scholarly journals Incremental benefit of drug therapies for chronic heart failure with reduced ejection fraction: a network meta-analysis

2018 ◽  
Vol 20 (9) ◽  
pp. 1315-1322 ◽  
Author(s):  
Michel Komajda ◽  
Michael Böhm ◽  
Jeffrey S. Borer ◽  
Ian Ford ◽  
Luigi Tavazzi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Reduced Ejection Fraction ◽  
Incremental Benefit

scholarly journals Participation in a Heart Failure Clinical Trial: Perspectives and Opportunities From the VICTORIA Trial and VICTORIA Simultaneous Registry

2021 ◽  
Author(s):  
Justin Ezekowitz ◽  
Robert J. Mentz ◽  
Cynthia M. Westerhout ◽  
Nancy K. Sweitzer ◽  
Michael M. Givertz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Risk Score ◽  
Meta Analysis ◽  
The United States ◽  
Unique Identifier ◽  
Eligibility Criteria ◽  
Reduced Ejection Fraction

Background: Randomized controlled trials (RCTs) often target enrollment of patients with demographics and outcomes less representative of the broader population of interest. To provide context for the VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), we designed a registry of hospitalized patients with worsening heart failure to characterize their clinical profile, outcomes, and reasons for their nonparticipation in a RCT. Methods: Fifty-one RCT sites in Canada and the United States participated. Eligible patients included those with chronic heart failure, hospitalized for heart failure, and an ejection fraction <45%; no other exclusions were applied. Sites identified patients between 2017 and 2019 during the RCT enrollment period. RCT eligibility criteria were applied, and non–mutually exclusive reasons for nonenrollment were captured. Mortality at 1 year was estimated via the Meta-Analysis Global Group in Chronic Heart Failure risk score or as observed in the RCT. Results: Overall, 2056 patients were enrolled in the registry; 61% (n=1256) were ineligible for the RCT, 37% (n=766) were eligible but not enrolled, and 2% (n=34) were also enrolled in the RCT. Registry participants had a median age of 70, 33% were women, and 63% were White. The median risk score predicted a 20.9% 1-year mortality, higher than in the RCT (predicted 14.7% and observed 11.5%). Major reasons for ineligibility in the RCT included the use of nitrates (23%), systolic blood pressure <100 mm Hg (12%), and substance use (11%) with other exclusion criteria <10%. For eligible patients, reasons for nonparticipation in the RCT included lack of interest in participating (28%), poor compliance (25%), inability to complete follow-up (23%), too sick (20%), unable to provide consent (17%), and distance from site (15%). Conclusions: Patients with worsening heart failure in routine clinical practice exhibit high-risk features, and approximately one-third were eligible for an RCT but excluded. The majority of these nonparticipating patients had modifiable reasons. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02861534.

Exercise Dynamic of Patients with Chronic Heart Failure and Reduced Ejection Fraction

2021 ◽  
Vol 23 (7) ◽  
Author(s):  
Sara Rovai ◽  
Irene Mattavelli ◽  
Elisabetta Salvioni ◽  
Ugo Corrà ◽  
Gaia Cattadori ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Reduced Ejection Fraction
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