Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data

Sato, Naoki; Kajimoto, Katsuya; Asai, Kuniya; Mizuno, Masayuki; Minami, Yuichiro; Nagashima, Michitaka; Murai, Koji; Muanakata, Ryo; Yumino, Dai; Meguro, Tomomi; Kawana, Masatoshi; Nejima, Jun; Sakurai, Toshihiko; Mizuno, Kyoichi; Tanaka, Keiji; Kasanuki, Hiroshi; Takano, Teruo

doi:10.1016/j.ahj.2010.03.019

Cited by 218 publications

(235 citation statements)

References 17 publications

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“…The rates of prescription of these agents were ~70% in the present study. These rates were similar to those in previous Japanese HF studies 3, 14. Although previous studies showed that aldosterone antagonist improved survival in HF patients,17, 18 aldosterone antagonist did not have a beneficial effect on survival in multivariate analysis in the present study.…”

Section: Discussionsupporting

confidence: 92%

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The association between high‐dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure

et al. 2017

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AimsFew studies have reported the impact of high‐dose loop diuretics at discharge on prognosis in Japanese patients with heart failure (HF). Our purpose was to assess the relationship between the dose of loop diuretics at discharge and cardiovascular mortality in patients with HF.Methods and resultsWe enrolled decompensated HF patients who were admitted to our hospital between March 2010 and March 2015, and compared HF patients who received high‐dose loop diuretics at discharge (HD group) with low‐dose loop diuretics at discharge (LD group) with regard to risk of cardiovascular mortality, and all‐cause mortality. High‐dose loop diuretic was defined as ≥40 mg/day of oral furosemide at discharge. A total of 215 patients were enrolled to the study. The median follow‐up duration was 641 days. All‐cause and cardiovascular mortality were significantly lower in the LD group than in the HD group (10.4% vs. 31.6%, P < 0.001; 2.2% vs. 24.6%, P < 0.001, respectively). High‐dose loop diuretics were associated with cardiovascular mortality in multivariate Cox proportional hazards model (hazard ratio, 16.06, 95% confidence interval 3.457 to 116.8; P < 0.001). The largest area under the receiver operating characteristic curve (0.85) for cardiovascular death was obtained with a threshold of 40 mg furosemide.ConclusionsHigh‐dose loop diuretic use at discharge was one of the predictors of cardiovascular mortality in patients with HF. An oral furosemide dose of 40 mg daily may be defined as ‘high‐dose’ loop diuretics in Japanese patients with chronic HF.

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Section: Discussionsupporting

confidence: 92%

“…Furosemide rapidly improves pulmonary congestion and dyspnoea in patients with acute decompensated HF. Generally speaking, loop diuretics are prescribed in 70–90% of patients with chronic HF 3, 5, 6. Some studies showed that aggressive decongestion had a beneficial effect on survival in these patients 7, 8.…”

Section: Introductionmentioning

confidence: 99%

The association between high‐dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure

et al. 2017

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“…The number of Japanese patients with heart failure was 979 000 in 2005 and is predicted to increase gradually as the population ages, reaching 1.3 million by 2030. 2 Moreover, the westernization of lifestyle and nutrition transition has facilitated the development of coronary artery disease and a higher proportion of ischaemic heart disease among heart failure patients 3, 4. Consequently, Japanese patients with heart failure have several unique clinical characteristics that might affect their prognosis including a high prevalence of preserved ejection fraction (HFpEF), multiple comorbidities, and lack of established treatment in elderly patients,5, 6, 7 and a longer length of hospital stay 4.…”

