cohen-Solal, A, additional, Freitas, C, additional, Patel, M J, additional, Ezekowitz, J A, additional, Hernandez, A F, additional, Pieske, B, additional, O'Connor, C M, additional, Westerhout, C M, additional, Alemayehu, W, additional, and Armstrong, P W, additional

Published
2022
Full Text
View/download PDF

16. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis

Author

Jackson, Colette E., Castagno, Davide, Maggioni, Aldo P., Køber, Lars, Squire, Iain B., Swedberg, Karl, Andersson, Bert, Richards, A. Mark, Bayes-Genis, Antoni, Tribouilloy, Christophe, Dobson, Joanna, Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian, Pocock, Stuart J., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Cygankiewitz, I., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A., Freedland, K.E., Carney, R.M., Rich, M.W., Taffet, G.E., Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2015
Full Text
View/download PDF

17. Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial

Author

Butler, J. Anker, S.D. Lund, L.H. Coats, A.J. Filippatos, G. Siddiqi, T.J. Friede, T. Fabien, V. Kosiborod, M. Metra, M. Piña, I.L. Pinto, F. Rossignol, P. van der Meer, P. Bahit, C. Belohlavek, J. Böhm, M. Brugts, J.J. Cleland, J.G. Ezekowitz, J. Bayes-Genis, A. Gotsman, I. Goudev, A. Khintibidze, I. Lindenfeld, J. Mentz, R.J. Merkely, B. Montes, E.C. Mullens, W. Nicolau, J.C. Parkhomenko, A. Ponikowski, P. Seferovic, P.M. Senni, M. Shlyakhto, E. Cohen-Solal, A. Szecsödy, P. Jensen, K. Dorigotti, F. Weir, M.R. Pitt, B. and Butler, J. Anker, S.D. Lund, L.H. Coats, A.J. Filippatos, G. Siddiqi, T.J. Friede, T. Fabien, V. Kosiborod, M. Metra, M. Piña, I.L. Pinto, F. Rossignol, P. van der Meer, P. Bahit, C. Belohlavek, J. Böhm, M. Brugts, J.J. Cleland, J.G. Ezekowitz, J. Bayes-Genis, A. Gotsman, I. Goudev, A. Khintibidze, I. Lindenfeld, J. Mentz, R.J. Merkely, B. Montes, E.C. Mullens, W. Nicolau, J.C. Parkhomenko, A. Ponikowski, P. Seferovic, P.M. Senni, M. Shlyakhto, E. Cohen-Solal, A. Szecsödy, P. Jensen, K. Dorigotti, F. Weir, M.R. Pitt, B.

Abstract

Aims: To investigate the impact of patiromer on the serum potassium level and its ability to enable specified target doses of renin-angiotensin-aldosterone system inhibitor (RAASi) use in patients with heart failure and reduced ejection fraction (HFrEF). Methods and results: A total of 1642 patients with HFrEF and current or a history of RAASi-related hyperkalemia were screened and 1195 were enrolled in the run-in phase with patiromer and optimization of the RAASi therapy [≥50% recommended dose of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor, and 50 mg of mineralocorticoid receptor antagonist (MRA) spironolactone or eplerenone]. Specified target doses of the RAASi therapy were achieved in 878 (84.6%) patients; 439 were randomized to patiromer and 439 to placebo. All patients, physicians, and outcome assessors were blinded to treatment assignment. The primary endpoint was between-group difference in the adjusted mean change in serum potassium. Five hierarchical secondary endpoints were assessed. At the end of treatment, the median (interquartile range) duration of follow-up was 27 (13-43) weeks, the adjusted mean change in potassium was +0.03 mmol/l in the patiromer group and +0.13 mmol/l in the placebo group [difference in the adjusted mean change between patiromer and placebo: -0.10 mmol/l (95% confidence interval, CI -0.13, 0.07); P < 0.001]. Risk of hyperkalemia >5.5 mmol/l [hazard ratio (HR) 0.63; 95% CI 0.45, 0.87; P = 0.006), reduction of MRA dose (HR 0.62; 95% CI 0.45, 0.87; P = 0.006), and total adjusted hyperkalemia events/100 person-years (77.7 vs. 118.2; HR 0.66; 95% CI 0.53, 0.81; P < 0.001) were lower with patiromer. Hyperkalemia-related morbidity-adjusted events (win ratio 1.53, P < 0.001) and total RAASi use score (win ratio 1.25, P = 0.048) favored the patiromer arm. Adverse events were similar between groups. Conclusion: Concurrent use of patiromer and high-dose MRAs reduc

Published
2022

18. Heart failure in younger patients: the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

Author

Wong, Chih M., Hawkins, Nathaniel M., Petrie, Mark C., Jhund, Pardeep S., Gardner, Roy S., Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian A., Squire, Iain B., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Ahmed, Ali, Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2014
Full Text
View/download PDF

19. Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event Insights From the VICTORIA Trial

Author

Lam C, Giczewska A, Sliwa K, Edelmann F, Refsgaard J, Bocchi E, Ezekowitz J, Hernandez A, O'Connor C, Roessig L, Patel M, Pieske B, Anstrom K, Armstrong P, VICTORIA Study Grp, and MOLLAR A

Abstract

IMPORTANCE The period following heart failure hospitalization (HFH) is a vulnerable time with high rates of death or recurrent HFH. OBJECTIVE To evaluate clinical characteristics, outcomes, and treatment response to vericiguat according to prespecified index event subgroups and time from index HFH in the Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction (VICTORIA) trial. DESIGN, SETTING, AND PARTICIPANTS Analysis of an international, randomized, placebo-controlled trial. All VICTORIA patients had recent (

Published
2021

20. Clinical Outcome Predictions for the VerICiguaT Global Study in Subjects With Heart Failure With Reduced Ejection Fraction (VICTORIA) Trial: VICTORIA Outcomes Model

Author

Mentz, R, Mulder, H, Mosterd, A, Sweitzer, N, Senni, M, Butler, J, Ezekowitz, J, Lam, C, Pieske, B, Ponikowski, P, Voors, A, Anstrom, K, Armstrong, P, O'Connor, C, VICTORIA Study, G, Mentz RJ, Mulder H, Mosterd A, Sweitzer NK, Senni M, Butler J, Ezekowitz JA, Lam CSP, Pieske B, Ponikowski P, Voors AA, Anstrom KJ, Armstrong PW, O'Connor CM, VICTORIA Study Group, Mentz, R, Mulder, H, Mosterd, A, Sweitzer, N, Senni, M, Butler, J, Ezekowitz, J, Lam, C, Pieske, B, Ponikowski, P, Voors, A, Anstrom, K, Armstrong, P, O'Connor, C, VICTORIA Study, G, Mentz RJ, Mulder H, Mosterd A, Sweitzer NK, Senni M, Butler J, Ezekowitz JA, Lam CSP, Pieske B, Ponikowski P, Voors AA, Anstrom KJ, Armstrong PW, O'Connor CM, and VICTORIA Study Group

