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Latest & greatest articles for heart failure
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on heart failure or other clinical topics then use Trip today.
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Hospital-based quality improvement interventions for patients with heartfailure: a systematic review To estimate the direction and magnitude of effect and quality of evidence for hospital-based heartfailure (HF) quality improvement interventions on process of care measures and clinical outcomes among patients with acute HF.We performed a structured search to identify relevant randomised trials evaluating the effect of in-hospital quality improvement interventions for patients hospitalised
the prespecified secondary end
points cardiovascular death and the composite of all-cause death and
hospitalization for heart failure.In this pragmatic, registry-based randomized clinical trial, we
used a nationwide quality registry for coronary care for trial procedures
and evaluated end points through the Swedish population registry
(mortality), the Swedish inpatient registry (heartfailure), and cause of
death registry (cardiovascular death). Patients with suspected acute
myocardial infarction and oxygen (...) saturation of ≥90% were randomly
assigned to receive either supplemental oxygen at 6 L/min for 6 to 12
hours delivered by open face mask or ambient air.A total of 6629 patients were enrolled. Acute heartfailure
treatment, left ventricular systolic function assessed by echocardiography, and
infarct size measured by high-sensitive cardiac troponin T were similar in the
2 groups during the hospitalization period. All-cause death or hospitalization
for heartfailure within 1 year after randomization
Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for HeartFailure: The PACT-HF Randomized Clinical Trial. Health care services that support the hospital-to-home transition can improve outcomes in patients with heartfailure (HF).To test the effectiveness of the Patient-Centered Care Transitions in HF transitional care model in patients hospitalized for HF.Stepped-wedge cluster randomized trial of 2494 adults hospitalized for HF across 10 (...) hospitals in Ontario, Canada, from February 2015 to March 2016, with follow-up until November 2016.Hospitals were randomized to receive the intervention (n = 1104 patients), in which nurse-led self-care education, a structured hospital discharge summary, a family physician follow-up appointment less than 1 week after discharge, and, for high-risk patients, structured nurse homevisits and heart function clinic care were provided to patients, or usual care (n = 1390 patients), in which transitional care
Trends in survival after a diagnosis of heartfailure in the United Kingdom 2000-2017: population based cohort study. To report reliable estimates of short term and long term survival rates for people with a diagnosis of heartfailure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group.Population based cohort study.Primary care, United Kingdom.Primary care data for 55 959 patients aged 45 and overwith a new diagnosis of heartfailure 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.Survival rates at one, five, and 10 years and cause of death for people with and without heartfailure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group.Overall, one, five, and 10 year survival rates increased by 6.6% (from 74.2% in 2000 to 80.8
Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With HeartFailure. Heartfailure is an established risk factor for postoperative mortality, but how left ventricular ejection fraction and heartfailure symptoms affect surgical outcomes is not fully described.To determine the risk of postoperative mortality among patients with heartfailure at various levels of echocardiographic (left ventricular systolic dysfunction (...) ) and clinical (symptoms) severity compared with those without heartfailure and to evaluate how risk varies across levels of surgical complexity.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 surgery (final study follow-up: September 1, 2017).Heartfailure, left
Repetitive levosimendan infusions for patients with advanced chronic heartfailure in the vulnerable post-discharge period. Hospitalization for acute heartfailure (HF) is associated with a substantial morbidity burden and with associated healthcare costs and an increased mortality risk. However, few if any major medical innovations have been witnessed in this area in recent times. Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management (...) of acute HF. Experience in several clinical studies has indicated that administration of intravenous levosimendan in intermittent cycles may reduce hospitalization and mortality rates in patients with advanced HF; however, none of those trials were designed or powered to give conclusive insights into that possibility. This paper describes the rationale and protocol of LeoDOR (levosimendan infusions for patients with advanced chronic heartfailure), a randomized, double-blind, placebo-controlled
Liraglutide and weight loss among patients with advanced heartfailure and a reduced ejection fraction: insights from the FIGHT trial. Obesity is present in up to 45% of patients with heartfailure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with HF and reduced ejection fraction (HFrEF) and a recent acute HF hospitalization remains unknown.The Functional (...) Impact of GLP-1 for HeartFailure Treatment study randomized 300 patients with HFrEF (ejection fraction ≤ 40%), both with and without diabetes and a recent HF hospitalization to liraglutide or placebo. The primary outcome for this post hoc analysis was the change in weight from baseline to last study visit. We conducted an 'on-treatment' analysis of patients with at least one follow-up visit on study drug (123 on liraglutide and 124 on placebo). The median age was 61 years, 21% were female, and 69
Pro-gastrin-releasing peptide and outcome in patients with heartfailure and anaemia: results from the RED-HF study. Neuroendocrine activation is associated with poor outcome in heartfailure (HF). The neuropeptide gastrin-releasing peptide (GRP), derived from the precursor proGRP1-125 (proGRP), has recently been implicated in inflammation and wound repair. We investigated the predictive value of proGRP on clinical outcomes in HF patients with reduced ejection fraction.The association between (...) plasma proGRP (time-resolved immunofluorometric assay) and the primary endpoint of death from any cause or first hospitalization for worsening of HF was evaluated using multivariable Cox proportional hazard models in 1541 patients with systolic HF and mild to moderate anaemia, enrolled in the Reduction of Events by Darbepoetin alfa in HeartFailure (RED-HF) trial. Median proGRP levels in the RED-HF cohort were markedly increased [95 ng/L (25th, 75th percentile, 69-129 ng/L)] with 64% patients above
