Latest & greatest articles for heart failure

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Top results for heart failure

1. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. (PubMed)

Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. OBJECTIVES: To report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group. DESIGN: Population based cohort study. SETTING: Primary care, United Kingdom. PARTICIPANTS: Primary care data for 55 959 patients aged 45 and overwith (...) a new diagnosis of heart failure and 278 679 age and sex matched controls in the Clinical Practice Research Datalink from 1 January 2000 to 31 December 2017 and linked to inpatient Hospital Episode Statistics and Office for National Statistics mortality data. MAIN OUTCOME MEASURES: Survival rates at one, five, and 10 years and cause of death for people with and without heart failure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group. RESULTS: Overall

2019 BMJ

2. Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With Heart Failure. (PubMed)

Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With Heart Failure. Importance: Heart failure is an established risk factor for postoperative mortality, but how left ventricular ejection fraction and heart failure symptoms affect surgical outcomes is not fully described. Objectives: To determine the risk of postoperative mortality among patients with heart failure at various levels of echocardiographic (left (...) ventricular systolic dysfunction) and clinical (symptoms) severity compared with those without heart failure and to evaluate how risk varies across levels of surgical complexity. Design, Setting, and Participants: US multisite retrospective cohort study of all adult patients receiving elective, noncardiac surgery in the Veterans Affairs Surgical Quality Improvement Project database from 2009 through 2016. A total of 609 735 patient records were identified and analyzed with 1 year of follow-up after having

2019 JAMA

3. External Validation of the MEESSI Acute Heart Failure Risk Score: A Cohort Study. (PubMed)

External Validation of the MEESSI Acute Heart Failure Risk Score: A Cohort Study. Background: The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) score was developed to predict 30-day mortality in patients presenting with acute heart failure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown. Objective: To externally validate the MEESSI-AHF score in another country. Design (...) were confirmed in sensitivity analyses that used multiple imputation for missing values in the overall cohort of 1572 patients. Limitations: External validation was done using a reduced model. Findings are specific to patients with AHF who present to the ED and are clinically stable enough to provide informed consent. Performance in patients with terminal kidney failure who are receiving long-term dialysis cannot be commented on. Conclusion: External validation of the MEESSI-AHF risk score showed

2019 Annals of Internal Medicine

4. Home-based cardiac rehabilitation for heart failure has high rates of participation

Home-based cardiac rehabilitation for heart failure has high rates of participation Home-based cardiac rehabilitation for heart failure has high participation Dissemination Centre Discover Portal NIHR DC Discover Home-based cardiac rehabilitation for heart failure has high rates of participation Published on 8 January 2019 doi: Home-based cardiac rehabilitation for people with heart failure improves quality of life at 12 months compared with usual care. Among those allocated to rehabilitation (...) on the research. Why was this study needed? Heart failure affects around 900,000 people in the UK. Despite the effectiveness of cardiac rehabilitation in reducing re-admission and risk of death from heart disease, and in improving quality of life, availability and attendance in the UK are poor. On average, only 43% of people eligible actually attend, and this varies from 13 to 88% around the country. Efforts to improve access by exploring newer more accessible alternative strategies to hospital-based

2019 NIHR Dissemination Centre

5. Uncertain benefits of BNP blood tests to monitor heart failure treatment

Uncertain benefits of BNP blood tests to monitor heart failure treatment Signal - Uncertain benefits of BNP blood tests to monitor heart failure treatment Dissemination Centre Discover Portal NIHR DC Discover Uncertain benefits of BNP blood tests to monitor heart failure treatment Published on 6 February 2018 In specialist clinics, using B-type natriuretic peptide (BNP) blood levels to guide treatment in people with chronic heart failure shows promise but did not improve survival for all groups (...) . In this review, the benefit was only seen in patients aged less than 75, who survived an extra 1.5 years on average, and possibly those with poor heart function (reduced ejection fraction). However, there was a reduction in hospital admissions for heart failure for everyone. BNP is a hormone released from the heart muscle, and higher levels may indicate more severe disease. It is currently used for diagnosis, but its use in monitoring treatment has become the subject of recent research interest

