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S1: Treatment variablesPatient PopulationMeasureSupporting InformationTimingSuggested Data SourcesAll patientsMedications initiatedMedication listTracked ongoingClinician-reportedPatients receiving deviceDevice procedure typeDevice type (pacemaker, ICD, or CRT)Patients receiving cardiac surgeryCardiac surgery procedure typeCABG, CABG+valve, CABG/valve+OtherPatients receiving rehabilitationMeasure initiatedRehabilitationICD: Implantable cardioverter-defibrillator; CRT: Cardiac resynchronization therapy; CABG: Coronary artery bypass graftS2: Heart failure registry publicationsADHERE: Acute Decompensated Heart Failure National Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1079-2082","PMID":"12966900","abstract":"The epidemiology and clinical characteristics of acute decompensated heart failure (ADHF) and the management of patients with ADHF are discussed. ADHF has become a significant health care problem in the United States. In an effort to fully understand the current epidemiology, clinical characteristics, and management of patients hospitalized with ADHF, a national registry was started in 2002 as a joint collaboration between academic heart failure specialists and the bio-pharmaceutical industry. The largest compilation of ADHF data has been collected in the Acute Decompensated Heart Failure National Registry (ADHERE). This article describes ADHERE, which suggests that the health care industry needs to conduct root-cause analysis of outpatient and inpatient practices toward these patients and make adjustments in these treatment patterns if we are going to reduce the morbidity, mortality, and health care costs in these patients.","author":[{"dropping-particle":"","family":"Munger","given":"Mark A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Carter","given":"Orly","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","id":"ITEM-1","issued":{"date-parts":[["2003","8","15"]]},"page":"S3-6","title":"Epidemiology and practice patterns of acute decompensated heart failure.","type":"article-journal","volume":"60 Suppl 4"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1007/s11897-004-0021-8","ISSN":"1546-9530","PMID":"16036035","abstract":"Despite 1 million or more annual hospitalizations, the management of acute decompensated heart failure remains largely empiric. Data are lacking regarding patient characteristics, usual comorbidities, commonly used treatment strategies, clinical outcomes, and adherence to recently published quality indicators. The Acute Decompensated Heart Failure National Registry (ADHERE(R)) has been established to capture data regarding the presentation, management, and expected outcomes of acute decompensated heart failure. The size of the registry and its web-based platform allow for evaluation of compliance with quality indicators, assessment of mortality risk, and correlation of parenteral treatment strategies with clinical outcomes. More than 100,000 patient episodes have been recorded in the registry. These patient data have been reviewed and reveal important findings regarding acute decompensated heart failure and potential opportunities to improve the quality of care.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Current heart failure reports","id":"ITEM-2","issue":"3","issued":{"date-parts":[["2004"]]},"page":"121-128","title":"Quality of care and outcomes in acute decompensated heart failure: The ADHERE Registry.","type":"article-journal","volume":"1"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1007/s10741-005-6128-5","ISSN":"1382-4147","PMID":"15809816","abstract":"The Acute Decompensated HEart Failure National REgistry (ADHERE(R)) confirms that the management of decompensated heart failure is an emergency department (ED) problem, as more than 75% of patients admitted to the hospital with heart failure arrive through the ED. This emphasizes the need for collaboration among emergency medicine, cardiology, nephrology, and hospitalists in the management of acute decompensated heart failure. Such collaboration is important for several reasons, including the enhancement of patient care. It is also known that most hospitals lose money on heart failure admissions. Strategies that can be employed to limit hospital losses on heart failure include reducing admissions from the ED; decreasing the length of hospital stay; increasing the use of the observation unit; reducing re-admissions, particularly through the first 30 days; and reducing the use of high-resource areas such as the intensive care unit (ICU). This article will focus on initiatives that can be implemented in the ED to help with these strategies. In particular, we will discuss early initiation of therapy and its ability to improve length of stay, reduce re-admissions, and reduce ICU admissions. Use of the observation unit for the management of heart failure will also be discussed as a way of decreasing admissions from the ED.","author":[{"dropping-particle":"","family":"Peacock","given":"W Franklin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart failure reviews","id":"ITEM-3","issue":"3","issued":{"date-parts":[["2004"]]},"page":"187-193","title":"Emergency department management of patients with acute decompensated heart failure.","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.ahj.2004.08.005","ISBN":"0002-8703","ISSN":"00028703","PMID":"15846257","abstract":"Background: The ADHERE is designed to study characteristics, management, and outcomes in a broad sample of patients hospitalized with acute decompensated heart failure. Heart failure is a leading cause of hospitalization for adults older than 65 years in the United States. Most available data on these patients are limited by patient selection criteria and study design of clinical trials and single-center studies. Methods: Participating hospitals identify patients with a primary or secondary discharge diagnosis of heart failure. Medical history, management, treatments, and health outcomes data are collected through review of medical records and entered into a database via secure web browser technology. Results: As of January 2004, data on 107 362 patients have been received from 282 participating hospitals. Of enrollees with available analyzable data (N = 105 388 from 274 hospitals), the mean age was 72.4 (±14.0), and 52% were women. The most common comorbid conditions were hypertension (73%), coronary artery disease (57%), and diabetes (44%). Evidence of mild or no impairment of systolic function was found in 46% of patients. Inhospital mortality was 4.0% and the median hospital length of stay was 4.3 days. Conclusions: The ADHERE demonstrates both the feasibility and significant implications of gathering representative data on large numbers of patients hospitalized with heart failure. Initial data provided important insights into the clinical characteristics and patterns of care of these patients. Ongoing registry work will provide the framework for improved treatment strategies for patients hospitalized with decompensated heart failure. ? 2005, Published by Elsevier Inc.","author":[{"dropping-particle":"","family":"Adams","given":"Kirkwood F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LeJemtel","given":"Thierry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Costanzo","given":"Maria Rosa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Berkowitz","given":"Robert L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Galvao","given":"Marie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horton","given":"Darlene P.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-4","issue":"2","issued":{"date-parts":[["2005"]]},"page":"209-216","title":"Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)","type":"article-journal","volume":"149"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.accreview.2005.09.054","ISBN":"0003-9926 1538-3679","ISSN":"10621458","PMID":"16009861","abstract":"BACKGROUND: Quality-of-care indicators have been developed for patients hospitalized with heart failure. However, little is known about current rates of conformity with these indicators or their variability across hospitals. METHODS: Data from 81 142 admissions occurring between July 1, 2002, and December 31, 2003, at 223 academic and non-academic hospitals in the United States participating in the Acute Decompensated Heart Failure National Registry (ADHERE) were analyzed. Rates of conformity with the 4 Joint Commission on Accreditation of Healthcare Organizations core performance measures--discharge instructions (HF-1), assessment of left ventricular function (HF-2), use of angiotensin-converting enzyme inhibitors in patients with left ventricular systolic dysfunction (HF-3), and smoking cessation counseling (HF-4)--as well as length of stay and in-hospital mortality rates were computed. RESULTS: Across all hospitals, the median rates of conformity with HF-1, HF-2, HF-3, and HF-4 were 24.0%, 86.2%, 72.0%, and 43.2%, respectively. Rates of conformity at individual hospitals varied from 0% to 100%, with statistically significant differences between academic and non-academic hospitals. Statistically significant positive independent predictors of overall conformity included the prevalence of comorbidities and the use of more intense pharmacologic management. Median hospital length of stay varied from 2.3 to 9.5 days, and in-hospital mortality varied from 0% to 11.1%. CONCLUSIONS: Among hospitals providing care for patients with heart failure, there is significant individual variability in conformity to quality-of-care indicators and clinical outcomes and a substantial gap in overall performance. Establishing educational initiatives and quality improvement systems to reduce this variability and eliminate this gap would be expected to substantially improve the care of these patients.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J Thomas","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Archives of internal medicine","id":"ITEM-5","issue":"13","issued":{"date-parts":[["2005"]]},"page":"1469-1477","title":"Adherence to heart failure quality-of-care indicators in US hospitals: analysis of the ADHERE Registry.","type":"article-journal","volume":"165"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1007/s10741-005-6127-6","ISBN":"1382-4147","ISSN":"13824147","PMID":"15809815","abstract":"Acute decompensated heart failure (ADHF) has emerged as a major public health problem, and HF has become the leading cause of hospitalization in persons over 65 years of age. It is estimated that there are 6.5 million hospital days attributed to ADHF each year. Patients hospitalized with ADHF face a substantial risk of readmission, as high as 50% by 6 months after discharge. Despite the large number of patients hospitalized and this substantial risk, data on these patients have been limited and there has been little effort to improve the quality of care for patients hospitalized with ADHF. The Acute Decompensated Heart Failure National Registry (ADHERE) was designed to bridge this gap in knowledge and care by prospectively studying the characteristics, management, and outcomes of a broad spectrum of patients hospitalized with ADHF. Participating community and university hospitals identified patients with a primary or secondary discharge diagnosis of HF and collected medical history, management, treatments, and health outcomes via secure Web browser technology. As of October 2004, more than 160,000 patients from 281 hospitals have been enrolled. These patients differ substantially from those typically enrolled in randomized clinical trials. Initial data from the ADHERE registry have provided important insights into the clinical characteristics, patterns of care, and outcomes of patients with ADHF. ADHERE has documented significant delays in diagnosis and initiation of ADHF therapies as well as a substantial under-use of evidenced-based, guideline-recommended chronic HF therapies at hospital discharge. As such, there are substantial opportunities to improve the quality of care for ADHF patients in the nation's hospitals.