Abstract

Background: The prediction of outcomes in patients with heart failure (HF) may inform prognosis, clinical decisions regarding treatment selection, and new trial planning. The VerICiguaT Global Study in Subjects With Heart Failure With Reduced Ejection Fraction included high-risk patients with HF with reduced ejection fraction and a recent worsening HF event. The study participants had a high event rate despite the use of contemporary guideline-based therapies. To provide generalizable predictive data for a broad population with a recent worsening HF event, we focused on risk prognostication in the placebo group. Methods and Results: Data from 2524 participants randomized to placebo with chronic HF (New York Heart Association functional class II–IV) and an ejection fraction of less than 45% were studied and backward variable selection was used to create Cox proportional hazards models for clinical end points, selecting from 66 candidate predictors. Final model results were produced, accounting for missing data, and nonlinearities. Optimism-corrected c-indices were calculated using 200 bootstrap samples. Over a median follow-up of 10.4 months, the primary outcome of HF hospitalization or cardiovascular death occurred in 972 patients (38.5%). Independent predictors of increased risk for the primary end point included HF characteristics (longer HF duration and worse New York Heart Association functional class), medical history (prior myocardial infarction), and laboratory values (higher N-terminal pro-hormone B-type natriuretic peptide, bilirubin, urate; lower chloride and albumin). Optimism-corrected c-indices were 0.68 for the HF hospitalization/cardiovascular death model, 0.68 for HF hospitalization/all-cause death, 0.72 for cardiovascular death, and 0.73 for all-cause death. Conclusions: Predictive models developed in a large diverse clinical trial with comprehensive clinical and laboratory baseline data—including novel measures—performed well in high-risk patients

Published
2021

21. A meta-analysis of echocardiographic measurements of the left heart for the development of normative reference ranges in a large international cohort: the EchoNoRMAL study

Author

Doughty, R. N., Gardin, J. M., Hobbs, F. D. R., McMurray, J. J. V., Nagueh, S. F., Poppe, K. K., Senior, R., Thomas, L., Whalley, G. A., Aune, E., Brown, A., Badano, L. P., Cameron, V., Chadha, D. S., Chahal, N., Chien, K. L., Daimon, M., Dalen, H., Detrano, R., Akif Duzenli, M., Ezekowitz, J., de Simone, G., Di Pasquale, P., Fukuda, S., Gill, P. S., Grossman, E., Hobbs, F. D. R., Kim, H. –K., Kuznetsova, T., Leung, N. K. W., Linhart, A., McDonagh, T. A., McGrady, M., McMurray, J. J. V., Mill, J. G., Mogelvang, R., Muiesan, M. L., Ng, A. C. T., Ojji, D., Otterstad, J. E., Petrovic, D. J., Poppe, K. K., Prendergast, B., Rietzschel, E., Schirmer, H., Schvartzman, P., Senior, R., Simova, I., Sliwa, K., Stewart, S., Squire, I. B., Takeuchi, M., Thomas, L., Whalley, G. A., Altman, D., Perera, R., Poppe, K. K., Triggs, C. M., Au Yeung, H., Beans Picón, G. A., Poppe, K. K., and Whalley, G. A.

Published
2014
Full Text
View/download PDF

22. Conducting clinical trials in heart failure during (and after) the COVID-19 pandemic: An Expert Consensus Position Paper from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Author

Anker, S.D. Butler, J. Khan, M.S. Abraham, W.T. Bauersachs, J. Bocchi, E. Bozkurt, B. Braunwald, E. Chopra, V.K. Cleland, J.G. Ezekowitz, J. Filippatos, G. Friede, T. Hernandez, A.F. Lam, C.S.P. Lindenfeld, J. McMurray, J.J.V. Mehra, M. Metra, M. Packer, M. Pieske, B. Pocock, S.J. Ponikowski, P. Rosano, G.M.C. Teerlink, J.R. Tsutsui, H. Van Veldhuisen, D.J. Verma, S. Voors, A.A. Wittes, J. Zannad, F. Zhang, J. Seferovic, P. Coats, A.J.S.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has important implications for the safety of participants in clinical trials and the research staff caring for them and, consequently, for the trials themselves. Patients with heart failure may be at greater risk of infection with COVID-19 and the consequences might also be more serious, but they are also at risk of adverse outcomes if their clinical care is compromised. As physicians and clinical trialists, it is our responsibility to ensure safe and effective care is delivered to trial participants without affecting the integrity of the trial. The social contract with our patients demands no less. Many regulatory authorities from different world regions have issued guidance statements regarding the conduct of clinical trials during this COVID-19 crisis. However, international trials may benefit from expert guidance from a global panel of experts to supplement local advice and regulations, thereby enhancing the safety of participants and the integrity of the trial. Accordingly, the Heart Failure Association of the European Society of Cardiology on 21 and 22 March 2020 conducted web-based meetings with expert clinical trialists in Europe, North America, South America, Australia, and Asia. The main objectives of this Expert Position Paper are to highlight the challenges that this pandemic poses for the conduct of clinical trials in heart failure and to offer advice on how they might be overcome, with some practical examples. While this panel of experts are focused on heart failure clinical trials, these discussions and recommendations may apply to clinical trials in other therapeutic areas. © 2020 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020.

Published
2020

24. Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction

Author

Armstrong PW, Pieske B, Anstrom KJ, Ezekowitz J, Hernandez AF, Butler J, Lam CSP, Ponikowski P, Voors AA, Jia G, McNulty SE, Patel MJ, Roessig L, Koglin J, O'Connor CM, and VICTORIA Study Group

Subjects
animal structures
Abstract

The effect of vericiguat, a novel oral soluble guanylate cyclase stimulator, in patients with heart failure and reduced ejection fraction who had recently been hospitalized or had received intravenous diuretic therapy is unclear.

