Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction

Vasan, Ramachandran S.; Larson, Martin G.; Benjamin, Emelia J.; Evans, Jane C.; Reiss, Craig K.; Levy, Daniel

doi:10.1016/s0735-1097(99)00118-7

Cited by 1,247 publications

(777 citation statements)

References 48 publications

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“…Women were less likely to have documented systolic dysfunction, a situation consistent with findings from other investigators. 2,20,21 We were not as successful in enrolling people 75 years and older. Despite keeping exclusion criteria to a minimum, the trial enrolled significantly fewer patients in this age group at successive steps of the recruitment process.…”

Section: Discussionmentioning

confidence: 95%

The success of recruiting minorities, women, and elderly into a randomized controlled effectiveness trial

Sisk

Horowitz

Wang

et al. 2008

Mount Sinai J Medicine

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Background-Heart failure, a leading cause of hospitalization among elderly people, disproportionately afflicts African-American and other non-White populations. Studies of health care interventions often do not include these groups in proportion to numbers in the patient population. Our objective was to assess whether a randomized controlled effectiveness trial enrolled patients by ethnicity/race, gender, and age in proportion to those eligible.

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Section: Discussionmentioning

confidence: 95%

The success of recruiting minorities, women, and elderly into a randomized controlled effectiveness trial

Sisk

Horowitz

Wang

et al. 2008

Mount Sinai J Medicine

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“…Our cohort had higher mortality compared with community-based cohorts which generally include patients who are less symptomatic. 22,23 …”

Section: Limitationsmentioning

confidence: 99%

Prognostic significance of hemoglobin level in patients with congestive heart failure and normal ejection fraction

Varadarajan

Gandhi

Sharma

et al. 2006

Clinical Cardiology

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SummaryBackground: Previous studies have shown low hemoglobin (Hb) to have an adverse effect on survival in patients with congestive heart failure (CHF) and reduced left ventricular (LV) ejection fraction (EF); but its effect on survival in patients with CHF and normal EF is not known.Hypothesis: This study sought to determine whether low Hb has an effect on survival in patients with both CHF and normal EF.Methods: Detailed chart reviews were performed by medical residents on 2,246 patients (48% with normal EF) with a discharge diagnosis of CHF in a large tertiary care hospital from 1990 to 1999. The CHF diagnosis was validated using the Framingham criteria. Mortality data were obtained from the National Death Index. Survival analysis was performed using Kaplan-Meier and Cox regression models.Results: By Kaplan-Meier analysis, low Hb (< 12 gm/dl) compared with normal hemoglobin was associated with a lower 5-year survival in patients with CHF and both normal (38 vs. 50%, p = 0.0008) and reduced (35 vs. 48%, p = 0.0009) EF. Using the Cox regression model, low Hb was an independent predictor of mortality after adjusting for age, gender, renal

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“…[2][3][4] Observation studies have concluded that the morbidity associated with DHF (including the rate of hospitalization) is similar to that associated with systolic HF. 5 Large randomized trials in selected patients with HF have led to major advances in the medical treatment of systolic HF. [6][7][8] On the contrary, few randomized trials have been carried out with regard to medical management of DHF, despite its high prevalence and mortality.…”

Section: Introductionmentioning

confidence: 99%

Demonstrating the pharmacogenetic effects of angiotensin-converting enzyme inhibitors on long-term prognosis of diastolic heart failure

Jl²,

Tsai

et al. 2009

Pharmacogenomics J

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The objective of this study was to evaluate the effects of angiotensin-converting enzyme (ACE) inhibitors and pharmacogenetic interaction on the survival of the patients with diastolic heart failure (DHF). A total of 285 subjects with DHF confirmed by echocardiography were recruited in the period between 1995 and 2003. Baseline characteristics (age, sex, prior history, medication, and echocardiographic findings) and genetic polymorphisms (ACE gene insertion/ deletion (I/D) polymorphism; T174M, M235T, G-6A, A-20C, G-152A, and G-217A polymorphisms of the angiotensinogen (AGT) gene; and A1166C polymorphisms of the angiotensin II type I receptor (AT1R)) were collected and matched (by propensity score) in those who received and those who did not receive ACE inhibitors. The patients were followed up to 10 years. Kaplan-Meier curves and Cox regression models were used to demonstrate the survival trend. The 85 patients who received ACE inhibitors and the other 85 patients who did not were found to have comparable baseline characteristics and polymorphism distribution. Prescription of ACE inhibitors was associated with a significant decrease in overall mortality (hazard ratio (HR), 0.45; 95% confidence interval (CI), 0.24-0.83; P ¼ 0.01), and a lower rate of cardiovascular events at 4000 days (HR, 0.53; 95% CI, 0.32-0.90; P ¼ 0.02). In addition, ACE I/D gene D allele was associated with higher overall mortality as compared with the I allele (HR, 2.04; P ¼ 0.003). This effect was diminished in those who received ACE inhibitors. The use of ACE inhibitor was associated with a significant decrease in long-term mortality and cardiovascular events in the patients with DHF. Genetic variants in the renin-angiotensin system genes were also associated, but their effects could be modified by the use of ACE inhibitors.

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Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction

Cited by 1,247 publications

References 48 publications

The success of recruiting minorities, women, and elderly into a randomized controlled effectiveness trial

The success of recruiting minorities, women, and elderly into a randomized controlled effectiveness trial

Prognostic significance of hemoglobin level in patients with congestive heart failure and normal ejection fraction

Demonstrating the pharmacogenetic effects of angiotensin-converting enzyme inhibitors on long-term prognosis of diastolic heart failure

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