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart Failure Reviews","id":"ITEM-6","issue":"3","issued":{"date-parts":[["2005"]]},"page":"179-185","title":"Overview of acutely decompensated congestive heart failure (ADHF): A report from the ADHERE Registry","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.jacc.2005.03.051","ISBN":"0735-1097 (Print)\r0735-1097 (Linking)","ISSN":"07351097","PMID":"15992636","abstract":"OBJECTIVES: We sought to compare the in-hospital mortality of patients with acute decompensated heart failure (ADHF) who were receiving parenteral treatment with one of four intravenous vasoactive medications. BACKGROUND: There are limited data regarding the effects of the choice of intravenous vasoactive medication on in-hospital mortality in patients hospitalized with ADHF. METHODS: This was a retrospective analysis of observational patient data from the Acute Decompensated Heart Failure National Registry (ADHERE), a multicenter registry designed to prospectively collect data on each episode of hospitalization for ADHF and its clinical outcomes. Data from the first 65,180 patient episodes (October 2001 to July 2003) were included in this analysis. Cases in which patients received nitroglycerin, nesiritide, milrinone, or dobutamine were identified and reviewed (n = 15,230). Risk factor and propensity score-adjusted odds ratios (ORs) for in-hospital mortality were calculated. RESULTS: Patients who received intravenous nitroglycerin or nesiritide had lower in-hospital mortality than those treated with dobutamine or milrinone. The risk factor and propensity score-adjusted ORs for nitroglycerin were 0.69 (95% confidence interval [CI] 0.53 to 0.89, p ≤ 0.005) and 0.46 (94% CI 0.37 to 0.57, p ≤ 0.005) compared with milrinone and dobutamine, respectively. The corresponding values for nesiritide compared with milrinone and dobutamine were 0.59 (95% CI 0.48 to 0.73, p ≤ 0.005) and 0.47 (95% CI 0.39 to 0.56, p ≤ 0.005), respectively. The adjusted OR for nesiritide compared with nitroglycerin was 0.94 (95% CI 0.77 to 1.16, p = 0.58). CONCLUSIONS: Therapy with either a natriuretic peptide or vasodilator was associated with significantly lower in-hospital mortality than positive inotropic therapy in patients hospitalized with ADHF. The risk of in-hospital mortality was similar for nesiritide and nitroglycerin. ? 2005 by the American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Adams","given":"Kirkwood F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Costanzo","given":"Maria Rosa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Berkowitz","given":"Robert L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lejemtel","given":"Thierry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cheng","given":"Mei L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-7","issue":"1","issued":{"date-parts":[["2005"]]},"page":"57-64","title":"In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: An analysis from the Acute Decompensated Heart Failure National Registry (ADHERE)","type":"article-journal","volume":"46"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1001/jama.293.5.572","ISBN":"1538-3598 (Electronic)\r0098-7484 (Linking)","ISSN":"1538-3598","PMID":"15687312","abstract":"CONTEXT: Estimation of mortality risk in patients hospitalized with acute decompensated heart failure (ADHF) may help clinicians guide care. OBJECTIVE: To develop a practical user-friendly bedside tool for risk stratification for patients hospitalized with ADHF. DESIGN, SETTING, AND PATIENTS: The Acute Decompensated Heart Failure National Registry (ADHERE) of patients hospitalized with a primary diagnosis of ADHF in 263 hospitals in the United States was queried with analysis of patient data to develop a risk stratification model. The first 33,046 hospitalizations (derivation cohort; October 2001-February 2003) were analyzed to develop the model and then the validity of the model was prospectively tested using data from 32,229 subsequent hospitalizations (validation cohort; March-July 2003). Patients had a mean age of 72.5 years and 52% were female. MAIN OUTCOME MEASURE: Variables predicting mortality in ADHF. RESULTS: When the derivation and validation cohorts are combined, 37,772 (58%) of 65,275 patient-records had coronary artery disease. Of a combined cohort consisting of 52,164 patient-records, 23,910 (46%) had preserved left ventricular systolic function. In-hospital mortality was similar in the derivation (4.2%) and validation (4.0%) cohorts. Recursive partitioning of the derivation cohort for 39 variables indicated that the best single predictor for mortality was high admission levels of blood urea nitrogen (> or =43 mg/dL [15.35 mmol/L]) followed by low admission systolic blood pressure (<115 mm Hg) and then by high levels of serum creatinine (> or =2.75 mg/dL [243.1 micromol/L]). A simple risk tree identified patient groups with mortality ranging from 2.1% to 21.9%. The odds ratio for mortality between patients identified as high and low risk was 12.9 (95% confidence interval, 10.4-15.9) and similar results were seen when this risk stratification was applied prospectively to the validation cohort. CONCLUSIONS: These results suggest that ADHF patients at low, intermediate, and high risk for in-hospital mortality can be easily identified using vital sign and laboratory data obtained on hospital admission. The ADHERE risk tree provides clinicians with a validated, practical bedside tool for mortality risk stratification.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Adams","given":"Kirkwood F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Boscardin","given":"W John","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-8","issue":"5","issued":{"date-parts":[["2005"]]},"page":"572-580","title":"Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis.","type":"article-journal","volume":"293"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1007/s10741-005-6129-4","ISBN":"1382-4147 (Print)\\n1382-4147 (Linking)","ISSN":"13824147","PMID":"15809817","abstract":"Significant renal dysfunction is common in patients hospitalized for heart failure and carries a grim prognosis. Patients with heart failure who have or develop renal dysfunction while being treated for heart failure are said to have the cardiorenal syndrome. The Acute Decompensated Heart Failure National Registry (ADHERE) database, which enrolled nonselected patients admitted to the hospital for acute decompensated heart failure (ADHF), was used to determine the causes for this renal dysfunction and whether treatment can optimize outcomes. Results show that the average patient admitted for ADHF is older than those typically enrolled in clinical trials and has at least moderate kidney damage, with significantly impaired glomerular filtration rates. Renal dysfunction in patients with heart failure is complex and often multifactorial in origin, but the syndrome may be reversible in some patients. Reduction of angiotensin II levels with angiotensin-converting enzyme (ACE) inhibitors may prevent glomerular hyperfiltration and ultimately preserve renal function; however, patients who are volume-depleted may be especially sensitive to ACE inhibitor-induced efferent arteriolar dilation, so ACE inhibitor therapy in patients with renal dysfunction should be initiated when the patient is volume replete. In conclusion, impaired renal function is common in heart failure patients and may be a key cause of the cascade involving fluid retention, decompensation, and eventual hospital admission. Future pharmacologic research should focus on therapies aimed at maintaining or improving renal function in heart failure patients to reduce the high mortality associated with the cardiorenal syndrome.","author":[{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart Failure Reviews","id":"ITEM-9","issue":"3","issued":{"date-parts":[["2005"]]},"page":"195-201","title":"The cardiorenal syndrome: Lessons from the ADHERE database and treatment options","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1016/j.jacc.2005.09.022","ISSN":"07351097","PMID":"16386668","abstract":"OBJECTIVES: The aims of this analysis were to describe the clinical characteristics, management, and outcomes of patients hospitalized for acute decompensated heart failure (HF) with preserved systolic function (PSF). BACKGROUND: Clinically meaningful characteristics of these patients have not been fully studied in a large database. METHODS: Data from >100,000 hospitalizations from the Acute Decompensated Heart Failure National Registry (ADHERE) database were analyzed. RESULTS: Heart failure with PSF was present in 50.4% of patients with in-hospital assessment of left ventricular function. When compared with patients with systolic dysfunction, patients with PSF were more likely to be older, women, and hypertensive and less likely to have had a prior myocardial infarction or be receiving an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. In-hospital mortality was lower in patients with PSF compared with patients with systolic dysfunction (2.8% vs. 3.9%; adjusted odds ratio [OR]: 0.86; p = 0.005), but duration of intensive care unit stay and total hospital length of stay were similar. Serum creatinine >2 mg/dl was associated with increased in-hospital mortality in both systolic function groups (PSF: 4.8%; systolic dysfunction: 8.4%; p < 0.0001), and the most powerful predictors of in-hospital mortality in both groups were blood urea nitrogen >37 mg/dl (OR: 2.53; 95% confidence interval [CI]: 2.22 to 2.87) and systolic blood pressure ≤125 mm Hg (OR: 2.58; 95% CI: 2.33 to 2.86). CONCLUSIONS: Heart failure with PSF is common and is characterized by a unique patient profile. Event rates are worrisome and reflect a need for more effective management strategies. ? 2006 by the American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stevenson","given":"Lynne Warner","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marco","given":"Teresa","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-10","issue":"1","issued":{"date-parts":[["2006"]]},"page":"76-84","title":"Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) database","type":"article-journal","volume":"47"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1016/j.annemergmed.2005.04.003","ISBN":"0196-0644","ISSN":"01960644","PMID":"16387212","abstract":"Study objective: Although chest radiography is quick and inexpensive, previous research suggests that it is often misleading in emergency department (ED) patients with decompensated heart failure, resulting in misdiagnosis and inappropriate treatment. This study determines the rate of negative chest radiography results in patients found to have disease and the potential contribution of negative findings to a diagnosis discordant with heart failure by an emergency physician. Methods: We used data from the Acute Decompensated Heart Failure National Registry (ADHERE), a registry of patients with a primary hospital discharge diagnosis of heart failure. We compared initial ED admitting diagnosis to the criterion standard of a hospital discharge diagnosis of heart failure and related these to radiographic findings of heart failure (interstitial edema, pulmonary edema, or vascular congestion, as determined by a staff radiologist) for patients first treated in the ED. The proportion of patients with a non-heart failure ED diagnosis and the diagnostic sensitivity of radiographic findings of heart failure are calculated. Results: There were 85,376 patients with chest radiograph results and an ED admitting diagnosis. Overall, there were 15,937 patients with no signs of congestion on ED chest radiography, giving a negative rate of 18.7% (95% confidence interval [CI] 18.4% to 18.9%). The proportion of patients with an ED non-heart failure admitting diagnosis was higher in patients with a negative chest radiograph result (23.3%; 95% CI 22.6% to 23.9%) than in patients with a positive chest radiograph result (13.0%; 95% CI 12.7% to 13.2%). Conclusion: Approximately 1 of every 5 patients admitted from the ED with acute decompensated heart failure had no signs of congestion on chest radiography. Patients lacking signs of congestion on ED chest radiography were more likely to have an ED non-heart failure diagnosis than patients with signs of congestion. Clinicians should not rule out heart failure in patients with no radiographic signs of congestion. Copyright ? 