scholarly journals A statin in the treatment of heart failure? Controlled rosuvastatin multinational study in heart failure (CORONA): Study design and baseline characteristics

2005 ◽  
Vol 7 (6) ◽  
pp. 1059-1069 ◽  
Author(s):  
John Kjekshus ◽  
Peter Dunselman ◽  
Malin Blideskog ◽  
Christina Eskilson ◽  
Åke Hjalmarson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Study Design ◽  
Multinational Study ◽  
Baseline Characteristics

scholarly journals Adverse clinical outcomes associated with RAAS inhibitor discontinuation: analysis of over 400 000 patients from the UK Clinical Practice Research Datalink (CPRD)

2021 ◽  
Author(s):  
Toby J L Humphrey ◽  
Glen James ◽  
Eric T Wittbrodt ◽  
Donna Zarzuela ◽  
Thomas F Hiemstra
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Clinical Practice ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Ckd Stage ◽  
First Occurrence ◽  
Baseline Characteristics

Abstract Background Users of guideline-recommended renin–angiotensin–aldosterone system (RAAS) inhibitors may experience disruptions to their treatment, e.g. due to hyperkalaemia, hypotension or acute kidney injury. The risks associated with treatment disruption have not been comprehensively assessed; therefore, we evaluated the risk of adverse clinical outcomes in RAAS inhibitor users experiencing treatment disruptions in a large population-wide database. Methods This exploratory, retrospective analysis utilized data from the UK’s Clinical Practice Research Datalink, linked to Hospital Episodes Statistics and the Office for National Statistics databases. Adults (≥18 years) with first RAAS inhibitor use (defined as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) between 1 January 2009 and 31 December 2014 were eligible for inclusion. Time to the first occurrence of adverse clinical outcomes [all-cause mortality, all-cause hospitalization, cardiac arrhythmia, heart failure hospitalization, cardiac arrest, advancement in chronic kidney disease (CKD) stage and acute kidney injury] was compared between RAAS inhibitor users with and without interruptions or cessations to treatment during follow-up. Associations between baseline characteristics and adverse clinical outcomes were also assessed. Results Among 434 027 RAAS inhibitor users, the risk of the first occurrence of all clinical outcomes, except advancement in CKD stage, was 8–75% lower in patients without interruptions or cessations versus patients with interruptions/cessations. Baseline characteristics independently associated with increased risk of clinical outcomes included increasing age, smoking, CKD, diabetes and heart failure. Conclusions These findings highlight the need for effective management of factors associated with RAAS inhibitor interruptions or cessations in patients for whom guideline-recommended RAAS inhibitor treatment is indicated.

scholarly journals Myopia Control with Orthokeratology Contact Lenses in Spain (MCOS): Study Design and General Baseline Characteristics

2009 ◽  
Vol 2 (4) ◽  
pp. 215-222 ◽  
Author(s):  
Jacinto Santodomingo-Rubido ◽  
César Villa-Collar ◽  
Bernard Gilmartin ◽  
Ramón Gutiérrez-Ortega
Keyword(s):  
Study Design ◽  
Contact Lenses ◽  
Baseline Characteristics ◽  
Myopia Control

scholarly journals Relationship of B-type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

2005 ◽  
Vol 80 (3) ◽  
pp. 174-180 ◽  
Author(s):  
Alan H.B. Wu ◽  
Torbjørn Omland ◽  
Cathrine Wold Knudsen ◽  
James McCord ◽  
Richard M. Nowak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptide ◽  
Multinational Study ◽  
Relationship Of

scholarly journals Lactate levels as a marker of tissue hypoperfusion in acute heart failure patients seen in the emergency department: a pilot study

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Kori Sauser ◽  
Lora Alkhawam ◽  
Linda Pierchala ◽  
Peter S. Pang
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Pilot Study ◽  
Acute Heart Failure ◽  
Tissue Ischemia ◽  
Tissue Hypoperfusion ◽  
Baseline Characteristics ◽  
Lactate Levels ◽  
Elevated Lactate ◽  
Mean Heart Rate

