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What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?

Each year in the USA there are over 1 million hospital admissions directly related to heart failure (HF). With similar rates across Europe, this places a huge economic burden on healthcare systems globally. Hospitalisation for HF is associated with poor clinical outcomes with 25% of patients being r...

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Autores principales: Cannon, Jane A, McKean, Andrew R, Jhund, Pardeep S, McMurray, John J V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692046/
https://www.ncbi.nlm.nih.gov/pubmed/26719808
http://dx.doi.org/10.1136/openhrt-2015-000283
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author Cannon, Jane A
McKean, Andrew R
Jhund, Pardeep S
McMurray, John J V
author_facet Cannon, Jane A
McKean, Andrew R
Jhund, Pardeep S
McMurray, John J V
author_sort Cannon, Jane A
collection PubMed
description Each year in the USA there are over 1 million hospital admissions directly related to heart failure (HF). With similar rates across Europe, this places a huge economic burden on healthcare systems globally. Hospitalisation for HF is associated with poor clinical outcomes with 25% of patients being readmitted with signs and symptoms of HF within 1 month of discharge and 10–20% dying in the 6 months after discharge. Although hospital admission could be a sign of disease progression, it is also possible that some of the treatments given acutely for example, inotropic therapy, may result in neurohormonal, haemodynamic and other effects accelerating end-organ damage and contributing to these poor outcomes after discharge. In contrast to the treatment of chronic heart failure (CHF), clinical trials conducted over the past decade in patients with acute HF (AHF) have failed to show significant reductions in morbidity or mortality despite some agents causing beneficial changes in symptoms. As such, the current treatment of patients hospitalised with HF is mainly based on consensus rather than clinical evidence and has changed little over time. We review RELAX-AHF in the context of the other key, large-scale AHF trials conducted over the past 15 years and compare and contrast study design and outcomes in an attempt to determine which factors might be associated with a successful trial in the future.
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spelling pubmed-46920462015-12-30 What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold? Cannon, Jane A McKean, Andrew R Jhund, Pardeep S McMurray, John J V Open Heart Heart Failure and Cardiomyopathies Each year in the USA there are over 1 million hospital admissions directly related to heart failure (HF). With similar rates across Europe, this places a huge economic burden on healthcare systems globally. Hospitalisation for HF is associated with poor clinical outcomes with 25% of patients being readmitted with signs and symptoms of HF within 1 month of discharge and 10–20% dying in the 6 months after discharge. Although hospital admission could be a sign of disease progression, it is also possible that some of the treatments given acutely for example, inotropic therapy, may result in neurohormonal, haemodynamic and other effects accelerating end-organ damage and contributing to these poor outcomes after discharge. In contrast to the treatment of chronic heart failure (CHF), clinical trials conducted over the past decade in patients with acute HF (AHF) have failed to show significant reductions in morbidity or mortality despite some agents causing beneficial changes in symptoms. As such, the current treatment of patients hospitalised with HF is mainly based on consensus rather than clinical evidence and has changed little over time. We review RELAX-AHF in the context of the other key, large-scale AHF trials conducted over the past 15 years and compare and contrast study design and outcomes in an attempt to determine which factors might be associated with a successful trial in the future. BMJ Publishing Group 2015-12-23 /pmc/articles/PMC4692046/ /pubmed/26719808 http://dx.doi.org/10.1136/openhrt-2015-000283 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Heart Failure and Cardiomyopathies
Cannon, Jane A
McKean, Andrew R
Jhund, Pardeep S
McMurray, John J V
What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?
title What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?
title_full What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?
title_fullStr What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?
title_full_unstemmed What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?
title_short What can we learn from RELAX-AHF compared to previous AHF trials and what does the future hold?
title_sort what can we learn from relax-ahf compared to previous ahf trials and what does the future hold?
topic Heart Failure and Cardiomyopathies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692046/
https://www.ncbi.nlm.nih.gov/pubmed/26719808
http://dx.doi.org/10.1136/openhrt-2015-000283
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