2006 by the American College of Emergency Physicians.","author":[{"dropping-particle":"","family":"Collins","given":"Sean P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lindsell","given":"Christopher J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Storrow","given":"Alan B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Annals of Emergency Medicine","id":"ITEM-11","issue":"1","issued":{"date-parts":[["2006"]]},"page":"13-18","title":"Prevalence of negative chest radiography results in the emergency department patient with decompensated heart failure","type":"article-journal","volume":"47"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1016/j.cardfail.2005.09.005","ISSN":"10719164","PMID":"16520256","abstract":"Background: The impact of gender differences has not been well described in patients hospitalized with acute decompensated heart failure (ADHF). Methods and Results: Through review of medical records, data on characteristics, treatments, and outcomes were analyzed on 105,388 patient records according to gender. Women accounted for 52% of these admissions and were older than men (74.5 versus 70.1 years,) and more commonly had preserved left ventricular function (51% versus 28%). Based on history, women were less likely to have coronary artery disease (51% versus 64%) and its risk factors, but more commonly had hypertension (76% versus 70%). Both genders received similar intravenous diuretic regimens, but fewer women received vasoactive therapy (24% vs 31%). Evidence-based oral therapies were underused in both genders. Women consistently received less procedure-oriented therapy. Mean length of stay (women 5.9, men 5.8 days) and the risk-adjusted in-hospital mortality (adjusted odds ratio 0.974 [0.910-1.042], P = .4390) were similar in both genders. Conclusion: More women than men are hospitalized with ADHF. Heart failure with preserved left ventricular function predominates in women. Though women are treated less aggressively, treatment gaps exists in both sexes. Despite these differences, length of stay and in-hospital mortality rates are similar. ? 2006 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Galvao","given":"Marie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kalman","given":"Jill","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Demarco","given":"Teresa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Galvin","given":"Catherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ghali","given":"Jalal K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moskowitz","given":"Robert M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-12","issue":"2","issued":{"date-parts":[["2006"]]},"page":"100-107","title":"Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: Analysis from the acute decompensated heart failure national registry (ADHERE)","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"10.1016/j.ahj.2007.03.012","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"17540205","abstract":"Background: The purpose of this study was to assess temporal trends in clinical characteristics, treatments, quality indicators, and outcomes for heart failure (HF) hospitalizations. Methods: Characteristics, treatments, quality measures, and inhospital outcomes were measured over 12 consecutive quarters (January 2002 to December 2004) using data from 159 168 enrollments from 285 ADHERE hospitals. Results: Baseline characteristics were similar or showed only modest changes, and severity of illness by logistic regression was unchanged over all 12 quarters. Inhospital treatment changed significantly over time with inotrope use decreasing from 14.7% to 7.9% (P < .0001). Discharge instructions increased 133%; smoking counseling, 132%; left ventricular function measurement, 8%; and β-blocker use, 29% (all P < .0001). Clinical outcomes improved over time, including need for mechanical ventilation, which decreased 5.3% to 3.4% (relative risk 0.64, P < .0001); length of stay (mean), 6.3 to 5.5 days; and mortality, 4.5% to 3.2% (relative risk 0.71, P < .0001). Conclusions: Over a 3-year period, demographics and clinical characteristics were relatively similar, but significant changes in intravenous therapy, enhancements in conformity to quality-of-care measures, increased administration of evidence-based HF medications, and substantial improvements in inhospital morbidity and mortality were observed during hospitalization for HF. ? 2007 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-13","issue":"6","issued":{"date-parts":[["2007"]]},"page":"1021-1028","title":"Temporal trends in clinical characteristics, treatments, and outcomes for heart failure hospitalizations, 2002 to 2004: findings from Acute Decompensated Heart Failure National Registry (ADHERE)","type":"article-journal","volume":"153"},"uris":[""]},{"id":"ITEM-14","itemData":{"DOI":"10.1016/j.jacc.2007.02.037","ISBN":"1558-3597 (Electronic)\r0735-1097 (Linking)","ISSN":"07351097","PMID":"17498579","abstract":"Objectives: This study was designed to determine whether admission B-type natriuretic peptide (BNP) levels are predictive of in-hospital mortality in acute decompensated heart failure (HF). Background: Levels of BNP have been demonstrated to facilitate the diagnosis of HF and predict mortality in chronic systolic HF. Methods: B-type natriuretic peptide levels within 24 h of presentation were obtained in 48,629 (63%) of 77,467 hospitalization episodes entered in ADHERE (Acute Decompensated Heart Failure National Registry). In-hospital mortality was assessed by BNP quartiles in the entire cohort and in patients with reduced (n = 19,544) as well as preserved (n = 18,164) left ventricular systolic function using chi-square and logistic regression models. Results: Quartiles (Q) of BNP were Q1 (<430), Q2 (430 to 839), Q3 (840 to 1,729), and Q4 (≥1,730 pg/ml). The BNP levels were <100 pg/ml in 3.3% of the total cohort. Patients in Q1 versus Q4 were younger, more likely to be women, and had lower creatinine and higher left ventricular ejection fraction. There was a near-linear relationship between BNP quartiles and in-hospital mortality: Q1 (1.9%), Q2 (2.8%), Q3 (3.8%), and Q4 (6.0%), p < 0.0001. B-type natriuretic peptide quartile remained highly predictive of mortality even after adjustment for age, gender, systolic blood pressure, blood urea nitrogen, creatinine, sodium, pulse, and dyspnea at rest, Q4 versus Q1 (adjusted odds ratio 2.23 [95% confidence interval 1.91 to 2.62, p < 0.0001]). The BNP quartiles independently predicted mortality in patients with reduced and preserved systolic function. Conclusions: An elevated admission BNP level is a significant predictor of in-hospital mortality in acute decompensated HF with either reduced or preserved systolic function, independent of other clinical and laboratory variables. (Registry for Acute Decompensated Heart Failure Patients; ; NCT00366639). ? 2007 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock","given":"William F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Phillips","given":"Christopher O.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Givertz","given":"Michael M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-14","issue":"19","issued":{"date-parts":[["2007"]]},"page":"1943-1950","title":"Admission B-Type Natriuretic Peptide Levels and In-Hospital Mortality in Acute Decompensated Heart Failure","type":"article-journal","volume":"49"},"uris":[""]},{"id":"ITEM-15","itemData":{"DOI":"10.1159/000093612","ISSN":"0008-6312","PMID":"16741357","abstract":"BACKGROUND: Since most acute decompensated heart failure (ADHF) patients present for hospital care via the emergency department (ED), we sought to determine the impact of early ED initiation of ADHF-specific therapy, as indicated by nesiritide use, on subsequent outcomes. METHODS: We queried the Acute Decompensated Heart Failure National Registry (ADHERE) to identify patients with initial systolic blood pressure >90 mm Hg and negative cardiac biomarkers, hospitalized after presentation to the ED, who received nesiritide but no other intravenous vasoactive drugs. Intensive care unit use and total hospital length of stay were compared based on the hospital unit where nesiritide therapy was initiated after multivariate adjustment for baseline differences in study populations. RESULTS: Nesiritide was started in the ED in 1,613 patients (EDN group) and after admission to an inpatient unit in 2,687 patients (INN group). EDN patients had higher baseline systolic and diastolic blood pressure (both p < 0.001); while INN patients were more likely to be male and have baseline renal dysfunction (both p < 0.001). Nesiritide was initiated a median of 2.8 and 15.5 h after presentation in EDN and INN patients, respectively (p < 0.001). Compared to INN, EDN patients had a shorter adjusted mean total hospital length of stay (5.4 vs. 6.9 days; p < 0.001), were less likely to require transfer to the intensive care unit from another inpatient unit (odds ratio [OR]: 0.301; 95% confidence interval [CI]: 0.206-0.440), and were more likely to be discharged home (OR: 1.154; 95% CI: 1.005-1.325). CONCLUSIONS: Initiation of ADHF-specific therapy early, while the patient is in the ED, is associated with improved clinical outcomes.","author":[{"dropping-particle":"","family":"Peacock","given":"W Frank","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Cardiology","id":"ITEM-15","issue":"1","issued":{"date-parts":[["2007"]]},"page":"44-51","title":"Impact of early initiation of intravenous therapy for acute decompensated heart failure on outcomes in ADHERE.","type":"article-journal","volume":"107"},"uris":[""]},{"id":"ITEM-16","itemData":{"DOI":"10.1016/j.ahj.2006.09.007","ISSN":"00028703","PMID":"17174642","abstract":"BACKGROUND: Prior studies on chronic systolic heart failure (HF) have demonstrated that body mass index (BMI) is inversely associated with mortality, the so-called obesity paradox. The aim of this study was to determine whether BMI influences the mortality risk in acute decompensated HF, a subject not previously studied. METHODS: The Acute Decompensated Heart Failure National Registry was analyzed for acute HF hospitalizations in 263 hospitals in the United States from October 2001 through December 2004. Patients with documented height and weight were divided into BMI (measured in kilograms per square meter) quartiles. Inhospital mortality by BMI quartile for all the patients and for those with reduced (n = 43,255) and preserved (n = 37,901) systolic function was assessed. RESULTS: Body mass index quartiles in the 108,927 hospitalizations were QI (16.0-23.6 kg/m2), QII (23.7-27.7 kg/m2), QIII (27.8-33.3 kg/m2), and QIV (33.4-60.0 kg/m2). Patients in the higher BMI quartiles were younger, had more diabetes, and had a higher left ventricular ejection fraction. Inhospital mortality rates decreased in a near-linear fashion across successively higher BMI quartiles. After adjustments for age, sex, blood urea nitrogen, blood pressure, creatinine, sodium, heart rate, and dyspnea at rest, BMI quartile still predicted mortality risk. For every 5-U increase in BMI, the odds of risk-adjusted mortality was 10% lower (95% CI 0.88-0.93, P < .0001). CONCLUSIONS: In this cohort of hospitalized patients with HF, higher BMI was associated with lower inhospital mortality risk. The relationship between BMI and adverse outcomes in HF appears to be complex and deserving of further study.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Srikanthan","given":"Preethi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Costanzo","given":"Maria Rosa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cintron","given":"Guillermo B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American heart journal","id":"ITEM-16","issue":"1","issued":{"date-parts":[["2007"]]},"page":"74-81","title":"An obesity paradox in acute heart failure: analysis of body mass index and inhospital mortality for 108,927 patients in the Acute Decompensated Heart Failure National Registry.","type":"article-journal","volume":"153"},"uris":[""]},{"id":"ITEM-17","itemData":{"DOI":"10.1016/j.annemergmed.2007.04.005","ISSN":"01960644","PMID":"17949853","abstract":"Study objective: Inhaled bronchodilators are often used in the emergency department (ED) before a definitive diagnosis is made. We evaluated the association between inhaled bronchodilators and outcomes in acute decompensated heart failure patients without chronic obstructive pulmonary disease. Methods: We conducted an analysis of the Acute Decompensated Heart Failure National Registry Emergency Module registry of patients with a principal discharge diagnosis of acute decompensated heart failure enrolled at 76 academic or community EDs. Dichotomous outcomes (mortality, ED discharges, ICU admission, ED IV vasodilator use, new dialysis, ED or in patient endotracheal intubation, ED BiPAP, and asymptomatic at discharge) in patients without a history of chronic obstructive pulmonary disease who were given bronchodilators were compared to those who were not given bronchodilators using logistic regression; odds ratios (ORs) and 95% confidence intervals (CIs) were calculated; and propensity score adjustments were made. Results: Of the 10,978 patients enrolled, 7299 (66.5%) did not have a history of chronic obstructive pulmonary disease. Bronchodilators were administered by the EMS or in the ED to 2317 (21%) patients. Patients without chronic obstructive pulmonary disease given bronchodilators were more likely to receive ED IV vasodilators (28.4% vs. 16.9%; propensity adjusted OR 1.40 [95% CI 1.18-1.67]) and in-patient mechanical ventilation (6.0% vs. 2.4%; propensity adjusted OR 1.69 [95% CI 1.21-2.37]) than patients without chronic obstructive pulmonary disease who were not given bronchodilators. Hospital mortality in patients without chronic obstructive pulmonary disease was similar regardless of bronchodilator treatment (3.4% vs. 2.6%, propensity adjusted OR 1.02 [95% CI 0.67, 1.56]). Conclusion: Many acute decompensated heart failure patients without a history of chronic obstructive pulmonary disease receive inhaled bronchodilators. Bronchodilator use was associated with a greater need for aggressive interventions and monitoring, and this may reflect an adverse effect of bronchodilators or it may be a marker for patients with more severe disease. ? 