Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)

Folláth, Ferenc; Yilmaz, Mehmet Birhan; Delgado, Juan; Parissis, John; Porcher, Raphaël; Gayat, Étienne; Burrows, Nigel; McLean, Anthony S.; Vilas-Boas, Fábio; Mebazaa, Alexandre

doi:10.1007/s00134-010-2113-0

Cited by 233 publications

(199 citation statements)

References 11 publications

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“…Several investigators have reported on the in‐hospital mortality in patients with acute heart failure, which is an ample concept that includes acute decompensation of chronic heart failure, cardiogenic shock with or without pulmonary edema, right ventricular failure, and APE 3, 6, 14, 19, 20, 21. In these studies, mortality has varied from 6.4% to 17.2% and they have shown advanced age,6, 14, 19, 21 severe left ventricular dysfunction,14 acute coronary syndromes,14 admission blood pressure,6, 19, 21 renal failure,6, 19, 21 need for inotropics,19 and anemia19 as principal predictors.…”

Section: Discussionmentioning

confidence: 99%

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Figueras

Bañeras

Peña‐Gil

et al. 2016

JAHA

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BackgroundLong‐term prognosis of acute pulmonary edema (APE) remains ill defined.Methods and ResultsWe evaluated demographic, echocardiographic, and angiographic data of 806 consecutive patients with APE with (CAD) and without coronary artery disease (non‐CAD) admitted from 2000 to 2010. Differences between hospital and long‐term mortality and its predictors were also assessed. CAD patients (n=638) were older and had higher incidence of diabetes and peripheral vascular disease than non‐CAD (n=168), and lower ejection fraction. Hospital mortality was similar in both groups (26.5% vs 31.5%; P=0.169) but APE recurrence was higher in CAD patients (17.3% vs 6.5%; P<0.001). Age, admission systolic blood pressure, recurrence of APE, and need for inotropics or endotracheal intubation were the main independent predictors of hospital mortality. In contrast, overall mortality (70.0% vs 57.1%; P=0.002) and readmission for nonfatal heart failure after a 45‐month follow‐up (10–140; 17.3% vs 7.6%; P=0.009) were higher in CAD than in non‐CAD patients. Age, peripheral vascular disease, and peak creatine kinase MB during index hospitalization, but not ejection fraction, were the main independent predictors of overall mortality, whereas coronary revascularization or valvular surgery were protective. These interventions were mostly performed during hospitalization index (294 of 307; 96%) and not intervened patients showed a higher risk profile.ConclusionsLong‐term mortality in APE is high and higher in CAD than in non‐CAD patients. Considering the different in‐hospital and long‐term mortality predictors herein described, which do not necessarily involve systolic function, it is conceivable that a more aggressive interventional program might improve survival in high‐risk patients.

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Section: Discussionmentioning

confidence: 99%

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Figueras

Bañeras

Peña‐Gil

et al. 2016

JAHA

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“…Patients can achieve a short‐term symptomatic improvement with current medical treatment,20 but during the first year after discharge, between 15% and 24% of patients die 21. Patients hospitalized for acute decompensated HF (ADHF) have particularly poor outcomes.…”

Section: Rationale For the Transition Studymentioning

confidence: 99%

Rationale and design of TRANSITION: a randomized trial of pre‐discharge vs. post‐discharge initiation of sacubitril/valsartan

et al. 2017

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AimsThe prognosis after hospitalization for acute decompensated heart failure (ADHF) remains poor, especially <30 days post‐discharge. Evidence‐based medications with prognostic impact administered at discharge improve survival and hospital readmission, but robust studies comparing pre‐discharge with post‐discharge initiation are rare. The PARADIGM‐HF trial established sacubitril/valsartan as a new evidence‐based therapy in patients with heart failure (HF) and reduced left ventricular ejection fraction (<40%) (rEF). In common with other landmark studies, it enrolled patients who were ambulatory at the time of inclusion. In addition, there is also still limited knowledge of initiation and up‐titration of sacubitril/valsartan in ACEi/ARB‐ naïve patients and in de novo HF with rEF patients.Methods and results TRANSITION is a multicentre, open‐label study in which ~1000 adults hospitalized for ADHF with rEF are randomized to start sacubitril/valsartan in a pre‐discharge arm (initiated ≥24 h after haemodynamic stabilization) or a post‐discharge arm (initiated within Days 1–14 after discharge). The protocol allows investigators to select the appropriate starting dose and dose adjustments according to clinical circumstances. Over a 10 week treatment period, the primary and secondary objectives assess the feasibility and safety of starting sacubitril/valsartan in‐hospital, early after haemodynamic stabilization. Exploratory objectives also include assessment of HF signs and symptoms, readmissions, N‐terminal pro‐B‐type natriuretic peptide and high‐sensitivity troponin T levels, and health resource utilization parameters.Conclusions TRANSITION will provide new evidence about initiating sacubitril/valsartan following hospitalization for ADHF, occurring either as de novo ADHF or as deterioration of chronic HF, and in patients with or without prior ACEI/ARB therapy. The results of TRANSITION will thus be highly relevant to the management of patients hospitalized for ADHF with rEF.

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“…Heart failure (HF) is a global public health problem affecting millions worldwide 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12. In the USA, the prevalence is 5.7 million and there are 670 000 new cases per year, while there are another 15 million people living with HF in Europe 13, 14, 15.…”

Section: Introductionmentioning

confidence: 99%

“…1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 These registries have either focused on in‐patient characterization and short‐term outcomes or maintained separate samples of acute HF hospitalizations and chronic HF follow‐up, limiting understanding of the transition from chronic maintenance to an acute state requiring hospitalization 24, 25. No prior detailed, longitudinal evaluations of long‐term disease progression, healthcare utilization, and health economics on a global scale have been reported.…”

Section: Introductionmentioning

confidence: 99%

International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT‐HF): rationale for and design of a global registry

Filippatos

Khan

Ambrosy

et al. 2015

European J of Heart Fail

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AimsThe clinical characteristics, initial presentation, management, and outcomes of patients hospitalized with new‐onset (first diagnosis) heart failure (HF) or decompensation of chronic HF are poorly understood worldwide. REPORT‐HF (International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure) is a global, prospective, and observational study designed to characterize patient trajectories longitudinally during and following an index hospitalization for HF.MethodsData collection for the registry will be conducted at ∼300 sites located in ∼40 countries. Comprehensive data including demographics, clinical presentation, co‐morbidities, treatment patterns, quality of life, in‐hospital and post‐discharge outcomes, and health utilization and costs will be collected. Enrolment of ∼20 000 adult patients hospitalized with new‐onset (first diagnosis) HF or decompensation of chronic HF over a 3‐year period is planned with subsequent 3 years follow‐up.PerspectiveThe REPORT‐HF registry will explore the clinical characteristics, management, and outcomes of HF worldwide. This global research programme may have implications for the formulation of public health policy and the design and conduct of international clinical trials.

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Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)

Cited by 233 publications

References 11 publications

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Rationale and design of TRANSITION: a randomized trial of pre‐discharge vs. post‐discharge initiation of sacubitril/valsartan

International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT‐HF): rationale for and design of a global registry

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