for the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators
HEART FAILURE (HF) IS A MAjor international public health problem presenting significant medical and economic challenges. In the United States, HF has high prevalence (Ͼ5 million individuals), high incidence (550 000 new cases yearly), increasing hospitalization rates (400 000 in 1979 to Ͼ1 million in 2004), and exorbitant cost (estimated to exceed $33 billion in 2007). 1 A considerable share of the burden of HF is accounted for by the acute HF syndromes (AHFS), defined as conditions with gradual or rapid changes in the signs and symptoms of HF that require urgent therapy. 2 Patients hospi-talized with AHFS have poor overall prognosis. [3][4][5][6][7][8] Congestion characterized by dyspnea, edema, rales, jugular venous dis-See also pp 1319 and 1374.
Among patients admitted for worsening signs and symptoms of HF and reduced EF, congestion improves substantially during hospitalization in response to standard therapy alone. However, patients with absent or minimal resting signs and symptoms at discharge still experienced a high mortality and readmission rate.
Early administration of serelaxin was associated with a reduction of 180-day mortality, and this occurred with fewer signs of organ damage and more rapid relief of congestion during the first days after admission.
Neither facilitation of PCI with reteplase plus abciximab nor facilitation with abciximab alone significantly improved the clinical outcomes, as compared with abciximab given at the time of PCI, in patients with ST-segment elevation myocardial infarction. (ClinicalTrials.gov number, NCT00046228 [ClinicalTrials.gov].)
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