2008 American College of Emergency Physicians.","author":[{"dropping-particle":"","family":"Singer","given":"Adam J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Char","given":"Douglas M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kirk","given":"J. Douglas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hollander","given":"Judd E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Summers","given":"Richard","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Christopher C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kellerman","given":"Lois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock","given":"William Frank","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Annals of Emergency Medicine","id":"ITEM-17","issue":"1","issued":{"date-parts":[["2008"]]},"page":"25-34","title":"Bronchodilator Therapy in Acute Decompensated Heart Failure Patients Without a History of Chronic Obstructive Pulmonary Disease","type":"article-journal","volume":"51"},"uris":[""]},{"id":"ITEM-18","itemData":{"DOI":"10.1111/j.1553-2712.2008.00059.x","ISBN":"1069-6563","ISSN":"10696563","PMID":"18370990","abstract":"OBJECTIVES: Continuous or bilevel positive airway pressure ventilation, called noninvasive ventilation (NIV), is a controversial therapy for acute decompensated heart failure (ADHF). While NIV is considered safe and effective in patients with chronic obstructive pulmonary disease (COPD), clinical trial data that have addressed safety in ADHF patients are limited, with some suggestion of increased mortality. The objective of this study was to assess mortality outcomes associated with NIV and to determine if a failed trial of NIV followed by endotracheal intubation (ETI) (NIV failure) is associated with worse outcomes, compared to immediate ETI. METHODS: This was a retrospective analysis of the Acute Decompensated Heart Failure National Registry (ADHERE), which enrolls patients with treatment for, or with a primary discharge diagnosis of, ADHF. The authors compared characteristics and outcomes in four groups: no ventilation, NIV success, NIV failure, and ETI. One-way analysis of variance or Wilcoxon testing was performed for continuous data, and chi-square tests were used for categorical data. In addition, multivariable logistic regression was used to adjust mortality comparisons for risk factors. RESULTS: Entry criteria were met by 37,372 patients, of which 2,430 had ventilation assistance. Of the ventilation group, 1,688 (69.5%) were deemed NIV success, 72 (3.0%) were NIV failures, and 670 (27.6%) required ETI. The NIV failure group had the lowest O(2) saturation (SaO(2)) (84 +/- 16%), compared to either NIV success (89.6 +/- 10%) or ETI (88 +/- 13%; p = 0.017). ETI patients were more likely to receive vasoactive medications (p < 0.001) than the NIV success cohort. When comparing NIV failures to ETI, there were no differences in treatment during hospitalization (p > 0.05); other than that the NIV failure group more often received vasodilators (68.1% vs. 54.3%; p = 0.026). In-hospital mortality was 7.9% with NIV, 13.9% with NIV failure, and 15.4% with ETI. After risk adjustment, the mortality odds ratio for NIV failure versus ETI increased to 1.43, although this endpoint was not statistically significant. CONCLUSIONS: In this analysis of ADHF patients receiving NIV to date, patients placed on NIV for ADHF fared better than patients requiring immediate ETI. Patients who failed NIV and required ETI still experienced lower mortality than those initially placed on ETI. Thus, while the ETI group may be more severely ill, starting therapy with NIV instead of i…","author":[{"dropping-particle":"","family":"Tallman","given":"Thomas a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock","given":"W. Frank","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Blicker","given":"Jamie Z.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Weber","given":"James","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Academic Emergency Medicine","id":"ITEM-18","issue":"4","issued":{"date-parts":[["2008"]]},"page":"355-362","title":"Noninvasive ventilation outcomes in 2,430 acute decompensated heart failure patients: An ADHERE registry analysis","type":"article-journal","volume":"15"},"uris":[""]},{"id":"ITEM-19","itemData":{"DOI":"10.1016/j.jacc.2008.05.010","ISSN":"07351097","PMID":"18687247","abstract":"Objectives: We undertook this analysis to determine whether there is a relationship between the time to measurement of immunoreactive B-type natriuretic peptide (iBNP) and early intervention for acutely decompensated heart failure (ADHF) and whether these variables are associated with morbidity and mortality in ADHF patients. Background: Although natriuretic peptides (NPs) can aid emergency department (ED) physicians in the diagnosis of ADHF, the relationship between the time to measurement of NP levels and time to treatment is not clear. In addition, the impact of time to treatment on clinical outcomes has not been demonstrated. Methods: Patients from ADHERE (Acute Decompensated Heart Failure National Registry) who were admitted to the ED and who received intravenous diuretics were included. Recordings of iBNP levels and the timing of intravenous diuretic therapy were documented. Patients were divided by quartiles of time to treatment and iBNP levels, creating 16 categories. Results: In 58,465 ADHF episodes from 209 hospitals, patients with the longest average time to iBNP draw also had the longest time to treatment. Mean ED time increased with increased time-to-treatment quartiles. Rales on initial examination were associated with early recognition of HF and earlier institution of therapy. The later the treatment took place, the fewer patients were asymptomatic at the time of hospital discharge. Within the time-to-treatment quartiles, mortality increased with increasing iBNP. Treatment delay was independently, but modestly, associated with increased in-hospital mortality with a risk-adjusted odds ratio 1.021, 95% confidence interval 1.010 to 1.033, and p < 0.0001, per every 4-h delay. Conclusions: In the ED setting, delayed measurement of iBNP levels and delay in treatment for ADHF were strongly associated. These delays were linked with modestly increased in-hospital mortality, independent of other prognostic variables. The adverse impact of delay was most notable in patients with greater iBNP levels (Registry for Acute Decompensated Heart Failure Patients; NCT00366639). ?? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Maisel","given":"Alan S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock","given":"William F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McMullin","given":"N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jessie","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-19","issue":"7","issued":{"date-parts":[["2008"]]},"page":"534-540","title":"Timing of Immunoreactive B-Type Natriuretic Peptide Levels and Treatment Delay in Acute Decompensated Heart Failure. An ADHERE (Acute Decompensated Heart Failure National Registry) Analysis","type":"article-journal","volume":"52"},"uris":[""]},{"id":"ITEM-20","itemData":{"DOI":"10.1016/j.cardfail.2007.10.017","ISSN":"10719164","PMID":"18325459","abstract":"Background: Venous thromboembolism (VTE) is a concerning problem for hospitalized heart failure (HF) patients. Current recommendations are that all hospitalized New York Heart Association Class III or IV HF patients should receive VTE prophylaxis. Our purpose was to describe the rate of use and the characteristics of patients receiving VTE prophylaxis in the Acute Decompensated Heart Failure National Registry (ADHERE). Methods and Results: HF hospitalization episodes in ADHERE were analyzed. Patients were excluded from analysis if they were receiving Coumadin or intravenous heparin, had elevated troponin levels, underwent cardiac catheterization or dialysis before or during hospitalization, or were initially admitted to the intensive care unit. VTE prophylaxis was defined as low-molecular-weight or subcutaneous unfractionated heparin administered at any time during hospitalization and intravenous vasoactive therapy was defined as any inotrope, inodilator, or vasodilator. Chi-square, analysis of variance, and Wilcoxon tests were used for univariate and multivariate analyses. Logistic regression was used to evaluate outcomes. A total of 155,073 entries were evaluated, with 71,376 eligible for VTE prophylaxis; 21,847 (31%) received VTE prophylaxis. VTE prophylaxis patients were more often African American (28% versus 21%) or admitted from the emergency department (84% versus 79%), compared with those who did not receive VTE prophylaxis (both P < .0001). Medical history and initial presentation characteristics were similar, except edema, which was more likely in VTE prophylaxis patients (71% versus 66%, P < .0001). Patients receiving VTE prophylaxis more often received an intravenous vasoactive agent (23% versus 18%), angiotensin-converting enzyme inhibitor (61% versus 54%), or β-blocker (63% versus 58%) during their hospitalization and were more likely discharged on an angiotensin-converting enzyme inhibitor (53% versus 49%) or β-blocker (57% versus 54%) than non-VTE prophylaxis patients, all P < .0001. VTE prophylaxis patients were more often admitted to the intensive care unit (4.8% versus 2.5%, P < .0001) and had longer median hospital stays (4.2 versus 3.8 days, P < .0001). Mortality was similar between cohorts (3.0% versus 2.9%, P = .69). Conclusions: Despite recommendations that all hospitalized New York Heart Association III and IV CHF patients receive venous thromboembolic disease prophylaxis, less than one third of eligible patients receive this g…","author":[{"dropping-particle":"","family":"Jois-Bilowich","given":"Preeti","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Michota","given":"Frank","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bartholomew","given":"John R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Glauser","given":"Jonathan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Diercks","given":"Deborah","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Weber","given":"James","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock IV","given":"W. Frank","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-20","issue":"2","issued":{"date-parts":[["2008"]]},"page":"127-132","title":"Venous Thromboembolism Prophylaxis in Hospitalized Heart Failure Patients","type":"article-journal","volume":"14"},"uris":[""]},{"id":"ITEM-21","itemData":{"DOI":"10.1016/j.ahj.2007.10.020","ISBN":"1097-6744 (Electronic)\\n0002-8703 (Linking)","ISSN":"00028703","PMID":"18215606","abstract":"Background: An improved understanding of the characteristics, treatment, and outcome of patients with \"Stage D\" heart failure (HF) may improve patient outcomes. We conducted an analysis of the ADHERE LM to enhance this understanding. Methods: ADHERE LM is a multicenter registry designed specifically to prospectively collect observational data on chronic Stage D HF. The findings were analyzed and compared to data from ADHERE CM, a multicenter registry designed to prospectively collect data on the entire spectrum of acute decompensated HF. Descriptive statistics and Kaplan-Meier analysis were used to evaluate data from all 1433 patients in ADHERE LM. Results: Compared to patients with acute decompensated HF, patients with chronic Stage D HF tended to be younger (69.6 vs 72.8 years), males (65% vs 49%), with hyperlipidemia/dyslipidemia (65% vs 41%), and with coronary artery disease (73% vs 57%). In Stage D patients, use of intravenous diuretics (73%) and vasoactive agents (84%) was common. Kaplan-Meier-estimated 1-year survival was 71.9% (95% CI 69.3%-74.5%) and estimated 1-year freedom from hospitalization or death was 32.9% (95% CI 30.2%-35.6%). Conclusions: Patients with Stage D HF are frequently males with dyslipidemia and coronary artery disease. Morbidity and mortality are high. Therapeutic decisions based on studies in HF patients with different characteristics may not be applicable; additional research is needed to determine optimal therapeutic regimens for these patients. ?? 