External Validation of the MEESSI Acute HeartFailure Risk Score: A Cohort Study. 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 heartfailure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown.To externally validate the MEESSI-AHF score in another country.Prospective cohort study (...) for missing values in the overall cohort of 1572 patients.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.External validation of the MEESSI-AHF risk score showed excellent discrimination. Recalibration may be needed when the score is introduced to new
Exercise-based cardiac rehabilitation for adults with heartfailure. Chronic heartfailure (HF) is a growing global health challenge. People with HF experience substantial burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous (2014) Cochrane systematic review reported that exercise-based cardiac rehabilitation (CR) compared to no exercise control shows improvement (...) -represented; and (2) most trials were undertaken in the hospital/centre-based setting.To determine the effects of exercise-based cardiac rehabilitation on mortality, hospital admission, and health-related quality of life of people with heart failure.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and three other databases on 29 January 2018. We also checked the bibliographies of systematic reviews and two trial registers.We included randomised controlled trials
Home-based cardiac rehabilitation for heartfailure has high rates of participation Home-based cardiac rehabilitation for heartfailure has high participation Discover Portal Discover Portal Home-based cardiac rehabilitation for heartfailure has high rates of participation Published on 8 January 2019 doi: Home-based cardiac rehabilitation for people with heartfailure improves quality of life at 12 months compared with usual care. Among those allocated to rehabilitation, 90% remained (...) was this study needed? Heartfailure 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 rehabilitation are required
‘Virtual wards’ reduce readmissions in people after hospitalisation for heartfailure ‘Virtual wards’ reduce readmissions in people after hospitalisation for heartfailure Discover Portal Discover Portal ‘Virtual wards’ reduce readmissions in people after hospitalisation for heartfailure Published on 14 August 2018 doi: People with heartfailure who receive care via virtual wards following discharge from hospital have lower rates of heartfailure-related readmission and death than people (...) and more rounded approach to care may improve post-discharge outcomes in people with heartfailure. 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, the cost to the NHS
.,Spethmann, S.,Schellong, S. M.,Schulze, P. C.,Bauersachs, J.,Wellge, B.,Schoebel, C.,Tajsic, M.,Dreger, H.,Anker, S. D.,Stangl, K. Lancet , 2018 BACKGROUND: Remote patient management in patients with heartfailure might help to detect early signs and symptoms of cardiac decompensation, thus enabling a prompt initiation of the appropriate treatment and care before a full manifestation of a heartfailure decompensation. We aimed to investigate the efficacy of our remote patient management intervention (...) Telemedicine programme can prolong life for heartfailure patients Telemedicine programme can prolong life for heartfailure patients Discover Portal Discover Portal Telemedicine programme can prolong life for heartfailure 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 heartfailure. A year-long study of 1,571
The heartfailure drug levosimendan doesn’t improve outcomes in adults with severe infections The heartfailure drug levosimendan doesn’t improve outcomes in adults with severe infections Discover Portal Discover Portal The heartfailure drug levosimendan doesn’t improve outcomes in adults with severe infections Published on 13 December 2016 doi: Septic shock is a life-threatening condition resulting from serious infection. Adding levosimendan to the usual care of adults with septic shock did (...) supply in patients with septic shock. Levosimendan is licensed in several countries to treat heartfailure, 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 of the heart, kidneys and other essential
“Case management” can prevent people with heartfailure being admitted again “Case management” can prevent people with heartfailure being admitted again Discover Portal Discover Portal “Case management” can prevent people with heartfailure being admitted again Published on 30 August 2016 doi: 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 heartfailure. Case management (...) 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? Heartfailure is a condition where the heart
Uncertain benefits of BNP blood tests to monitor heartfailure treatment Uncertain benefits of BNP blood tests to monitor heartfailure treatment Discover Portal Discover Portal Uncertain benefits of BNP blood tests to monitor heartfailure treatment Published on 6 February 2018 doi: In specialist clinics, using B-type natriuretic peptide (BNP) blood levels to guide treatment in people with chronic heartfailure 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 heartfailure 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. This research pooled data
after a recent heart attack. Share your views on the research. Why was this study needed? Conditions such as severe heart attacks or coronary artery disease damage heart muscle which becomes weaker. This reduces the amount of blood that the heart can pump leading eventually to heartfailure, which affects about 900,000 people in the UK. Life expectancy is shortened and the risk of sudden cardiac death is increased. Management, depending on the specific type of heart disease, uses a combination (...) Aldosterone antagonists reduce deaths, including sudden deaths, in people with heartfailure Aldosterone antagonists reduce deaths, including sudden deaths, in people with heartfailure Discover Portal Discover Portal Aldosterone antagonists reduce deaths, including sudden deaths, in people with heartfailure Published on 17 May 2016 doi: In adults with longstanding heartfailure or recent heart attack aldosterone antagonists reduced sudden cardiac deaths and deaths from any cause. There were