Published
2020

25. Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry

Author

Komajda, M. Schöpe, J. Wagenpfeil, S. Tavazzi, L. Böhm, M. Ponikowski, P. Anker, S.D. Filippatos, G.S. Cowie, M.R. Aleksanyan, A. Atayan, L. Avetisyan, A. Davtyan, N. Drambyan, M. Gevorgyan, K. Grigoryan, M. Hakobyan, Z. Hayrapetyan, H. Kocharyan, L. Kramarevskaya, T. Melqonyan, A. Muradyan, F. Nanyan, R. Ordyan, A. Ordyan, M. Piruzyan, A. Podosyan, G. Safaryan, K. Sargsyan, T. Sarkisyan, A. Sisakyan, H. Ter-Grigoryan, V. Ustyan, T. Alexopoulos, C. Amerena, J. Arstall, M. Ayres, B. Barron, G. Beltrame, J. Bou-Samra, J. Brown, M. Cross, D. Dwyer, N. Eccleston, N. Hare, D. Ho, B. Hopper, I. Jackson, B. Korczyk, D. Lattimore, J.D. Levendel, A. Macfadyen, R. Pandeli, V. Playford, D. Richardson, M. Senior, J.A. Shah, A. Shetty, P. Soward, A. Srivastava, P. Swale, M. Vogl, E. Wai, B. William, M. Worthington, A. Wright, S. Brunner, B. Fuhrmann, W. Horer, L. Maca, T. Nahler, A. Ortner, H. Racz, G. Scheibner, P. Sebald, C. Abdullayev, A. Abdullayev, R. Ahmadov, A. Alakbarov, E. Aliyev, F. Aliyev, F. Bakhshaliyev, A. Bakhshiyev, M. Dadashova, G. Dashdamirov, R. Faradjova, N. Guliyev, A. Guliyev, F. Guliyeva, S. Hajiyev, G. Ibrahimov, F. Imanov, G. Isayeva, A. Isayeva, M. Jabrailova, U. Jafarov, R. Jahangirov, T. Khalilov, A. Khalilov, S. Mehdiyev, S. Najafov, R. Samedova, H. Shahhuseynov, S. Yusifly, R. Yusifov, T. Zahidova, K. Zeynalov, A. Abdullatif, A. Al-Banna, R. Haiky, W. Husain, A. Jamsheer, A. Barbuk, O. Belskaya, M. Borodko, V. Kurlianskaya, A. Mackevich, S. Mankevich, N. Moroz-Vodolazhskaya, N. Ravtovich, O. Saevich, A. Troyanova, T. Chughtai, A. Johar, S. Luqman, N. Nair, T.C.-R. Deyoung, P. Ezekowitz, J. Frenette, M. Howlett, J. Huynh, T. Nguyen, V. Toma, M. Orenstein, T. Rinne, M.R.C. Virani, S. Zieroth, S. Ailiman, M. Cong, H. Ding, W. Dong, W. Dong, Y. Gao, C. Li, L. Li, Z. Liang, Y. Liu, X. Liu, S. Luo, S. Shi, H. Tian, Q. Wang, D. Wang, J. Wei, M. Wu, C. Xu, D. Yang, X. Yang, Z. Zhang, C. Zhang, Q. Zhang, Y. Zhang, R. Zheng, Y. Zhao, L. Zhou, J. Buch, P. Davidsen, F. Eiskjær, H. Bruun, N.E. Kragh-Thomsen, N.E. Franow, H. Køber, L. Korup, E. Madsen, B.K. Mikkelsen, K. Nielsen, K.A. Nørgaard, A. Refsgaard, J. Rickers, H. Kaiser, P. Sykulski, R. Zeuthen, E.L. El Fottoh, A.A. El Badry, M. El Hady, Y.A. El Kady, E. El Khatib, H. Fawzy, M. Hegazy, H. Salama, M.K. Mortada, A. Mostafa, T. Mwafy, A. Ossama, M. Samir, S. Seleem, M. Sobhy, B. Bregadze, G. Chelidze, K. Chumburidze, V. Jalabadze, K. Khabeishvili, G. Kiphiani, Z. Klimiashvili, Z. Kvitsiani, A. Mamatsashvili, M. Melia, I.M.A. Oragvelidze, T. Orjonikidze, S. Paposhvili, K. Petriashvili, S. Phaghava, Z. Shushania, M. Tsetskhladze, E. Tsinamdzgvishvili, B. Abdel-Qader, M. Al-Zoebi, A. Böhm, G. Bosch, R. Brune, S. Bunge, K. Dominick, K. Duda, S. Erdogan, A.E. Faber, G. Fach, C. Fechtrup, C. Frickel, S. Giokoglu, K. Haas, J. Hagenow, A. Haj-Yehia, A. Hansen, C. Hartung, W.M. Hauser, E.R. Hofmeister, A. Hohensee, H. Hüttemann, M. Keim, M. Krämer, A. Langwasser, K. Lodde, B.P. Lorch, G. Lüer, C. Müller, K. Placke, J. Plesch, B. Potolidis, L. Richter, F. Rieker, W.A. Schlichting, J. Stenzel, G. Theuer, J.D. Marcin, A. Warkentin, R. Wegner, M. Wilke, A. Agrafiotis, I. Aleksandridis, I. Farmakis, D. Giannakoulas, G. Karavidas, A. Lamprou, A. Ninios, V. Panagiotopoulos, K. Papadopoulos, K. Siachos, S. Dékány, M. Borbéy, A. Borsányi, T. Forster, T. Gavallér, H. Gyuricza, I. Heltai, K. Herczeg, B. HŐgye, M. Losonczi, I. Merkely, B. Metz, E. Muk, B. Nagy, K. Ökrös, M. Piry, K. Poós, G. Sárszegi, Z. Somogyi, T. Sziliczei-Németh, E. Tátrai, T. Zima, E. Zsigmond, A. Daly, C. Mahon, N. Meany, B. Abbdi, I. Awaysheh, R. Azouka, M. Hamoudeh, S. Nammas, A. Okkeh, O. Aimakova, G. Ismagulova, Z. Issabekova, A. Junusbekova, G.A. Koshumbayeva, K. Madaliyev, K. Mekebekova, D. Mukatova, A. Ospanova, G. Sadvakassova, G. Sunkarbekova, Z. Yegorova, Y. Zhangelova, S. Kim, K.H. Al-Mutairi, M. Gaber, Y. Ghali, I. Ghanem, A. Hafez, H. Haiba, M. Koushy, T. Mahmoud, A. Raafat, G. Sallam, M. Senousi, O. Soliman, M. Massih, T.A. Ali, S.A. Jaoude, S.A. Azzi, N. Badaoui, G. Bayeh, H. Beydoun, A. Chammas, E. Dib, H. Gebran