2019 NIHR Dissemination Centre

6. “Case management” can prevent people with heart failure being admitted again

“Case management” can prevent people with heart failure being admitted again Signal - “Case management” can prevent people with heart failure being admitted again Dissemination Centre Discover Portal NIHR DC Discover “Case management” can prevent people with heart failure being admitted again Published on 30 August 2016 Case management that is initiated in hospital and led by specialist nurses may reduce unplanned hospital readmissions and length of hospital stay for adults with heart failure (...) that hospital-initiated case management is cost effective – particularly in relation to the NHS. A few studies examined case management that was started in the community. The findings are promising and may lead to further studies that confirm these findings in the UK setting. Commissioners would also need to know other things too, such as the components of case management that are most beneficial and the costs. Share your views on the research. Why was this study needed? Heart failure is a condition where

2019 NIHR Dissemination Centre

7. The heart failure drug levosimendan doesn’t improve outcomes in adults with severe infections

The heart failure drug levosimendan doesn’t improve outcomes in adults with severe infections Signal - The heart failure drug levosimendan doesn’t improve outcomes in adults with severe infections Dissemination Centre Discover Portal NIHR DC Discover The heart failure drug levosimendan doesn’t improve outcomes in adults with severe infections Published on 13 December 2016 Septic shock is a life-threatening condition resulting from serious infection. Adding levosimendan to the usual care (...) on markers of heart function and blood supply in patients with septic shock. Levosimendan is licensed in several countries to treat heart failure, but does not currently have approval from the US Food and Drug Administration. Share your views on the research. Why was this study needed? There are 150,000 cases of severe sepsis in the UK every year, with 44,000 deaths. Mortality is very high, 30 to 40% even with the best available treatment. Severe infections can lead to septic shock with failure

2019 NIHR Dissemination Centre

8. Aldosterone antagonists reduce deaths, including sudden deaths, in people with heart failure

Aldosterone antagonists reduce deaths, including sudden deaths, in people with heart failure Signal - Aldosterone antagonists reduce deaths, including sudden deaths, in people with heart failure Dissemination Centre Discover Portal NIHR DC Discover Aldosterone antagonists reduce deaths, including sudden deaths, in people with heart failure Published on 17 May 2016 In adults with longstanding heart failure or recent heart attack aldosterone antagonists reduced sudden cardiac deaths and deaths (...) from any cause. There were important side effects, including an increase in kidney injury. Most studies focussed specifically on left heart failure. More research is needed to establish the place of these types of drugs in practice and clinical decision making should be mindful of the impact on effectiveness and side-effects. The findings are in line with current NICE guidance, which include aldosterone antagonists as options in the management of people with this specific type of heart failure or

2019 NIHR Dissemination Centre

9. A blood test threshold for diagnosing heart failure in general practice is reviewed

A blood test threshold for diagnosing heart failure in general practice is reviewed Signal - A blood test threshold for diagnosing heart failure in general practice is reviewed Dissemination Centre Discover Portal NIHR DC Discover A blood test threshold for diagnosing heart failure in general practice is reviewed Published on 3 May 2017 The cut-off level for the blood test NTproBNP appears to provide the best balance of detecting true cases while excluding false positives when lowered to 125 pg (...) /ml. The trial supported by the NIHR included a sample of people presenting to their GP with suspected heart failure. It aimed to see which method was best for identifying those who needed referral: the blood test alone; clinical decision rules based on clinical symptoms; or the combination of both. The blood test alone at the 125 pg/ml cut-off correctly identified 94% of people with heart failure but led to 50% of people who did not have heart failure being referred for further investigation

2019 NIHR Dissemination Centre

10. Telemedicine programme can prolong life for heart failure patients

Telemedicine programme can prolong life for heart failure patients Telemedicine programme can prolong life for heart failure patients Dissemination Centre Discover Portal NIHR DC Discover Telemedicine programme can prolong life for heart failure patients Published on 20 November 2018 doi: A comprehensive programme of daily telemedicine monitoring and 24-hour access to a physician-led hotline can reduce the number of deaths and the time spent in hospital, among patients with heart failure. A (...) year-long study of 1,571 patients who had been admitted to hospital with heart failure within the past 12 months found that those assigned to daily telemonitoring, monthly health education and telephone support from specialist staff, were 30% less likely to die than those assigned to usual care. This was a 3 percentage point reduction from 11% per year in the control group to 8% in the telemedicine group. This group also spent around a third fewer days in hospital. This suggests telemedicine could