Section: Introductionmentioning

confidence: 99%

“…2 Moreover, the westernization of lifestyle and nutrition transition has facilitated the development of coronary artery disease and a higher proportion of ischaemic heart disease among heart failure patients 3, 4. Consequently, Japanese patients with heart failure have several unique clinical characteristics that might affect their prognosis including a high prevalence of preserved ejection fraction (HFpEF), multiple comorbidities, and lack of established treatment in elderly patients,5, 6, 7 and a longer length of hospital stay 4. Furthermore, there is a higher prevalence of angiotensin II receptor blockers use compared with angiotensin‐converting enzyme inhibitors use,4 and common use of tolvaptan, a vasopressin V2 receptor antagonist, which is newly approved for heart failure only in Japan 4, 8, 9…”

Section: Introductionmentioning

confidence: 99%

“…Although several observational studies of Japanese patients with heart failure have been conducted during the last two decades, these studies excluded patients who could not agree in writing to the study consent form, which resulted in non‐consecutive patient enrolment and a sample that is not truly representative of the current real‐world clinical practice of Japan 4, 10, 11. In addition, information regarding physical findings and the socio‐economic background of patients with ADHF were limited in these previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Kyoto Congestive Heart Failure (KCHF) study: rationale and design

et al. 2017

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AimsOver the last decade, major developments in medicine have led to significant changes in the clinical management of heart failure patients. This study was designed to evaluate the recent trends in clinical characteristics, management, and short‐term and long‐term prognosis of patients with acute decompensated heart failure (ADHF) in Japan.Methods and resultsThe Kyoto Congestive Heart Failure study is a prospective, observational, multicentre cohort study, enrolling consecutive ADHF patients from 19 participating hospitals in Japan from November 2014 to March 2016. A total of 4000 patients will be enrolled into the study and patients' anthropometric, socio‐economic, and clinical data from hospital admission to discharge will be collected. In addition, in a pre‐determined subgroup of patients (n=1500), a longitudinal follow‐up for 2 years is scheduled.ConclusionsThe Kyoto Congestive Heart Failure study will provide valuable information regarding patients with ADHF in the real‐world clinical practice of Japan and will be indispensable for future clinical and policy decision‐making with respect to heart failure.

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Decongestive treatment adjustments in heart failure patients remotely monitored with a multiparametric implantable defibrillators algorithm

Guerra

D’Onofrio

Ruvo

et al. 2022

Clinical Cardiology

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Aims: HeartLogic algorithm combines data from multiple implantable defibrillators (ICD)-based sensors to predict impending heart failure (HF) decompensation. A treatment protocol to manage algorithm alerts is not yet known, although decongestive treatment adjustments are the most frequent alert-triggered actions reported in clinical practice. We describe the implementation of HeartLogic for remote monitoring of HF patients, and we evaluate the approach to diuretic dosing and timing of the intervention in patients with device alerts. Methods:The algorithm was activated in 229 ICD patients at eight centers. The median follow-up was 17 months (25th-75th percentile: 11-24). Remote data reviews and patient phone contacts were undertaken at the time of HeartLogic alerts, to assess the patient's status and to prevent HF worsening. We analyzed alert-triggered augmented HF treatments, consisting of isolated increases in diuretics dosage.Results: We reported 242 alerts (0.8 alerts/patient-year) in 123 patients, 137 (56%) alerts triggered clinical actions to treat HF. The HeartLogic index decreased after the 56 actions consisting of diuretics increase. Specifically, alerts resolved more quickly when the increases in dosing of diuretics were early rather than late: 28 days versus 62 days, p < .001. The need of hospitalization for further treatments to resolve the alert condition was associated with higher HeartLogic index values on the day of the diuretics increase (odds ratio: 1.11, 95% CI: 1.02-1.20, p = .013) and with late interventions (odds ratio: 5.11, 95% CI: 1.09-24.48, p = .041). No complications were reported after drug adjustments.

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Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data

Cited by 218 publications

References 17 publications

The association between high‐dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure

The association between high‐dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure

Kyoto Congestive Heart Failure (KCHF) study: rationale and design

Decongestive treatment adjustments in heart failure patients remotely monitored with a multiparametric implantable defibrillators algorithm

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