, M. Ghanem, G. Haidar, H. Hamadeh, M. Hamoui, O. Hobeika, R. Jazra, C. Kabbani, S. Kadri, Z. Karanaminassian, R. Kassab, R. Kleit, M. Mansour, H. Mousallem, N. Semaan, C. Simonian, A. Sarkis, A. Succar, S. Zalloum, R. Zind, R. Anusauskiene, J. Grigaliuniene, A. Karaliute, R. Kavoliuniene, A. Kozlovaite, V. Miliuniene, D. Rinkuniene, D. Rudys, A. Stasaityte, D. Aziz, F.A.A. Rahim, A.A.A. Ahmad, R. Ahmadsah, S.H.K.A. Ang, C.C. Ang, S.H. Cham, Y.L. Chee, K.H. Chooi, K.C. Chu, C.M. Fam, T.L. Fong, A. Ismail, O. Ismail, J.R. Kamarulzaman, M.H. Kasim, S.S. Khiew, N.Z. Krishnan, C. Krishinan, S. Lau, G. Lee, L.Y. Liew, H.B. Lim, C.W. Mahendran, K. Dass, R.D.M. Mohamad, R. Arshad, M.K.M. Unit, H.M. Mustapha, Z. Ng, W.K. Ong, T.K. Oon, Y.Y. Ramli, A.W. Ramanathan, G.R.L. Ross, N.T. Said, A. Sarwar, M. Tan, E. Tan, S.K. Voon, C.Y. Yusoff, M.R. Abidin, H.A.Z. Chua, S.K. Yew, K.L. Amin, N.H.M. Kandiah, K. Chong, L.A. Mohamed, M.S. Lim, B.K. Koh, K.T. Low, D.W. Abdelkhirane, C. Allali, Y. Askour, M. Balafrej, K. Bendagha, N. Bendriss, L. Benjelloun, H. Chaib, A. Cherradi, G. Cherti, M. Chtioui, M. El Belghiti, A.R. Fihri, O.F. Habbal, R. El Hattaoui, M. Khatouri, A. Kheyi, J. Kriem, J. Soufiane, N. Soufiani, A. Zaimi, S. Adamczyk-Kot, D. Barg, Z. Bartkowiak, R. Braciszewicz, W. Czajkowska, E. Dudek-Niechciał, M. Grzelakowski, P. Jarosik, Z. Jerzykowska, O. Koprowski, P. Krysiak, W. Łajkowski, Z. Ziemlewska-Krawczyk, E. Lelonek, M. Lewicka, E. Płonka, J. Sadowski, J. StĘpieŃ-Adamczewska, V. Szponar, J. WrzesiŃski, K. Brito, D.A. Araújo, I. Figueiredo, J.P.A. Campelo, M.B. Sardinha, P.M.B. Fernando, P. de Brito Domingues Sanches Peres de Noronha, M.A. Baptista, S.B.C. Cardoso Pinto, J.P. Piçarra, B.M.C. Farto e Abreu, P. da Fonseca, M.C.F.G. Soares, A.I.C.G.O. Resende, J.D.A. Durão, D.L. Nascimento, A.I.F.V. Bernardes, E.L.M.O. Marques, F. Ramos, M.A.N. Sargento, L.J.M. dos Santos, J.P.F. Raimundo, A. da Luz Ventosa, A.M.S. Sarmento, P. Aguiar, C.M.T. Ahmed, E. Al-Suwaidi, J. Al Dabdoob, W. Badr, A. Gomaa, M. Albu, M. Antohi, I. Apavaloaei, C. Ardelean, A. Badea, G. Bicescu, G. Blaj, C. Bogdan, L. Bucatanschi, M. Buzea, A. Calarasu, V. Catinean, S. Christodorescu, R. Cocoi, D. Costache, L. Cretu, D. Crisu, D. Dima-Cozma, C. Dumitrescu, S. Enache, V. Firastrau, V. Frigy, A. Gherghina, A. Girbea, S. Gutu, A. Horovitz, M. Hortopan, G. Istratoaie, O. Jianu, C. Jinga, L. Lighezan, D. Luka, A. Magheru, S. Mercea, D. Miklos, K. Moga, R. Oprea, N. Paraschiv, D.M. Pop, D. Rusu, R. Sirbu, I. Socoteanu, E. Stanciulescu, G. Suteu, A. Tetiu, O. Traistaru, A. Tudoran, M. Turiceanu, M.C. Viinkler, L. Adonina, E. Akinina, S. Alferov, P. Arkhipov, M. Aroutunov, G. Babkin, A. Barbashina, T. Bochkareva, J. Boldueva, S. Bukhonkina, J. Chumakova, S.G. Fayans, I. Furmenko, G. Galyavich, A. Grinstein, Y. Klein, G. Kastanayan, A. Kazachkova, T. Korolev, S. Koshelskaya, O. Kosmacheva, E. Koziolova, N. Kuimov, A. Kushnarenko, N. Lebedev, P. Matushin, G. Mineeva, E. Motylev, I. Nedbaykin, A. Nevzorova, V. Rachkova, S. Rebrov, A. Reznik, I. Saiganov, S. Sayfutdinov, R. Schekotov, V. Serdechnaya, E. Shalaev, S. Shtegman, O. Sitnikova, M. Smolenskaya, O. Sulimov, V. Tarlovskaya, E. Temnikova, E. Timonin, D. Tolstov, S. Uskatch, T. Ustyuzhanin, V. Valeeva, R. Vasyuk, Y. Viktorova, I. Yakushin, S. Zadionchenko, V. Zateischikov, D. Zhirov, I. Bollová, D. Dulková, K. Fazekaš, F. Hermel, I. KŇazeje, M. NedĚĽová, I. Nociar, J. Procházka, L. Pundová, L. Slanina, M. Varga, I. Almenar, L. Beltrán, P. Cobo, M. Delgado, J. Enjuanes, C. Garrido, I. Gómez, M.A. Manito, N. Marzal, D. Murga, N. Ocampo, M. Pérez, J. Sánchez, I. Buakhamsri, A. Leemasawat, K. Kanoksilp, A. Kiatchoosakun, S. Phrommintikul, A. Porapakkham, P. Rodprasert, S. Senthong, V. Wongcharoen, W. Wongwantanee, S. Bahadir, H. Emül, A. Gokce, M. Gurcagan, A. Kaya, O.K. Keser, A. Pinar, P. Taș, M.H. Tosun, H.B. Yazlar, A.S. Yilmaz, S. Yuksel, Y. Bagriy, A. Ivchyna, N. Lyashenko, A. Matviychuk, N. Shchukina, O. Tkach, N. Tseluyko, V. Vasylieva, L. Abdallah, A. Agrawal, A. Basleeb, F. Bazargani, N. Hatou, E. Al Kaddour, A.R. Al Kasser, M. Al Mulla, A. Radaideh, G. Salustri, A. on behalf of the QUALIFY Investigators