2019 NIHR Dissemination Centre

11. ‘Virtual wards’ reduce readmissions in people after hospitalisation for heart failure

‘Virtual wards’ reduce readmissions in people after hospitalisation for heart failureVirtual wards’ reduce readmissions in people after hospitalisation for heart failure Dissemination Centre Discover Portal NIHR DC Discover ‘Virtual wards’ reduce readmissions in people after hospitalisation for heart failure Published on 14 August 2018 doi: People with heart failure who receive care via virtual wards following discharge from hospital have lower rates of heart failure-related readmission (...) the idea that an enhanced and more rounded approach to care may improve post-discharge outcomes in people with heart failure. The review described interventions that are applicable to UK care models. The evidence may be a starting point for further evaluation or trials of these. Share your views on the research. Why was this study needed? Unplanned readmissions of people within a short time after discharge from hospital are detrimental to both patients and healthcare systems. From 2009 to 2010

2019 NIHR Dissemination Centre

12. Disease management interventions for heart failure. (PubMed)

Disease management interventions for heart failure. BACKGROUND: Despite advances in treatment, the increasing and ageing population makes heart failure an important cause of morbidity and death worldwide. It is associated with high healthcare costs, partly driven by frequent hospital readmissions. Disease management interventions may help to manage people with heart failure in a more proactive, preventative way than drug therapy alone. This is the second update of a review published in 2005 (...) and updated in 2012. OBJECTIVES: To compare the effects of different disease management interventions for heart failure (which are not purely educational in focus), with usual care, in terms of death, hospital readmissions, quality of life and cost-related outcomes. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and CINAHL for this review update on 9 January 2018 and two clinical trials registries on 4 July 2018. We applied no language restrictions. SELECTION CRITERIA: We included randomised

2019 Cochrane

13. Chronic congestive heart failure

Chronic congestive heart failure Chronic congestive heart failure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Chronic congestive heart failure Last reviewed: December 2018 Last updated: January 2019 Summary A complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. It is a major and growing public health (...) problem. It is the only cardiovascular disease that is increasing in incidence and prevalence, partly because the population is ageing, but also because of improved cardiovascular interventions for disease processes that reduce early mortality but may result in cardiac changes that lead to heart failure. The key manifestations are dyspnoea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary congestion and peripheral oedema. Diagnosis is largely clinical

2019 BMJ Best Practice

14. Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA

Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA 30586723 2019 01 14 1524-4539 139 3 2019 Jan 15 Circulation Circulation Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA. 351-361 10.1161/CIRCULATIONAHA.118.038352 Individuals with type 2 diabetes mellitus are at increased risk for heart failure (...) (HF), particularly those with coexisting atherosclerotic cardiovascular disease and/or kidney disease. Some but not all dipeptidyl peptidase-4 inhibitors have been associated with increased HF risk. We performed secondary analyses of HF and related outcomes with the dipeptidyl peptidase-4 inhibitor linagliptin versus placebo in CARMELINA (The Cardiovascular and Renal Microvascular Outcome Study With Linagliptin), a cardiovascular outcomes trial that enrolled participants with type 2 diabetes

2019 EvidenceUpdates

15. Catheter Ablation of Atrial Fibrillation in Patients With Heart Failure: A Meta-analysis of Randomized Controlled Trials. (PubMed)

Catheter Ablation of Atrial Fibrillation in Patients With Heart Failure: A Meta-analysis of Randomized Controlled Trials. Background: Atrial fibrillation (AF) and heart failure (HF) frequently coexist and are associated with increased morbidity and mortality risk. Purpose: To compare benefits and harms between catheter ablation and drug therapy in adult patients with AF and HF. Data Sources: ClinicalTrials.gov, PubMed, Web of Science (Clarivate Analytics), EBSCO Information Services, Cochrane (...) Central Register of Controlled Trials, Google Scholar, and various scientific conference sessions from 1 January 2005 to 1 October 2018. Study Selection: Randomized controlled trials (RCTs) published in English that had at least 6 months of follow-up and compared clinical outcomes of catheter ablation versus drug therapy in adults with AF and HF. Data Extraction: 2 investigators independently extracted data and assessed study quality. Data Synthesis: 6 RCTs involving 775 patients met inclusion