2008 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Costanzo","given":"Maria R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-21","issue":"2","issued":{"date-parts":[["2008"]]},"page":"339-347","title":"Characteristics of \"Stage D\" heart failure: Insights from the Acute Decompensated Heart Failure National Registry Longitudinal Module (ADHERE LM)","type":"article-journal","volume":"155"},"uris":[""]},{"id":"ITEM-22","itemData":{"DOI":"10.1111/j.1751-7133.2008.04641.x","ISBN":"1527-5299","ISSN":"15275299","PMID":"18550923","abstract":"The substantial public health impact of hospitalization for acute decompensated heart failure, from an economic and clinical perspective, has generated substantial interest in understanding predictors of risk in this syndrome. Utilization of classification and regression tree (CART) analysis on the Acute Decompensated Heart Failure National Registry (ADHERE) dataset has provided important risk stratification from readily available clinical variables. Increasingly, high-risk patients were identified by combination of blood urea nitrogen level of 43 mg/dL, serum creatinine level of 2.75 mg/dL, and systolic blood pressure less than 115 mm Hg, which were all independent predictors of high risk for in-hospital mortality. On the basis of these 3 variables, acutely decompensated heart failure patients can be readily stratified into groups at low, intermediate, and high risk for in-hospital mortality, with mortality risks ranging from 2.1% to 21.9%. Although risk stratification alone cannot improve outcomes, identification of patients at high and low risk may improve resource utilization and better focus the intensity of care according to outcome.","author":[{"dropping-particle":"","family":"Adams","given":"Kirkwood F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Uddin","given":"Nabil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Herbert Patterson","given":"J.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-22","issue":"3","issued":{"date-parts":[["2008"]]},"page":"127-134","title":"Clinical predictors of in-hospital mortality in acutely decompensated heart failure-piecing together the outcome puzzle","type":"article-journal","volume":"14"},"uris":[""]},{"id":"ITEM-23","itemData":{"DOI":"10.1111/j.1553-2712.2008.00030.x","ISBN":"1553-2712 (Electronic)\\r1069-6563 (Linking)","ISSN":"10696563","PMID":"18275445","abstract":"OBJECTIVES: It has been reported that the mortality risk for heart failure differs between men and women. It has been postulated that this is due to differences in comorbid features. Variation in risk profiles by gender may limit the performance of stratification algorithms available for heart failure in women. This analysis examined the ability of a published risk stratification model to predict outcomes in women. METHODS: The Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM) database was used. Characteristics, treatments, and outcomes for men and women were compared. The ADHERE registry classification and regression tree (CART) analysis was used for the risk stratification evaluation. RESULTS: Of 10,984 ADHERE-EM patients, 5,736 (52.2%) were women. In-hospital mortality was similar between men and women (p = 0.727). Significant differences (p < 0.0002) were noted by gender in all three variables in the CART model (blood urea nitrogen [BUN] > or = 43 mg/dL, systolic blood pressure < 115 mm Hg, and serum creatinine > or = 2.75 mg/dL). However, the CART model effectively stratified both genders into distinct risk groups with no significant difference in mortality by gender within stratified groups. CONCLUSIONS: The ADHERE Registry CART tool is effective at predicting risk in ED patients, regardless of gender.","author":[{"dropping-particle":"","family":"Diercks","given":"Deborah B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kirk","given":"J. Douglas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hollander","given":"Judd E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Weber","given":"Jim Edward","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Summers","given":"Richard L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock IV","given":"W. Franklin","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Academic Emergency Medicine","id":"ITEM-23","issue":"2","issued":{"date-parts":[["2008"]]},"page":"151-158","title":"Risk stratification in women enrolled in the Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM)","type":"article-journal","volume":"15"},"uris":[""]},{"id":"ITEM-24","itemData":{"DOI":"10.1016/j.amjcard.2008.06.045","ISBN":"1879-1913 (Electronic)\\r0002-9149 (Linking)","ISSN":"00029149","PMID":"18940295","abstract":"Illicit stimulant drug use may have a profound clinical impact in acute decompensated heart failure (ADHF). The chronic use of cocaine and methamphetamine may lead to overt cardiomyopathy and ADHF. The Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM) collected data on patients presenting to emergency departments with ADHF at 83 geographically dispersed hospitals in the United States. This registry was queried to determine the rate of self-reported illicit drug use in emergency department patients presenting with ADHF and compare these patients with those without illicit drug use. The registry enrolled 11,258 patients with ADHF with drug use data from January 2004 to March 2006. Of these patients, 594 (5.3%) self-reported current or past stimulant drug use. Compared with nonusers, these patients were more likely to be younger (median age 49.7 vs 76.1 years), to be African American (odds ratio 11.9, 95% confidence interval 9.8 to 14.4), and to have left ventricular ejection fractions <40% (odds ratio 3.4, 95% confidence interval 2.8 to 4.2). Admitted users had no difference in mortality (adjusted odds ratio 0.83, 95% confidence interval 0.25 to 2.72) compared with nonusers. In conclusion, data from ADHERE-EM suggest that a clinically important percentage of patients with ADHF report the use of illicit stimulant drugs. Although these patients are younger with a greater degree of LV dysfunction, they did not have greater risk-adjusted mortality. ? 2008 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Diercks","given":"Deborah B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kirk","given":"J. Douglas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jois-Bilowich","given":"Preeti","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hollander","given":"Judd E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Weber","given":"Jim Edward","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock IV","given":"W. Franklin","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-24","issue":"9","issued":{"date-parts":[["2008"]]},"page":"1216-1219","title":"Illicit Stimulant Use in a United States Heart Failure Population Presenting to the Emergency Department (from the Acute Decompensated Heart Failure National Registry Emergency Module)","type":"article-journal","volume":"102"},"uris":[""]},{"id":"ITEM-25","itemData":{"DOI":"10.1056/NEJMoa0706824","ISSN":"1533-4406","PMID":"18480204","abstract":"BACKGROUND: Cardiac troponin provides diagnostic and prognostic information in acute coronary syndromes, but its role in acute decompensated heart failure is unclear. The purpose of our study was to describe the association between elevated cardiac troponin levels and adverse events in hospitalized patients with acute decompensated heart failure. METHODS: We analyzed hospitalizations for acute decompensated heart failure between October 2001 and January 2004 that were recorded in the Acute Decompensated Heart Failure National Registry (ADHERE). Entry criteria included a troponin level that was obtained at the time of hospitalization in patients with a serum creatinine level of less than 2.0 mg per deciliter (177 micromol per liter). A positive troponin test was defined as a cardiac troponin I level of 1.0 microg per liter or higher or a cardiac troponin T level of 0.1 microg per liter or higher. RESULTS: Troponin was measured at the time of admission in 84,872 of 105,388 patients (80.5%) who were hospitalized for acute decompensated heart failure. Of these patients, 67,924 had a creatinine level of less than 2.0 mg per deciliter. Cardiac troponin I was measured in 61,379 patients, and cardiac troponin T in 7880 patients (both proteins were measured in 1335 patients). Overall, 4240 patients (6.2%) were positive for troponin. Patients who were positive for troponin had lower systolic blood pressure on admission, a lower ejection fraction, and higher in-hospital mortality (8.0% vs. 2.7%, P<0.001) than those who were negative for troponin. The adjusted odds ratio for death in the group of patients with a positive troponin test was 2.55 (95% confidence interval, 2.24 to 2.89; P<0.001 by the Wald test). CONCLUSIONS: In patients with acute decompensated heart failure, a positive cardiac troponin test is associated with higher in-hospital mortality, independently of other predictive variables. ( number, NCT00366639 [].).","author":[{"dropping-particle":"","family":"Peacock","given":"W Frank","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marco","given":"Teresa","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Diercks","given":"Deborah","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Apple","given":"Fred S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wu","given":"Alan H B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The New England journal of medicine","id":"ITEM-25","issue":"20","issued":{"date-parts":[["2008"]]},"page":"2117-2126","title":"Cardiac troponin and outcome in acute heart failure.","type":"article-journal","volume":"358"},"uris":[""]},{"id":"ITEM-26","itemData":{"DOI":"10.1136/emj.2007.050419","ISBN":"1472-0213 (Electronic)\r1472-0205 (Linking)","ISSN":"1472-0213","PMID":"18356349","abstract":"OBJECTIVE: Morphine is a long-standing therapy in acute decompensated heart failure (ADHF), despite few supporting data. A study was undertaken to compare the outcomes of patients who did and did not receive morphine for ADHF. METHODS: The study was a retrospective analysis of the Acute Decompensated Heart Failure National Registry (ADHERE) which enrols hospitalised patients with treatment for, or a primary discharge diagnosis of, ADHF. Patients were stratified into cohorts based on whether or not they received intravenous morphine. ANOVA, Wilcoxon and chi(2) tests were used in univariate analysis, followed by multivariate analysis controlling for parameters previously associated with mortality. Analyses were repeated for ejection fraction subgroups and in patients not on mechanical ventilation. RESULTS: There were 147 362 hospitalisations in ADHERE at December 2004, 20 782 of whom (14.1%) received morphine and 126 580 (85.9%) did not. There were no clinically relevant differences between the groups in the initial age, heart rate, blood pressure, blood urea nitrogen, creatinine, haemoglobin, ejection fraction or atrial fibrillation. A higher prevalence of rest dyspnoea, congestion on chest radiography, rales and raised troponin occurred in the morphine group. Patients on morphine received more inotropes and vasodilators, were more likely to require mechanical ventilation (15.4% vs 2.8%), had a longer median hospitalisation (5.6 vs 4.2 days), more ICU admissions (38.7% vs 14.4%), and had greater mortality (13.0% vs 2.4%) (all p<0.001). Even after risk adjustment and