Abstract

Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology

Published
2019

28. A meta-analysis of echocardiographic measurements of the left heart for the development of normative reference ranges in a large international cohort: the EchoNoRMAL study

Author

Anderson T., Dyck J., Ezekowitz J. A., Chirinos J. A., De Buyzere M. L., Gillebert T. C., Rietzschel E., Segers P., Van Daele C. M., Doughty R. N., Poppe K. K., Walsh H. A., Whalley G. A., Chen P. C., Chien K. L., Lin H. J., Su, T. C., Mogelvang R., Jensen J. S., Chadha D. S., Goel K., Misra A., Detrano R., Cameron V., Richards A. M., Troughton R., Di Pasquale P., Paterna S., Duzenli M. A., Hobbs F. D. R., Davies M. K., Davis R. C., Roalfe A., Calvert M., Freemantle N., Gill, P. S., Lip G. Y. H., Kuznetsova T., Staessen J. A., Dargie H. J., Ford I., McDonagh T. A., McMurray J. J. V., Grossman E., Galasko G., Lahiri A., Senior R., Blauwet L., Sliwa K., Stewart S., Brown A., Carrington M., Krum H., McGrady M., Zeitz C., Dalen H., Hansen H. E. M., Støylen A., Thorstensen A., Daimon M., Watanabe H., Yoshikawa J., Fukuda S., Kim H. K., Leung N. K. W., Linhart A., Chahal N., Chambers J. C., Kooner J., Davies J., Loke I., Ng, L., Squire I. B., Aune E., Otterstad J. E., Leung D. Y., Ng A. C. T., Ojji D., Arnold L., Coffey S., D'Arcy J., Hammond C., Mabbett C., Lima C., Loudon M., Pinheiro N., Prendergast B., Reynolds R., Badano L. P., Muraru D., Peluso D., Dal Bianco L., Petrovic D. J., Petrovic J., Schvartzman P., Fuchs F. D., Katova T., Simova I., Kaku K., Takeuchi M., Boyd A., Thomas L., Chia E. M., Schirmer H., Angelo L. C., Pereira A. C., Krieger J. E., Mill J. G., Rodrigues S. L., Muiesan M. L., Paini A., Rosei E. A., Salvetti M., Gardin J. M., Nagueh S. F., Altman D., Perera R., Triggs C. M., Au Yeung H., Beans Picon G. A., IZZO, RAFFAELE, DE LUCA, NICOLA, TRIMARCO, BRUNO, DE SIMONE, GIOVANNI, Anderson, T., Dyck, J., Ezekowitz, J. A., Chirinos, J. A., De Buyzere, M. L., Gillebert, T. C., Rietzschel, E., Segers, P., Van Daele, C. M., Doughty, R. N., Poppe, K. K., Walsh, H. A., Whalley, G. A., Izzo, Raffaele, DE LUCA, Nicola, Trimarco, Bruno, DE SIMONE, Giovanni, Chen, P. C., Chien, K. L., Lin, H. J., Su, T. C., Mogelvang, R., Jensen, J. S., Chadha, D. S., Goel, K., Misra, A., Detrano, R., Cameron, V., Richards, A. M., Troughton, R., Di Pasquale, P., Paterna, S., Duzenli, M. A., Hobbs, F. D. R., Davies, M. K., Davis, R. C., Roalfe, A., Calvert, M., Freemantle, N., Gill, P. S., Lip, G. Y. H., Kuznetsova, T., Staessen, J. A., Dargie, H. J., Ford, I., Mcdonagh, T. A., Mcmurray, J. J. V., Grossman, E., Galasko, G., Lahiri, A., Senior, R., Blauwet, L., Sliwa, K., Stewart, S., Brown, A., Carrington, M., Krum, H., Mcgrady, M., Zeitz, C., Dalen, H., Hansen, H. E. M., Støylen, A., Thorstensen, A., Daimon, M., Watanabe, H., Yoshikawa, J., Fukuda, S., Kim, H. K., Leung, N. K. W., Linhart, A., Chahal, N., Chambers, J. C., Kooner, J., Davies, J., Loke, I., Ng, L., Squire, I. B., Aune, E., Otterstad, J. E., Leung, D. Y., Ng, A. C. T., Ojji, D., Arnold, L., Coffey, S., D'Arcy, J., Hammond, C., Mabbett, C., Lima, C., Loudon, M., Pinheiro, N., Prendergast, B., Reynolds, R., Badano, L. P., Muraru, D., Peluso, D., Dal Bianco, L., Petrovic, D. J., Petrovic, J., Schvartzman, P., Fuchs, F. D., Katova, T., Simova, I., Kaku, K., Takeuchi, M., Boyd, A., Thomas, L., Chia, E. M., Schirmer, H., Angelo, L. C., Pereira, A. C., Krieger, J. E., Mill, J. G., Rodrigues, S. L., Muiesan, M. L., Paini, A., Rosei, E. A., Salvetti, M., Gardin, J. M., Nagueh, S. F., Altman, D., Perera, R., Triggs, C. M., Au Yeung, H., Beans Picon, G. A., and Badano, L

Subjects
Male, Pediatrics, International Cooperation, Left, Ethnic Group, Sex Factor, Ventricular Function, Left, Heart Ventricle, Cohort Studies, Echocardiography, Meta-analysis, Reference ranges, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Atrial Function, Left, Ethnic Groups, Female, Heart Atria, Heart Ventricles, Humans, Middle Aged, Reference Standards, Sex Factors, Young Adult, Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and Imaging, Nuclear Medicine and Imaging, 80 and over, Ethnicity, Ventricular Function, Age Factor, Young adult, education.field_of_study, General Medicine, Atrial Function, Parametric Regression Method, Cohort, Cardiology, Radiology, Human, Cohort study, medicine.medical_specialty, Population, Internal medicine, medicine, Meta-analysi, Radiology, Nuclear Medicine and imaging, education, business.industry, Reference range, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Quantile regression, Reference Standard, Normative, Cohort Studie, business
Abstract

Aim: To develop age-, sex-, and ethnic-Appropriate normative reference ranges for standard echocardiographic measurements of the left heart by combining echocardiographic measurements obtained from adult volunteers without clinical cardiovascular disease or significant cardiovascular risk factors, from multiple studies around the world.Methods and results: The Echocardiographic Normal Ranges Meta-Analysis of the Left heart (EchoNoRMAL) collaboration was established and population-based data sets of echocardiographic measurements combined to perform an individual person data meta-Analysis. Data from 43 studies were received, representing 51 222 subjects, of which 22 404 adults aged 18-80 years were without clinical cardiovascular or renal disease, hypertension or diabetes. Quantile regression or an appropriate parametric regression method will be used to derive reference values at the 5th and 95th centile of each measurement against age. Conclusion: This unique data set represents a large, multi-ethnic cohort of subjects resident in a wide range of countries. The resultant reference ranges will have wide applicability for normative data based on age, sex, and ethnicity. © The Author 2013.

