Heart failure guidelines in North America and Europe: agreement or disagreement?

Between 1984 and 1988, a resurgence of acute rheumatic fever (ARF) was reported in several pediatric centers.1-3 During the same time, pediatric cases,4-6 and, recently, adult cases6 of poststreptococcal reactive arthritis (PSRA) have been reported. Although several of these patients had or developed multisystemic manifestations,4,5 none of these cases fully adhered to the guidelines of the revised Jones criteria.7 Thus, these individuals were given the diagnosis of PSRA or poststreptococcal rheumatic syndrome (PSRS) rather than ARF.4-6,8-10 One of the leading causes of acquired pediatric heart disease in North America is carditis of ARF,3 and severe cases can result in congestive heart failure, the need for valve replacement, or death.11

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Comparable Clinical Benefits with Beta-Blockers in Heart Failure Patients from North America and Europe: Evidence from a Meta-Analysis of Randomized Clinical Trials

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2013.06.093 ◽

2013 ◽

Vol 19 (8) ◽

pp. S28

Author(s):

Saurav Chatterjee ◽

Robert J. Mentz ◽

Partha Sardar ◽

John J. Ryan

Keyword(s):

Heart Failure ◽

Clinical Trials ◽

North America ◽

Randomized Clinical Trials ◽

Beta Blockers ◽

Meta Analysis ◽

Heart Failure Patients ◽

Clinical Benefits

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Home telemonitoring in heart failure patients and the effect of study design on outcome: A literature review

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211037197 ◽

2021 ◽

pp. 1357633X2110371

Author(s):

Chukwuemeka A. Umeh ◽

Maunika Reddy ◽

Ankit Dubey ◽

Mohammad Yousuf ◽

Sumanta Chaudhuri ◽

...

Keyword(s):

Heart Failure ◽

High Risk ◽

North America ◽

Hospital Admission ◽

Study Design ◽

Randomized Controlled ◽

Home Telemonitoring ◽

Pubmed Database ◽

Wide Range ◽

Study Designs

Introduction A wide range of study designs have been utilized in evaluations of home telemonitoring and these studies have produced conflicting outcomes over the years. While some of the research has shown that telemonitoring is beneficial in reducing all-cause mortality, hospital admission, length of stay in hospital and emergency room visits, other studies have not shown such benefits. This study, therefore, aims to examine several home telemonitoring study designs and the influence of study design on study outcomes. Method Articles were obtained by searching PubMed database with the term heart failure combined with the following terms: telemonitoring, telehealth, home monitoring, and remote monitoring. Searches were limited to randomized controlled trial conducted between year January 1, 2000 and February 6, 2021. The characteristics of the study designs and study outcomes were extracted and analyzed. Result Our review of 34 randomized controlled trials of heart failure telemonitoring did not show any significant influence of study design on reduction in number of hospitalizations and/or decrease in mortality. Studies that were done outside North America (USA and Canada) and studies that selected patients at high risk of re-hospitalization were more likely to result in decreased hospitalization and/or mortality, though this was not statistically significant. All the studies that met our inclusion criteria were from high-income countries and only one study enrolled patients at high risk of re-hospitalization. Conclusion There is a need for more studies to understand why telemonitoring studies in Europe were more likely to reduce hospital admission and mortality compared to those in North America. There is also a need for more studies on the effect of telemonitoring in patients at high risk of hospital readmission.

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Abstract 161: Atrial Fibrillation in India: Insights from the PINNACLE India Outpatient Registry

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.161 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Nathan T Glusenkamp ◽

Samantha A Risch ◽

Prafulla Kerkar ◽

Ganesh Kumar ◽

William J Oetgen

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

North America ◽

Data Collection ◽

Disease Burden ◽

Treatment Patterns ◽

Data Collection Tool ◽

Electronic Data Collection ◽

Life Threatening ◽

Associated Conditions

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide. Most studies of AF focus on white populations in North America or Europe. Less is known about prevalence, etiology and treatment patterns of AF in India. To better understand the disease burden, we examined data from the PINNACLE India registry. Methods: PINNACLE India is the first cardiovascular data collection and reporting program in India. Data are collected by transmission from paper scanners and an electronic data collection tool. Patients are followed longitudinally if they return to a data collecting site. Results: AF is recorded in 0.39% (246) unique patients and 0.59% (865) of all encounters. The gender breakdown among AF patients is consistent with literature, but prevalence is low compared to other countries. Although we suspect that the diagnosis or documentation of AF is low, it appears that those diagnosed get treatment, since 35.77% are on Warfarin, 4.07% are on Dabigatran, and a substantial proportion is on other antithrombotic therapies. Conclusion: AF is tough to diagnose since it is often asymptomatic and clinicians need many tests to confirm diagnosis. Lack of documentation or detection of AF and its associated conditions is a concern. AF can lead to life threatening problems such as stroke and heart failure. The surveillance of AF in India is important in order to identify opportunities for intervention. Continued data collection through the use of a cardiovascular registry can improve the understanding of AF in India.

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