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2. MACHINE-LEARNING FOR THE ELECTROCARDIOGRAM-BASED PREDICTION OF SHORT-TERM AND LONG-TERM MORTALITY AT THE TIME OF DISCHARGE IN A POPULATION-LEVEL COHORT OF PATIENTS WITH ACCESS TO UNIVERSAL HEALTHCARE

Author

Sun, W., primary, Kalmady, S., additional, Sepehrvand, N., additional, Salimi, A., additional, Nademi, Y., additional, Bainey, K., additional, Ezekowitz, J., additional, Hindle, A., additional, Greiner, R., additional, McAlister, F., additional, Sandhu, R., additional, and Kaul, P., additional

Published
2023
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6. 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

7. 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

8. 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

12. 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
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14. 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
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15. 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
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16. 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

17. 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

22. 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
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23. 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

25. 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

27. Effect of Nesiritide in Patients with Acute Decompensated Heart Failure

Author

OʼConnor, C. M., Starling, R. C., Hernandez, A. F., Armstrong, P. W., Dickstein, K., Hasselblad, V., Heizer, G. M., Komajda, M., Massie, B. M., McMurray, J. J.V., Nieminen, M. S., Reist, C. J., Rouleau, J. L., Swedberg, K., Adams, K. F., Jr., Anker, S. D., Atar, D., Battler, A., Botero, R., Bohidar, N. R., Butler, J., Clausell, N., Corbalán, R., Costanzo, M. R., Dahlstrom, U., Deckelbaum, L. I., Diaz, R., Dunlap, M. E., Ezekowitz, J. A., Feldman, D., Felker, G. M., Fonarow, G. C., Gennevois, D., Gottlieb, S. S., Hill, J. A., Hollander, J. E., Howlett, J. G., Hudson, M. P., Kociol, R. D., Krum, H., Laucevicius, A., Levy, W. C., Méndez, G. F., Metra, M., Mittal, S., Oh, B.-H., Pereira, N. L., Ponikowski, P., Wilson, W. H., Tanomsup, S., Teerlink, J. R., Triposkiadis, F., Troughton, R. W., Voors, A. A., Whellan, D. J., Zannad, F., and Califf, R. M.

Published
2011

30. 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

34. 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
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36. 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

37. 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
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38. THE EFFICACY AND SAFETY OF APIXABAN VERSUS WARFARIN ARE PRESERVED IN PATIENTS WITH ATRIAL FIBRILLATION AND EXTREME BODY WEIGHT: INSIGHTS FROM THE ARISTOTLE STUDY

Author

Fudim, M., primary, Alexander, J., additional, Wojdyla, D., additional, Ezekowitz, J., additional, Hanna, M., additional, Atar, D., additional, Hijazi, Z., additional, Bahit, M., additional, Lopez-Sendon, J., additional, Wallentin, L., additional, Granger, C., additional, Hohnloser, S., additional, and Lopes, R., additional

Published
2018
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41. NON-VITAMIN K ANTAGONIST ORAL ANTICOAGULANT (NOAC) USE AND DOSING IN CANADIAN PRACTICE: INSIGHTS FROM THE OPTIMIZING PHARMACOTHERAPY IN THE MANAGEMENT APPROACH TO LOWERING RISK IN ATRIAL FIBRILLATION (OPTIMAL-AF) PROGRAM

Author

Bell, A., primary, Ezekowitz, J., additional, Tan, M., additional, Laflamme, D., additional, Goldin, L., additional, Leblanc, K., additional, Habert, J., additional, Lin, P., additional, Saunders, K., additional, Ngui, D., additional, Ng, A., additional, Desroches, J., additional, and Goodman, S., additional

Published
2018
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42. 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
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47. 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

48. 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

49. 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

50. THE RELATIONSHIP BETWEEN HEART FAILURE READMISSION AND MORTALITY IN PATIENTS RECEIVING TRANSCATHETER AORTIC VALVE IMPLANTATION

Author

Nazzari, H., primary, Hawkins, N., additional, Lauck, S., additional, Ding, L., additional, Polderman, J., additional, Yu, M., additional, Gerami, O., additional, Ezekowitz, J., additional, Boone, R., additional, Cheung, A., additional, Ye, J., additional, Wood, D., additional, Webb, J., additional, and Toma, M., additional

Published
2016
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