Published
2013
Full Text
View/download PDF

29. Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry

Author

Komajda, M. Schöpe, J. Wagenpfeil, S. Tavazzi, L. Böhm, M. Ponikowski, P. Anker, S.D. Filippatos, G.S. Cowie, M.R. Aleksanyan, A. Atayan, L. Avetisyan, A. Davtyan, N. Drambyan, M. Gevorgyan, K. Grigoryan, M. Hakobyan, Z. Hayrapetyan, H. Kocharyan, L. Kramarevskaya, T. Melqonyan, A. Muradyan, F. Nanyan, R. Ordyan, A. Ordyan, M. Piruzyan, A. Podosyan, G. Safaryan, K. Sargsyan, T. Sarkisyan, A. Sisakyan, H. Ter-Grigoryan, V. Ustyan, T. Alexopoulos, C. Amerena, J. Arstall, M. Ayres, B. Barron, G. Beltrame, J. Bou-Samra, J. Brown, M. Cross, D. Dwyer, N. Eccleston, N. Hare, D. Ho, B. Hopper, I. Jackson, B. Korczyk, D. Lattimore, J.D. Levendel, A. Macfadyen, R. Pandeli, V. Playford, D. Richardson, M. Senior, J.A. Shah, A. Shetty, P. Soward, A. Srivastava, P. Swale, M. Vogl, E. Wai, B. William, M. Worthington, A. Wright, S. Brunner, B. Fuhrmann, W. Horer, L. Maca, T. Nahler, A. Ortner, H. Racz, G. Scheibner, P. Sebald, C. Abdullayev, A. Abdullayev, R. Ahmadov, A. Alakbarov, E. Aliyev, F. Aliyev, F. Bakhshaliyev, A. Bakhshiyev, M. Dadashova, G. Dashdamirov, R. Faradjova, N. Guliyev, A. Guliyev, F. Guliyeva, S. Hajiyev, G. Ibrahimov, F. Imanov, G. Isayeva, A. Isayeva, M. Jabrailova, U. Jafarov, R. Jahangirov, T. Khalilov, A. Khalilov, S. Mehdiyev, S. Najafov, R. Samedova, H. Shahhuseynov, S. Yusifly, R. Yusifov, T. Zahidova, K. Zeynalov, A. Abdullatif, A. Al-Banna, R. Haiky, W. Husain, A. Jamsheer, A. Barbuk, O. Belskaya, M. Borodko, V. Kurlianskaya, A. Mackevich, S. Mankevich, N. Moroz-Vodolazhskaya, N. Ravtovich, O. Saevich, A. Troyanova, T. Chughtai, A. Johar, S. Luqman, N. Nair, T.C.-R. Deyoung, P. Ezekowitz, J. Frenette, M. Howlett, J. Huynh, T. Nguyen, V. Toma, M. Orenstein, T. Rinne, M.R.C. Virani, S. Zieroth, S. Ailiman, M. Cong, H. Ding, W. Dong, W. Dong, Y. Gao, C. Li, L. Li, Z. Liang, Y. Liu, X. Liu, S. Luo, S. Shi, H. Tian, Q. Wang, D. Wang, J. Wei, M. Wu, C. Xu, D. Yang, X. Yang, Z. Zhang, C. Zhang, Q. Zhang, Y. Zhang, R. Zheng, Y. Zhao, L. Zhou, J. Buch, P. Davi and Komajda, M. Schöpe, J. Wagenpfeil, S. Tavazzi, L. Böhm, M. Ponikowski, P. Anker, S.D. Filippatos, G.S. Cowie, M.R. Aleksanyan, A. Atayan, L. Avetisyan, A. Davtyan, N. Drambyan, M. Gevorgyan, K. Grigoryan, M. Hakobyan, Z. Hayrapetyan, H. Kocharyan, L. Kramarevskaya, T. Melqonyan, A. Muradyan, F. Nanyan, R. Ordyan, A. Ordyan, M. Piruzyan, A. Podosyan, G. Safaryan, K. Sargsyan, T. Sarkisyan, A. Sisakyan, H. Ter-Grigoryan, V. Ustyan, T. Alexopoulos, C. Amerena, J. Arstall, M. Ayres, B. Barron, G. Beltrame, J. Bou-Samra, J. Brown, M. Cross, D. Dwyer, N. Eccleston, N. Hare, D. Ho, B. Hopper, I. Jackson, B. Korczyk, D. Lattimore, J.D. Levendel, A. Macfadyen, R. Pandeli, V. Playford, D. Richardson, M. Senior, J.A. Shah, A. Shetty, P. Soward, A. Srivastava, P. Swale, M. Vogl, E. Wai, B. William, M. Worthington, A. Wright, S. Brunner, B. Fuhrmann, W. Horer, L. Maca, T. Nahler, A. Ortner, H. Racz, G. Scheibner, P. Sebald, C. Abdullayev, A. Abdullayev, R. Ahmadov, A. Alakbarov, E. Aliyev, F. Aliyev, F. Bakhshaliyev, A. Bakhshiyev, M. Dadashova, G. Dashdamirov, R. Faradjova, N. Guliyev, A. Guliyev, F. Guliyeva, S. Hajiyev, G. Ibrahimov, F. Imanov, G. Isayeva, A. Isayeva, M. Jabrailova, U. Jafarov, R. Jahangirov, T. Khalilov, A. Khalilov, S. Mehdiyev, S. Najafov, R. Samedova, H. Shahhuseynov, S. Yusifly, R. Yusifov, T. Zahidova, K. Zeynalov, A. Abdullatif, A. Al-Banna, R. Haiky, W. Husain, A. Jamsheer, A. Barbuk, O. Belskaya, M. Borodko, V. Kurlianskaya, A. Mackevich, S. Mankevich, N. Moroz-Vodolazhskaya, N. Ravtovich, O. Saevich, A. Troyanova, T. Chughtai, A. Johar, S. Luqman, N. Nair, T.C.-R. Deyoung, P. Ezekowitz, J. Frenette, M. Howlett, J. Huynh, T. Nguyen, V. Toma, M. Orenstein, T. Rinne, M.R.C. Virani, S. Zieroth, S. Ailiman, M. Cong, H. Ding, W. Dong, W. Dong, Y. Gao, C. Li, L. Li, Z. Liang, Y. Liu, X. Liu, S. Luo, S. Shi, H. Tian, Q. Wang, D. Wang, J. Wei, M. Wu, C. Xu, D. Yang, X. Yang, Z. Zhang, C. Zhang, Q. Zhang, Y. Zhang, R. Zheng, Y. Zhao, L. Zhou, J. Buch, P. Davi

Abstract

Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology

Published
2019

30. 4348Cluster analysis of cardiovascular risk phenotypes in patients with type 2 diabetes and established atherosclerotic cardiovascular disease: a potential approach to precision medicine

Author

Sharma, A, primary, Zheng, Y, additional, Ezekowitz, J A, additional, Westerhout, C M, additional, Goodman, S G, additional, Armstrong, P W, additional, Buse, J B, additional, Green, J B, additional, Kaufman, K D, additional, McGuire, D K, additional, Ambrosio, G, additional, Chuang, L M, additional, Lopes, R D, additional, Peterson, E D, additional, and Holman, R R, additional

Published
2018
Full Text
View/download PDF

31. Ethnic-specific normative reference values for echocardiographic la and LV size, LV mass, and systolic function: The EchoNoRMAL study

Author

Poppe, K. K., Doughty, R. N., Gardin, J. M., Nagueh, S. F., Whalley, G. A., Cameron, V., Chadha, D. S., Chien, K. L., Detrano, R., Akif Duzenli, M., Ezekowitz, J., Di Pasquale, P., Mogelvang, R., Altman, D. G., Perera, R., Triggs, C. M., Au Yeung, H., Beans Picon, G. A., Anderson, T., Dyck, J., Ezekowitz, J. A., Chirinos, J. A., De Buyzere, M. L., Gillebert, T. C., Rietzschel, E., Segers, P., Van daele, C. M., Walsh, H. A., Izzo, R., De Luca, N., Trimarco, B., De Simone, G., Goel, K., Misra, A., Chen, P. C., Lin, H. J., T. C., Su, Richards, A. M., Troughton, R., Skov Jensen, J., Paterna, S., Hobbs, F. D. R., Davies, M. K., Davis, R. C., Roalfe, A., Calvert, M., Freemantle, N., Gill, P. S., Lip, G. Y. H., Kuznetsova, T., Staessen, J. A., Dargie, H. J., Ford, I., Mcdonagh, T. A., Mcmurray, J. J. V., Grossman, E., Galasko, G., Lahiri, A., Senior, R., Brown, A., Carrington, M., Krum, H., Mcgrady, M., Stewart, S., Zeitz, C., Blauwet, L., Sliwa, K., Dalen, H., Moelmen Hansen, H. E., Stoylen, A., Thorstensen, A., Daimon, M., Watanabe, H., Yoshikawa, J., Fukuda, S., Kim, H. K., Leung, N. K. W., Linhart, A., Chahal, N., Chambers, J. C., Kooner, J., Davies, J., Loke, I., Ng, L., Squire, I. B., Aune, E., Otterstad, J. E., Leung, D. Y., A. C. T., Ng, Ojji, D., Arnold, L., Coffey, S., D'Arcy, J., Hammond, C., Mabbett, C., Lima, C., Loudon, M., Pinheiro, N., Prendergast, B., Reynolds, R., Badano, L. P., Muraru, D., Peluso, D., DAL BIANCO, Laura, Petrovic, D. J., Petrovic, J., Schvartzman, P., Fuchs, F. D., Katova, T., Simova, I., Kaku, K., Takeuchi, M., Boyd, A., Chia, E. M., Thomas, L., Schirmer, H., Angelo, L. C., Pereira, A. C., Krieger, J. E., Mill, J. G., Rodrigues, S. L., Muiesan, Maria Lorenza, Paini, Anna, AGABITI ROSEI, Enrico, and Salvetti, Massimo

Subjects
Nuclear Medicine and Imaging, echocardiography, ethnic appropriate, reference ranges, Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and Imaging, Radiology
Published
2015

35. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, and Gude F

Abstract

Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

36. The hospital frailty risk score in patients with heart failure is strongly associated with outcomes but less so with pharmacotherapy.