exclusion of ventilated patients, morphine was an independent predictor of mortality (OR 4.84 (95% CI 4.52 to 5.18), p<0.001). CONCLUSIONS: Morphine is associated with increased adverse events in ADHF which includes a greater frequency of mechanical ventilation, prolonged hospitalisation, more ICU admissions and higher mortality.","author":[{"dropping-particle":"","family":"Peacock","given":"W F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hollander","given":"J E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Diercks","given":"D B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"C L","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Emergency medicine journal : EMJ","id":"ITEM-26","issue":"4","issued":{"date-parts":[["2008"]]},"page":"205-209","title":"Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis.","type":"article-journal","volume":"25"},"uris":[""]},{"id":"ITEM-27","itemData":{"DOI":"10.1001/archinte.168.11.1152","ISBN":"1538-3679","ISSN":"1538-3679","PMID":"18541822","abstract":"BACKGROUND: Outcomes in patients with chronic heart failure vary by race. Racial differences in the characteristics and outcomes of patients with acute decompensated heart failure (ADHF) have not been well characterized. Therefore, we assessed race-related differences in presentation, treatment, in-patient experiences, and short-term mortality due to ADHF before and after accounting for known covariates. METHODS: The Acute Decompensated Heart Failure National Registry database was analyzed to evaluate demographic and mortality differences in African American and white patients with ADHF entered into the database from its initiation in September 2001 to December 31, 2004. Stratified analyses by cause, age, left ventricular function, and history of heart failure subgroups were also conducted. RESULTS: A total of 105,872 episodes of ADHF occurred in white patients and 29,862 occurred in African American patients. African American patients with ADHF were younger than white patients (mean [SD] age, 63.5 [15.4] vs 72.5 [12.5] years) and had lower mean left ventricular ejection fractions. The prevalence of hypertension, diabetes mellitus, and obesity was higher in African American patients. African American race was associated with lower in-hospital mortality after adjustment for known predictors (2.1% vs 4.5%; adjusted odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72-0.87; P < .001). This association persisted for all age cohorts, was independent of the use of intravenous vasoactive drugs, and was especially present in African American patients in the nonischemic subgroup (adjusted OR, 0.74; 95% CI, 0.57-0.96) but not the ischemic subgroup (adjusted OR, 0.91; 95% CI, 0.76-1.09). CONCLUSION: In ADHF, African American race is associated with lower in-hospital mortality compared with white race, despite certain indicators of increased disease severity.","author":[{"dropping-particle":"","family":"Kamath","given":"Sandeep a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drazner","given":"Mark H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Archives of internal medicine","id":"ITEM-27","issue":"11","issued":{"date-parts":[["2008"]]},"page":"1152-1158","title":"Characteristics and outcomes in African American patients with decompensated heart failure.","type":"article-journal","volume":"168"},"uris":[""]},{"id":"ITEM-28","itemData":{"DOI":"10.1093/eurjhf/hfr064","ISBN":"1879-0844","ISSN":"13889842","PMID":"21712289","abstract":"To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF).","author":[{"dropping-particle":"","family":"West","given":"Ryenn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kociol","given":"Robb","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oconnor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-28","issue":"9","issued":{"date-parts":[["2011"]]},"page":"945-952","title":"Characterization of heart failure patients with preserved ejection fraction: A comparison between ADHERE-US registry and ADHERE-International registry","type":"article-journal","volume":"13"},"uris":[""]},{"id":"ITEM-29","itemData":{"DOI":"10.1016/j.ahj.2012.03.009","ISSN":"00028703","PMID":"22709752","abstract":"Background: Patients hospitalized with heart failure (HF) have elevated B-type natriuretic peptide (BNP) levels and increased risk for thromboembolic events. Associations between BNP level and thromboembolic events in patients with HF without atrial fibrillation (AF) are not well studied. Methods: We linked data from the ADHERE registry for 2003 through 2006 with Medicare claims to identify patients ≥65 years who were hospitalized with HF, did not have AF, and did not receive warfarin at discharge. We estimated rates of all-cause mortality, thromboembolic events, myocardial infarction (MI), and stroke using Kaplan-Meier methods and the cumulative incidence function. We used Cox models to assess associations between log BNP level and each outcome after adjustment for potential confounders. Results: The study population included 11,679 patients from 146 sites. Patients in the highest quartile of BNP level were older and more often male and African American. They had higher rates of coronary artery disease, renal insufficiency, and peripheral vascular disease and lower rates of diabetes mellitus and chronic obstructive pulmonary disease. After multivariable adjustment, each 30% increase in BNP level was associated with increased risks of death (hazard ratio 1.07, 95% CI 1.05-1.08) and MI (1.07, 1.04-1.10) but not thromboembolism or stroke. Conclusion: Higher BNP level upon admission with HF among older patients without AF was associated with increased risks of MI and mortality; however, higher BNP level was not associated with subsequent thromboembolism or stroke. ? 2012 Mosby, Inc.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Klaskala","given":"Winslow","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-29","issue":"6","issued":{"date-parts":[["2012"]]},"page":"994-1001","publisher":"Mosby, Inc.","title":"B-type natriuretic peptide level and postdischarge thrombotic events in older patients hospitalized with heart failure: Insights from the Acute Decompensated Heart Failure National Registry","type":"article-journal","volume":"163"},"uris":[""]},{"id":"ITEM-30","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.113.000838","ISSN":"1941-3289","author":[{"dropping-particle":"","family":"Khazanie","given":"P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"B. G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"L. G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"G. C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"S. C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"P. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"S. M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"J. P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"F. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"P. N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"J. P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"a. F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"L. H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-30","issue":"6","issued":{"date-parts":[["2014"]]},"page":"926-934","title":"Clinical Effectiveness of Cardiac Resynchronization Therapy Versus Medical Therapy Alone Among Patients With Heart Failure: Analysis of the ICD Registry and ADHERE","type":"article-journal","volume":"7"},"uris":[""]},{"id":"ITEM-31","itemData":{"DOI":"10.1161/JAHA.114.001088","ISSN":"2047-9980","PMID":"25015076","abstract":"BackgroundA subset of patients hospitalized with acute heart failure experiences worsening clinical status and requires escalation of therapy. Worsening heart failure is an end point in many clinical trials, but little is known about its prevalence in clinical practice and its associated outcomes. Methods and ResultsWe analyzed inpatient data from the Acute Decompensated Heart Failure National Registry linked to Medicare claims to examine the prevalence and outcomes of patients with worsening heart failure, defined as the need for escalation of therapy at least 12 hours after hospital presentation. We compared patients with worsening heart failure to patients with an uncomplicated hospital course and patients with a complicated presentation. Of 63 727 patients hospitalized with acute heart failure, 11% developed worsening heart failure. These patients had the highest observed rates of mortality, all-cause readmission, and Medicare payments at 30 days and 1 year after hospitalization (P < 0.001 for all comparisons). The adjusted hazards of 30-day mortality were 2.56 (99% CI, 2.34 to 2.80) compared with an uncomplicated course and 1.29 (99% CI, 1.17 to 1.42) compared with a complicated presentation. The adjusted cost ratios for postdischarge Medicare payments at 30 days were 1.35 (99% CI, 1.24 to 1.46) compared with an uncomplicated course and 1.11 (99% CI, 1.02 to 1.22) compared with a complicated presentation. ConclusionsIn-hospital worsening heart failure was common and was associated with higher rates of mortality, all-cause readmission, and postdischarge Medicare payments. Prevention and treatment of in-hospital worsening heart failure represents an important goal for patients hospitalized with acute heart failure.","author":[{"dropping-particle":"","family":"DeVore","given":"Adam D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sharma","given":"Puza P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"Laura G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mentz","given":"Robert J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Waltman Johnson","given":"Katherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAHA","id":"ITEM-31","issue":"4","issued":{"date-parts":[["2014"]]},"page":"e001088-","title":"In-Hospital Worsening Heart Failure and Associations With Mortality, Readmission, and Healthcare Utilization","type":"article-journal","volume":"3"},"uris":[""]}],"mendeley":{"formattedCitation":"^{1,2,11–20,3,21–30,4,31,5–10}","plainTextFormattedCitation":"1,2,11–20,3,21–30,4,31,5–10","previouslyFormattedCitation":"^1–31"},"properties":{"noteIndex":0},"schema":""}1,2,11–20,3,21–30,4,31,5–10ADHERE-I: Acute Decompensated Heart Failure National Registry International ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfr064","ISBN":"1879-0844","ISSN":"13889842","PMID":"21712289","abstract":"To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF).","author":[{"dropping-particle":"","family":"West","given":"Ryenn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kociol","given":"Robb","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oconnor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2011"]]},"page":"945-952","title":"Characterization of heart failure patients with preserved ejection fraction: A comparison between ADHERE-US registry and ADHERE-International registry","type":"article-journal","volume":"13"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.ahj.2012.02.008","ISBN":"1097-6744","ISSN":"00028703","PMID":"22607858","abstract":"Background: We sought to characterize patient factors and regional variations associated with vitamin K antagonist (VKA) use in patients with heart failure (HF) and atrial fibrillation (AF) in areas outside the United States and Europe. Methods: The ADHERE-International registry enrolled patients with decompensated HF from 10 Asia Pacific and Latin American countries from December 2005 to January 2009. Rates of VKA use in patients with HF and either new-onset AF or a history of AF were determined and compared according to CHADS 2 scores. Multivariable logistic regression and hierarchical modeling with random effects for hospitals were used to determine clinical and regional factors associated with VKA use at discharge. Results: Among 9,706 admissions, there were 2,358 (24.3%) with prior AF and 674 (6.9%) with new-onset AF. The median age was 71 years (25th-75th percentiles 59-79) for prior AF and 69 (57-80) for new-onset AF patients. The overall rate of VKA use at discharge was 39.5%. Vitamin K antagonist use at discharge was 36.2% in patients with CHADS 2 scores ≥2 versus 50.2% in patients with CHADS 2 score equal to 1 (P <.0001). Vitamin K antagonist use was 36.4% in patients with hypertension, 28.1% in patients >75 years old, 34.8% in diabetics, and 44.4% in those with prior stroke/transient ischemic attack. After adjusting for patient characteristics, the highest and lowest rates of anticoagulation were in Australia (65.2%) and Taiwan (25.1%). Conclusion: International use of guidelines-recommended anticoagulation in HF patients with AF varies significantly across countries and represents an important opportunity for improving quality of care. ? 