2018 Annals of Internal Medicine

16. Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. (PubMed)

Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. Importance: The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. It is unclear whether the HRRP has been associated with change in patient mortality. Objective: To determine whether the HRRP (...) was associated with a change in patient mortality. Design, Setting, and Participants: Retrospective cohort study of hospitalizations for HF, AMI, and pneumonia among Medicare fee-for-service beneficiaries aged at least 65 years across 4 periods from April 1, 2005, to March 31, 2015. Period 1 and period 2 occurred before the HRRP to establish baseline trends (April 2005-September 2007 and October 2007-March 2010). Period 3 and period 4 were after HRRP announcement (April 2010 to September 2012) and HRRP

2018 JAMA

17. Specialist nurses can manage heart failure drug dosing successfully

Specialist nurses can manage heart failure drug dosing successfully Signal - Specialist nurses can manage heart failure drug dosing successfully Dissemination Centre Discover Portal NIHR DC Discover Specialist nurses can manage heart failure drug dosing successfully Published on 9 February 2016 Use of specialist nurses to optimise drug dosages using protocols in people with heart failure was more effective than dose monitoring by other health professionals. These nurses had advanced practice (...) certification. This finding came from a review of seven trials with more than 1600 patients. International guidelines recommend two or three first-line medications for people with heart failure. These drugs (beta-adrenergic blocking agents, angiotensin converting enzyme inhibitors and angiotensin receptor blockers) can improve survival and are usually started at low doses by cardiologists and then gradually increased over time, a process managed between cardiologists and GPs. This can be a prolonged process

2018 NIHR Dissemination Centre

18. Telehealth can help people with heart failure avoid hospital admission

Telehealth can help people with heart failure avoid hospital admission Signal - Telehealth can help people with heart failure avoid hospital admission Dissemination Centre Discover Portal NIHR DC Discover Telehealth can help people with heart failure avoid hospital admission Published on 18 January 2016 Home telephone or telemonitoring support can bring some aspects of specialised care and monitoring into the homes of people with heart failure. This updated Cochrane review confirmed that people (...) with heart failure who received home telehealth support were less likely to die or go into hospital for problems relating to their heart failure than those getting usual care. Usual care involved visiting a GP surgery or hospital for care and monitoring, which may be difficult for frail people with limited mobility. The review included seventeen new trials since the last review was published five years ago. More evidence is needed on which people would gain most benefit, particularly considering

2018 NIHR Dissemination Centre

19. Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement. (PubMed)

Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement. Importance: Data are lacking on the effect of a renin-angiotensin system (RAS) inhibitor prescribed after transcatheter aortic valve replacement (TAVR). Treatment with a RAS inhibitor may reverse left ventricular remodeling and improve function. Objective: To investigate the association of prescription of a RAS inhibitor and outcomes after (...) : Initial hospital discharge prescription of a RAS inhibitor after TAVR. Main Outcomes and Measures: Primary outcomes were all-cause death and readmission due to heart failure at 1 year after discharge, which were considered separately. The secondary outcome was health status assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ; score range: 0-100, with a higher score indicating less symptom burden and better quality of life; a small effect size was defined as 5 points) at 1 year. Results

2018 JAMA

20. Chronic Heart Failure and Exercise Rehabilitation: A Systematic Review and Meta-Analysis

Chronic Heart Failure and Exercise Rehabilitation: A Systematic Review and Meta-Analysis 29698639 2018 11 24 1532-821X 99 12 2018 Dec Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Chronic Heart Failure and Exercise Rehabilitation: A Systematic Review and Meta-Analysis. 2570-2582 S0003-9993(18)30234-X 10.1016/j.apmr.2018.03.015 The aim of this systematic review was to identify the effect of specific exercise parameters on physical function and quality of life (QOL (...) ) in people with chronic heart failure living in the community. A total of 5 electronic databases were searched for relevant studies published after 1994. The screening process was completed by 2 independent researchers, with a third independent reviewer for conflict resolution. Studies were selected if they included only chronic hHart failure participants, and the sole intervention was a structured exercise training program in an outpatient or community setting. Two independent researchers completed

2018 EvidenceUpdates