Author

McAlister, F. A., Savu, A., Ezekowitz, J. A., Armstrong, P. W., and Kaul, P.

Subjects
HEART failure patients, OLDER patients, HEART failure
Abstract

Background: Although frailty is known to be an important prognostic factor in heart failure (HF), HF risk-adjustment models do not incorporate frailty measures and the interplay between frailty, age and pharmacotherapy is unclear.Objectives: To explore the relationships between frailty, pharmacotherapy and outcomes in heart failure (HF).Methods: Retrospective cohort study of all adults in Alberta, Canada hospitalized for the first time for HF between 2004 and 2016. Frailty was defined using the Hospital Frailty Risk Score (HFRS).Results: In 26 626 patients (mean age 77.4 years), the 8887 (33.4%) defined as frail (HFRS ≥ 5) were older, had higher Charlson scores and more prior emergency department visits or hospitalizations. The HFRS and the Charlson Score were only weakly correlated (r = 0.35). Whilst more common in older patients (41.4% of patients 80 or older), frailty was present in 22.4% of patients younger than 65. Frail patients had longer lengths of stay and worse outcomes postdischarge, but adding the HFRS to age, sex and Charlson score did not improve prediction of events (c-statistics 0.69 for 30-day mortality after admission, and 0.54 for 30-day readmission/ED visit/or death after discharge). Frail patients younger than 65 were significantly more likely than nonfrail patients 80 or older to be prescribed high-dose evidence-based HF therapies (27.1% vs. 22.2%, P = 0.003).Conclusion: Although the HFRS reflects aspects of frailty that patient age and Charlson scores do not, the addition of the HFRS to standard risk prediction equations provides little additional information. Prescribing practices correlate more with patient age than frailty status. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

37. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, and Gude, F

Subjects
Male, medicine.medical_specialty, Prognosi, Heart failure, Lower risk, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, Meta-analysi, Aged, Randomized Controlled Trials as Topic, Ejection fraction, business.industry, Hazard ratio, Stroke Volume, Atrial fibrillation, medicine.disease, Confidence interval, Meta-analysis, Cardiology, Etiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Aims A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). Methods and results We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

38. Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: Results from the MAGGIC individual patient data meta-analysis

Author

Berry, C, Poppe, K, Gamble, G, Earle, N, Ezekowitz, J, Squire, I, Mcmurray, J, Mcalister, F, Komajda, M, Swedberg, K, Maggioni, A, Ahmed, A, Whalley, G, Doughty, R, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Muñoa, M, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Kober, L, Perna, E, Cimbaro Canella, J, Alvarenga, P, Pantich, R, Ríos, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Poppe KK, Gamble GD, Earle NJ, Ezekowitz JA, Squire IB, McMurray JJV, McAlister FA, Komajda M, Swedberg K, Maggioni AP, Ahmed A, Whalley GA, Doughty RN, Tarantini L, Granger C, Køber L, Massie B, Pocock S, Somaratne J, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Di Lenarda A, Lenzen M, Lucci D, Macín S, Madsen B, Martínez-Sellés M, Oliva F, Rich M, Richards M, Senni M, Taffet G, Tribouilloy C, Troughton R, Tsutsui H, Ariti C, Dobson J, Hall C, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Held P, Michelson EL, Olofsson B, Östergren J, Yusuf S, Torp-Pedersen C, Scholte op Reimer W, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazón-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Myers J, Arena R, Armstrong PW, Cujec B, Paterson I, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Muñoa MD, Frades E, Díaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Kober L, Perna ER, Cimbaro Canella JP, Alvarenga P, Pantich R, Ríos N, Farias EF, Badaracco JR, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardají A, Pascual-Figal D, Ordoñez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, Cygankiewitz I, Bayes De Luna A, Newton JD, Blackledge HM, Wright SP, Kerzner R, Gage BF, Freedland KE, Huynh BC, Rovner A, Carney RM, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Soulière V, Lévy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Poppe, K, Gamble, G, Earle, N, Ezekowitz, J, Squire, I, Mcmurray, J, Mcalister, F, Komajda, M, Swedberg, K, Maggioni, A, Ahmed, A, Whalley, G, Doughty, R, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Muñoa, M, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Kober, L, Perna, E, Cimbaro Canella, J, Alvarenga, P, Pantich, R, Ríos, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Poppe KK, Gamble GD, Earle NJ, Ezekowitz JA, Squire IB, McMurray JJV, McAlister FA, Komajda M, Swedberg K, Maggioni AP, Ahmed A, Whalley GA, Doughty RN, Tarantini L, Granger C, Køber L, Massie B, Pocock S, Somaratne J, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Di Lenarda A, Lenzen M, Lucci D, Macín S, Madsen B, Martínez-Sellés M, Oliva F, Rich M, Richards M, Senni M, Taffet G, Tribouilloy C, Troughton R, Tsutsui H, Ariti C, Dobson J, Hall C, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Held P, Michelson EL, Olofsson B, Östergren J, Yusuf S, Torp-Pedersen C, Scholte op Reimer W, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazón-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Myers J, Arena R, Armstrong PW, Cujec B, Paterson I, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Muñoa MD, Frades E, Díaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Kober L, Perna ER, Cimbaro Canella JP, Alvarenga P, Pantich R, Ríos N, Farias EF, Badaracco JR, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardají A, Pascual-Figal D, Ordoñez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, Cygankiewitz I, Bayes De Luna A, Newton JD, Blackledge HM, Wright SP, Kerzner R, Gage BF, Freedland KE, Huynh BC, Rovner A, Carney RM, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Soulière V, Lévy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, and Gude F

Abstract

Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50%; HF-REF was EF < 50%. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.