2012 Mosby, Inc.","author":[{"dropping-particle":"","family":"Suarez","given":"Jorge","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Atherton","given":"John J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hayward","given":"Christopher S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krum","given":"Henry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopes","given":"Renato D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-2","issue":"5","issued":{"date-parts":[["2012"]]},"page":"804-811","publisher":"Mosby, Inc.","title":"International variation in use of oral anticoagulation among heart failure patients with atrial fibrillation","type":"article-journal","volume":"163"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.cardfail.2011.09.003","ISBN":"1071-9164","ISSN":"10719164","PMID":"22196846","abstract":"Background: Heart failure (HF) is a leading cause of hospitalization. Although a number of multicenter international HF hospital registries have been published, there are limited data for the Asia Pacific region. Methods: ADHERE (ie, Acute Decompensated Heart Failure Registry) International-Asia Pacific is an electronic web-based observational database of 10,171 patients hospitalized with a principal diagnosis of HF from 8 Asia-Pacific countries between January 2006 and December 2008. Results: The median age (67 years) varied by more than 2 decades across the region. Fifty-seven percent of patients were male. Ninety percent of patients were Asian and 8.4% were white. Dyspnea was the presenting symptom in 95%, with 80% having documented rales. During the index hospitalization, left ventricular function was assessed in 50%, and intravenous therapies included diuretics (85%), vasodilators (14%), and positive inotropes (15%). In-hospital mortality was 4.8%. Discharge medications included angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers (63%), β-blockers (41%), and aldosterone antagonists (31%). Conclusions: Compared with other multicenter registries, patients hospitalized with acute HF in the Asia Pacific region tend to present with more severe clinical symptoms and signs and are younger, especially in countries at an earlier stage in their epidemiological transition. Echocardiography and disease-modifying medications are used less often, highlighting potential opportunities to improve outcomes. ? 2012 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Atherton","given":"John J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hayward","given":"Christopher S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wan Ahmad","given":"Wan Azman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kwok","given":"Bernard","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jorge","given":"Jesus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krum","given":"Henry","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-3","issue":"1","issued":{"date-parts":[["2012"]]},"page":"82-88","publisher":"Elsevier Inc","title":"Patient characteristics from a regional multicenter database of acute decompensated heart failure in Asia Pacific (ADHERE International-Asia Pacific)","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"^28,32,33","plainTextFormattedCitation":"28,32,33","previouslyFormattedCitation":"^28,32,33"},"properties":{"noteIndex":0},"schema":""}28,32,33AHEAD: Acute Heart Failure Database ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/cc10584","ISBN":"0195-668X","ISSN":"1364-8535","PMID":"22152228","abstract":"INTRODUCTION: The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.\\n\\nMETHODS: The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.\\n\\nRESULTS: Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.\\n\\nCONCLUSIONS: The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.","author":[{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmír","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarová","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Critical Care","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2011"]]},"page":"R291","publisher":"BioMed Central Ltd","title":"Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry","type":"article-journal","volume":"15"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.jcrc.2012.03.011","ISSN":"08839441","PMID":"22699032","abstract":"Study Objective: The aim of this study was to explore the prognostic role of serum uric acid (UA) measurement in the hospital and long-term mortality assessment in subjects with acute heart failure (AHF) from the Acute HEart FAilure Database registry (AHEAD). The AHEAD registry comprised 4153 patients with AHF syndromes hospitalized at the AHEAD participating centers. Patients and Methods: The study included 1255 patients who were admitted to the AHEAD participating centers with acute decompensated chronic heart failure, de novo heart failure, or cardiogenic shock between September 2006 and October 2009 and who had information about serum UA concentration available at the time of hospital admission. The hospital and long-term mortality was followed using the centralized database of the Ministry of Health, Czech Republic. The mean age of the cohort was 73.4 years, the female population represented 43%, the median hospital stay was 8 days, and the mean hospital mortality was 7.6%. Results: The median UA concentration of the patients with AHF was 432 μmol/L (7.26 mg/dL), the median estimated glomerular filtration rate (eGFR) was 49.0 mL/min, and N-terminal pro-brain natriuretic peptide level was 5510 pg/mL. Among other laboratory variables, UA concentration greater than 515 μmol/L (8.67 mg/dL) was associated with increased hospital mortality (P < .001), as well as eGFR less than 30 mL/min (P < .001), Na 135 mmol/L or less, and positive troponin. Uric acid concentration greater than 500 μmol/L (8.41 mg/dL) was associated with increased long-term mortality (P < .001), followed by eGFR less than 30 mL/min (P < .001), Na 135 mmol/L or less, and hemoglobin level lower than 130 g/L (P < .001). The 1-year survival rate of patients discharged from hospital (n = 1159) was 75.6%, and the 2-year rate was 66.8%. Survival of patients treated with allopurinol for hyperuricemia was significantly lower compared with untreated subjects (70.1 vs 77.2 for 1-year survival and 60.3 vs 68.5 for 2-year survival). Conclusion: In patients with AHF, increased UA levels and documented allopurinol therapy for hyperuricemia were associated with increased hospital and long-term mortality. Allopurinol therapy is not a cause but the identifier of the subjects at risk. ? 2012 Elsevier Inc.","author":[{"dropping-particle":"","family":"Málek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O??ádal","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pa?enica","given":"Ji?í","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsk?","given":"Ji?í","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vítovec","given":"Ji?í","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsk?","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ale?","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marián","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Coufal","given":"Zdeněk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklík","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kruger","given":"Andreas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vondraková","given":"Dagmar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"?pinar","given":"Jind?ich","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Critical Care","id":"ITEM-2","issue":"6","issued":{"date-parts":[["2012"]]},"title":"Uric acid, allopurinol therapy, and mortality in patients with acute heart failure-results of the Acute HEart FAilure Database registry","type":"article-journal","volume":"27"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.5507/bp.2012.015","ISSN":"12138118","author":[{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ales","given":"Linhart","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zidova","given":"Klaudia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Littnerova","given":"Simona","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Biomedical Papers","id":"ITEM-3","issue":"1","issued":{"date-parts":[["2012"]]},"page":"21-28","title":"Gender differences in total cholesterol levels in patients with acute heart failure and its importance for short and long time prognosis","type":"article-journal","volume":"156"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.ejim.2012.11.005","ISSN":"09536205","PMID":"23219321","abstract":"Background The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival. ? 2012 European Federation of Internal Medicine.","author":[{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horakova","given":"Katerina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Internal Medicine","id":"ITEM-4","issue":"2","issued":{"date-parts":[["2013"]]},"page":"151-160","title":"Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)","type":"article-journal","volume":"24"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.5507/bp.2014.014","ISSN":"12138118","PMID":"24622040","abstract":"AIMS Liver pathology caused by cardiac dysfunction is relatively well recognized, however, its clinical importance has not been fully evaluated. The aim of this study was to assess the prevalence of liver function tests (LFTs) abnormalities and to identify associated factors mediating hepatic impairment in patients with acute heart failure (AHF). METHODS The AHEAD (Acute Heart Failure Database) registry is a database conducted in 9 university hospitals and 5 regional health care facilities in the Czech Republic. From December 2004 to October 2012, the data of 8818 patients were included. The inclusion criteria for the database followed the European guidelines for AHF. Serum activities of all LFTs and total bilirubin were available in 1473 patients at the baseline. RESULTS In patients with AHF, abnormal LFTs were seen in 76% patients (total bilirubin in 34%, γ-glutamyltransferase in 44%, alkaline phosphatase in 20%, aspartate aminotransferase in 42%, alanine aminotransferase in 35%). Patients with cardiogenic shock were more likely to have LFTs abnormalities compared to mild AHF and pulmonary oedema. LFTs abnormalities were strongly associated with AHF severity (left ventricular ejection fraction and NYHA functional class) and clinical manifestation. While hepatocellular LFTs pattern predominated in left sided forward AHF, cholestatic profile occurred mainly in bilateral and right sided AHF. Additionally, patients with moderate to severe tricuspid regurgitation had significantly higher prevalence of abnormalities in cholestatic LFTs. CONCLUSIONS Defining the LFTs profile typical for AHF plays an important role in management of AHF patients, since it may avoid redundant hepatic investigations and diagnostic misinterpretations.","author":[{"dropping-particle":"","family":"Vyskocilova","given":"Klaudia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mikusova","given":"Tereza","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Josef","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Littnerova","given":"Simona","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Biomedical Papers","id":"ITEM-5","issue":"Table 1","issued":{"date-parts":[["2014","3","13"]]},"title":"Prevalence and clinical significance of liver function abnormalities in patients with acute heart failure","type":"article-journal"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1007/s11739-012-0862-1","ISBN":"1970-9366 (Electronic)\r1828-0447 (Linking)","ISSN":"19709366","PMID":"23054408","author":[{"dropping-particle":"","family":"Václavík","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"?pinar","given":"Jind?ich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vindi?","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vítovec","given":"Ji?í","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsk?","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"?íhalík","given":"?estmír","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ale?","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Málek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Táborsk?","given":"Milo?","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsk?","given":"Ji?