Acute heart failure (AHF) may lead to subclinical tissue ischemia due to hypoperfusion from inadequate forward flow or congestion. The aim of the present study is to test whether lactate levels are elevated in emergency department (ED) patients with AHF. A prospective pilot study of ED AHF patients was conducted. Venous lactate level was measured at baseline and 6-12 hours after initial draw. Of the 50 patients enrolled, mean age was 65.3 years, 68% were male. Only 7 (14%) had an elevated lactate on either draw, with no differences in baseline characteristics between patients with and without elevated lactate. Patients with an elevated lactate had a higher mean heart rate (99 <em>vs</em> 81, P=0.03) and trended toward an increased rate of abnormal initial temperature (57 <em>vs</em> 23%, P=0.06). In this pilot study, only a minority of acute HF patients had an elevated lactate on presentation.

scholarly journals The Progression of the Stargardt Disease Type 4 (ProgStar-4) Study: Design and Baseline Characteristics (ProgStar-4 Report No. 1)

2018 ◽  
Vol 60 (3) ◽  
pp. 185-194 ◽  
Author(s):  
Rupert W. Strauss ◽  
Beatriz Muñoz ◽  
Mohamed I. Ahmed ◽  
Millena Bittencourt ◽  
Etienne M. Schönbach ◽  
...  
Keyword(s):  
Study Design ◽  
Disease Type ◽  
Stargardt Disease ◽  
Baseline Characteristics

Abstract 16587: More Than Five Years After FDA Approval, There Remains Very Limited Adoption of New Evidence-Based, Highly Effective Medications for the Treatment of Patients With Heart Failure, Especially Among Those on Medicare

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Joseph B Muhlestein ◽  
Heidi T May ◽  
Tami L Bair ◽  
Stacey Knight ◽  
Kirk U Knowlton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Regression ◽  
Sglt2 Inhibitor ◽  
Clinical Effectiveness ◽  
Major Adverse Cardiovascular Events ◽  
Evidence Based ◽  
Cox Regression Analysis ◽  
Reduced Ejection Fraction ◽  
Highly Effective ◽  
Baseline Characteristics

Background: Over the past decade, the FDA has approved several new medications that are highly effective when added to existing standard therapy in the treatment of heart failure with reduced ejection fraction (HFrEF). It is possible that, despite the presence of substantial evidence regarding the clinical effectiveness of these new medications, their high cost and the complex medical reimbursement system in America may prevent their routine adoption. Methods: We analyzed 5,824 Intermountain Healthcare patients, age ≥18 years with a new clinical diagnosis of HFrEF (LVEF ≤35%), from 1/1/2015 onward, for the use of newly-approved sacubitril/valsartan or any sodium-glucose cotransporter-2 inhibitor (SGLT2-I). We collected baseline characteristics and medication utilization data. We followed the patients for 1.7±1.4 years for future major adverse cardiovascular events (MACE), including death, myocardial infarction (MI), stroke, and heart failure hospitalization (HFH). We identified differences between groups by multivariable Cox regression analysis. Results: Baseline characteristics and incidence of MACE, according to insurance status and the use of common HFrEF medications, are shown in the Table. Overall, only 344 (5.9%) and 169 (2.9%) of patients ever received a prescription for sacubitril/valsartan or an SGLT2 inhibitor, respectively. The figures show survival curves for MACE of patients receiving or not receiving the newly-approved medications. Conclusion: In this large, modern, real-world HFrEF population, the adoption of newly-approved evidence-based HFrEF medications is minimal in all patients and especially in Medicare patients. This lack of adoption is associated with a significant worsening in patient outcomes. These findings demonstrate a critical need to resolve our present healthcare financial crisis, which is almost certainly the reason for these findings.

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