Published
2016

39. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Granger, C, Massie, B, Somaratne, J, Ahmed, A, Cowie, M, Gonzalez-Juanatey, J, Gorini, M, Kearney, M, di Lenarda, A, Lenzen, M, Macin, S, Madsen, B, Maggioni, A, McAlister, F, Oliva, F, Rich, M, Richards, M, Squire, I, Taffet, G, Earle, N, Perera, K, Dobson, J, Pocock, S, Poppe, K, Whalley, G, Andersson, B, Hall, C, Richards, AM, Troughton, R, Lainchbury, J, Berry, C, Hogg, K, Norrie, J, Stevenson, K, Brett, M, McMurray, J, Pfeffer, MA, Granger, CB, Held, P, McMurray, JJV, Michelson, EL, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Lenzen, MJ, Reimer, WJMS, Boersma, E, Vantrimpont, PJMJ, Follath, F, Swedberg, K, Cleland, J, Komajda, M, Gotsman, I, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Grigorian-Shamagian, L, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, MA, Guazzi, M, Myers, J, Arena, R, McAlister, FA, Ezekowitz, J, Armstrong, PW, Cujec, B, Paterson, I, Cowie, MR, Wood, DA, Coats, AJS, Thompson, SG, Suresh, V, Poole-Wilson, PA, Sutton, GC, Martinez-Selles, M, Robles, JAG, Prieto, L, Munoa, MD, Frades, E, Diaz-Castro, O, Tarantini, L, Faggiano, P, Senni, M, Lucci, D, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Maggioni, AP, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, TM, Boesgaard, S, Hassager, C, Nielsen, OW, Aldershvile, J, Nielsen, H, Kober, L, Macin, SM, Perna, ER, Canella, JPC, Alvarenga, P, Pantich, R, Rios, N, Farias, EF, Badaracco, JR, Madsen, BK, Hansen, JF, Stokholm, KH, Brons, J, Husum, D, Mortensen, LS, Bayes-Genis, A, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Almendral, J, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, AB, Newton, JD, Blackledge, HM, Squire, IB, Wright, SP, Whalley, GA, Doughty, RN, Kerzner, R, Gage, BF, Huynh, BC, Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, TA, Bleyer, AJ, Kutka, NJ, Luchi, RJ, Tribouilloy, C, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsutsui, H, Tsuchihashi, M, Takeshita, A, MacCarthy, PA, Kearney, MT, Cubbon, R, Nolan, J, Lee, AJ, Prescott, RJ, Shah, AM, Brooksby, WP, Fox, KAA, Varela-Roman, A, Gonzalez-Juanatey, JR, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, JL, and Gude, F

Subjects
Meta-analysis, Heart failure, Prognosis
Abstract

A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF epsilon 50. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28), and have a history of hypertension (51 vs. 41). Ischaemic aetiology was less common (43 vs. 59) in patients with HF-PEF. There were 121 [95 confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95 CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95 CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40. Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

40. Abstract PD5-03: Prophylactic beta blockade preserves left ventricular ejection fraction in HER2-overexpresssing breast cancer patients receiving trastuzumab: Primary results of the MANTICORE randomized controlled trial

Author

Pituskin, E, primary, Mackey, JR, additional, Koshman, S, additional, Jassal, D, additional, Pitz, M, additional, Haykowsky, MJ, additional, Thompson, R, additional, Oudit, G, additional, Ezekowitz, J, additional, and Paterson, I, additional

Published
2016
Full Text
View/download PDF

41. Abstract S1-05: Prophylactic beta blockade preserves left ventricular ejection fraction in HER2-overexpresssing breast cancer patients receiving trastuzumab: Primary results of the MANTICORE randomized controlled trial

Author

Pituskin, E, primary, Mackey, JR, additional, Koshman, S, additional, Jassal, D, additional, Pitz, M, additional, Haykowsky, MJ, additional, Thompson, R, additional, Oudit, G, additional, Ezekowitz, J, additional, and Paterson, I, additional

Published
2016
Full Text
View/download PDF

42. Stroke and bleeding outcomes with apixaban versus warfarin in patients with high creatinine, low body weight or high age receiving standard dose apixaban for stroke prevention in atrial fibrillation

Author

Alexander, J., Andersson, Ulrika, Lopes, R. D., Hijazi, Ziad, Hohnloser, S. H., Ezekowitz, J., Halvorsen, S., Hanna, M., Granger, C. B., Wallentin, Lars, Alexander, J., Andersson, Ulrika, Lopes, R. D., Hijazi, Ziad, Hohnloser, S. H., Ezekowitz, J., Halvorsen, S., Hanna, M., Granger, C. B., and Wallentin, Lars

Abstract

Meeting Abstract: 2032

Published
2015

43. Risk of stroke, systemic embolism or death according to heart failure and left ventricular function status in patients with atrial fibrillation : results of the ARISTOTLE trial

Author

McMurray, J. J. V., Lewis, B., Ezekowitz, J., Gersh, B., Lopes, R. D., Wojdyla, D., Mohan, P., Wallentin, Lars, Alexander, J. H., Granger, C. B., McMurray, J. J. V., Lewis, B., Ezekowitz, J., Gersh, B., Lopes, R. D., Wojdyla, D., Mohan, P., Wallentin, Lars, Alexander, J. H., and Granger, C. B.

Published
2012
Full Text
View/download PDF

44. The Prevalence of Natural Health Product Use in Patients with Acute Cardiovascular Disease

Author

Alherbish, A., Charrois, Theresa, Ackman, M., Tsuyuki, R., Ezekowitz, J., Alherbish, A., Charrois, Theresa, Ackman, M., Tsuyuki, R., and Ezekowitz, J.

Abstract

Background: Natural health products (NHP) use may have implications with respect to adverse effects, drug interactions and adherence yet the prevalence of NHP use by patients with acute cardiovascular disease and the best method to ascertain this information is unknown. Objective: To identify the best method to ascertain information on NHP, and the prevalence of use in a population with acute cardiovascular disease. Methods: Structured interviews were conducted with a convenience sample of consecutive patients admitted with acute cardiovascular disease to the University of Alberta Hospital during January 2009. NHP use was explored using structured and open-ended questions based on Health Canada’s definition of NHP. The medical record was reviewed, and documentation of NHP use by physicians, nurses, and pharmacists, compared against the gold-standard structured interview.Results: 88 patients were interviewed (mean age 62 years, standard deviation [SD 14]; 80% male; 41% admitted for acute coronary syndromes). Common co-morbidities included hypertension (59%), diabetes (26%) and renal impairment (19%). NHP use was common (78% of patients) and 75% of NHP users reported daily use. The category of NHP most commonly used was vitamins and minerals (73%) followed by herbal products (20%), traditional medicines including Chinese medicines (9%), homeopathic preparations (1%) and other products including amino acids, essential fatty acids and probiotics (35%). In a multivariable model, only older age was associated with increased NHP use (OR 1.5 per age decile [95%CI 1.03 to 2.2]). When compared to the interview, the highest rate of NHP documentation was the pharmacist history (41%). NHP were documented in 22% of patients by the physician and 19% by the nurse. Conclusions: NHP use is common in patients admitted with acute cardiovascular disease. However, health professionals do not commonly identify NHP as part of the medication profile despite its potential importance. Structu

Published
2011

45. Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: results from the MAGGIC individual patient data meta-analysis.

Author

Berry, C., Poppe, K. K., Gamble, G. D., Earle, N. J., Ezekowitz, J. A., Squire, I. B., McMurray, J. J. V., McAlister, F. A., Komajda, M., Swedberg, K., Maggioni, A. P., Ahmed, A., Whalley, G. A., Doughty, R. N., and Tarantini, L.

Subjects
PROGNOSTIC tests, ANEMIA, HEART failure patients, EJECTION (Psychology), META-analysis, PATIENTS
Abstract

Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb<120 g/l in women and <130 g/l in men. HF-PEF was defined as EF≥50%; HF-REF was EF<50%. Cox proportional hazard modelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-cause mortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HF-PEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results