í","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marián","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fel??ci","given":"Marián","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklík","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pa?enica","given":"Ji?í","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Internal and Emergency Medicine","id":"ITEM-6","issue":"3","issued":{"date-parts":[["2014"]]},"page":"283-291","title":"ECG in patients with acute heart failure can predict in-hospital and long-term mortality","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1371/journal.pone.0117142","ISSN":"1932-6203","author":[{"dropping-particle":"","family":"Littnerova","given":"Simona","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jirí","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ostadal","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spac","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Hiti","given":"Hikmet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fojt","given":"Richard","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kruger","given":"Andreas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Josef","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mikusová","given":"Tereza","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Monhart","given":"Zdenek","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bohacova","given":"Stanislava","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pohludkova","given":"Lidka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rohac","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vondrakova","given":"Dagmar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vyskocilova","given":"Klaudia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Plos One","id":"ITEM-7","issue":"2","issued":{"date-parts":[["2015"]]},"page":"e0117142","title":"Positive Influence of Being Overweight/Obese on Long Term Survival in Patients Hospitalised Due to Acute Heart Failure","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"^34–40","plainTextFormattedCitation":"34–40","previouslyFormattedCitation":"^34–40"},"properties":{"noteIndex":0},"schema":""}34–40ALARM-HF: Acute Heart Failure Global Registry of Standard Treatment ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfq138","ISBN":"1879-0844","ISSN":"13889842","PMID":"20837636","abstract":"Acute pulmonary oedema (APE) is the second, after acutely decompensated chronic heart failure (ADHF), most frequent form of acute heart failure (AHF). This subanalysis examines the clinical profile, prognostic factors, and management of APE patients (n = 1820, 36.7%) included in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF).","author":[{"dropping-particle":"","family":"Parissis","given":"John T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nikolaou","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ikonomidis","given":"Ignatios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Delgado","given":"Juan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vilas-Boas","given":"Fabio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paraskevaidis","given":"Ioannis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mc Lean","given":"Antony","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kremastinos","given":"Dimitrios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2010"]]},"page":"1193-1202","title":"Acute pulmonary oedema: Clinical characteristics, prognostic factors, and in-hospital management","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1007/s00134-010-2113-0","ISBN":"0013401021130","ISSN":"03424642","PMID":"21210078","abstract":"We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward.","author":[{"dropping-particle":"","family":"Follath","given":"F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yilmaz","given":"M. B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Delgado","given":"J. F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"J. T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Porcher","given":"R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gayat","given":"E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Burrows","given":"Nigel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mclean","given":"a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vilas-Boas","given":"F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Intensive Care Medicine","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2011"]]},"page":"619-626","title":"Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)","type":"article-journal","volume":"37"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1007/s00134-010-2073-4","ISSN":"03424642","PMID":"21086112","abstract":"To date, treatment with intravenous (IV) agents such as vasodilators, diuretics, and inotropes has shown marginal or mixed benefits in acute heart failure (AHF) trials. The aim of this study was to identify the risks and benefits of IV drugs in patients hospitalized with acute decompensated heart failure.","author":[{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Porcher","given":"Raphael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gayat","given":"Etienne","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nikolaou","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Boas","given":"Fabio Vilas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Delgado","given":"J. F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Intensive Care Medicine","id":"ITEM-3","issue":"2","issued":{"date-parts":[["2011"]]},"page":"290-301","title":"Short-term survival by treatment among patients hospitalized with acute heart failure: The global ALARM-HF registry using propensity scoring methods","type":"article-journal","volume":"37"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.amjcard.2010.08.044","ISBN":"1879-1913 (Electronic)\r0002-9149 (Linking)","ISSN":"00029149","PMID":"21146691","abstract":"Acute heart failure (AHF) with preserved left ventricular ejection fraction (PLVEF) represents a significant part of AHF syndromes featuring particular characteristics. We sought to determine the clinical profile and predictors of in-hospital mortality in patients with AHF and PLVEF in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). This survey is an international observational study of 4,953 patients admitted for AHF in 9 countries (6 European countries, Mexico, and Australia) from October 2006 to March 2007. Patients with PLVEF were defined by an LVEF ≥ 45%. Of the total cohort, 25% of patients had PLVEF. In-hospital mortality was significantly lower in this subgroup (7% vs 11% in patients with decreased LVEF, p = 0.013). Candidate variables included demographics, baseline clinical findings, and treatment. Multivariate logistic regression analysis showed that the variables independently associated with in-hospital mortality included systolic blood pressure at admission (p <0.001), serum sodium (p = 0.041), positive troponin result (p = 0.023), serum creatinine >2 mg/dl (p = 0.042), history of peripheral vascular disease and anemia (p = 0.004 and p = 0.015, respectively), secondary (hospitalization for other reason) versus primary AHF diagnosis (p = 0.043), and previous treatment with diuretics (p = 0.023) and angiotensin-converting enzyme inhibitors (p = 0.021). In conclusion, patients with AHF and PLVEF have lower in-hospital mortality than those with decreased LVEF. Low systolic blood pressure, low serum sodium, renal dysfunction, positive markers of myocardial injury, presence of co-morbidities such as peripheral vascular disease and anemia, secondary versus primary AHF diagnosis, and absence of treatment with diuretics and angiotensin-converting enzyme inhibitors at admission may identify high-risk patients with AHF and PLVEF.","author":[{"dropping-particle":"","family":"Parissis","given":"John T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ikonomidis","given":"Ignatios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rafouli-Stergiou","given":"Pinelopi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Delgado","given":"Juan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Farmakis","given":"Dimitrios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vilas-Boas","given":"Fabio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paraskevaidis","given":"Ioannis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anastasiou-Nana","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-4","issue":"1","issued":{"date-parts":[["2011"]]},"page":"79-84","publisher":"Elsevier Inc.","title":"Clinical characteristics and predictors of in-hospital mortality in acute heart failure with preserved left ventricular ejection fraction.","type":"article-journal","volume":"107"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1177/2048872614527012","ISBN":"2048872614527","ISSN":"2048-8734","PMID":"24595245","abstract":"AIM: Temporal trends of epidemiological data on acute heart failure (AHF) are limited. We sought to assess changes in epidemiology, clinical presentation and management of AHF in Greece using data from two international registries conducted three years apart.\\n\\nMETHODS AND RESULTS: The Acute Heart Failure Global Registry of Standard Treatment (ALARM-HF) and the European Society of Cardiology-Heart Failure (ESC-HF) pilot survey were conducted during 2006-2007 and 2009-2010, respectively. A total of 432 AHF patients were recruited by Greek sites in the two registries (255 in ALARM-HF and 177 in ESC-HF pilot survey). About 60% of patients in both registries presented with acutely decompensated chronic HF and 40% with de novo AHF. The use of life-prolonging, guideline-recommended medications increased over time (pre-admission use of angiotensin-converting enzyme (ACE) inhibitors/ angiotensin receptor blockers (ARBs) from 47% to 60%, beta-blockers from 31% to 65%, aldosterone antagonists from 18% to 45%). Those therapies also increased during hospitalisation in both registries. Patients were treated by cardiologists in >90% of cases during hospitalisation; the main intravenous therapies in both registries were diuretics (94% and 97%), followed by vasodilators (47% and 22%) and inotropes (31% and 20%). The length of hospitalisation remained similar (6-7 days in both registries), while in-hospital mortality dropped from 8.5% in the ALARM-HF to 4.5% in the ESC-HF pilot survey.\\n\\nCONCLUSIONS: A temporal increase in the use of life-prolonging therapies along with an improvement of in-hospital mortality was observed. Clinical profiles, in-hospital management and outcome of AHF patients in Greece were similar to other European countries, despite regional differences in healthcare systems.","author":[{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Farmakis","given":"Dimitrios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bistola","given":"Vassiliki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Karavidas","given":"Apostolos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John T","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European heart journal. Acute cardiovascular care","id":"ITEM-5","issued":{"date-parts":[["2014"]]},"title":"Temporal trends in epidemiology, clinical presentation and management of acute heart failure: results from the Greek cohorts of the Acute Heart Failure Global Registry of Standard Treatment and the European Society of Cardiology-Heart Failure pilot survey","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"^41–45","plainTextFormattedCitation":"41–45","previouslyFormattedCitation":"^41–45"},"properties":{"noteIndex":0},"schema":""}41–45ASIAN-HF: Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hft045","ISBN":"1388-9842","ISSN":"13889842","PMID":"23568645","abstract":"Aims: Our aim is to determine mortality and morbidity in Asian patients under clinical management for heart failure (HF). Specifically, we will define the incidence of, and risk factors for, sudden cardiac death, as well as the socio-cultural factors influencing therapeutic choices in these patients.MethodsThis is a prospective observational multinational Asian registry of 5000 patients with symptomatic HF (stage C) and LV systolic dysfunction (EF < 40%) involving 44 centres across 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand). Data collection includes demographic variables, clinical symptoms, functional status, date of HF diagnosis and prior cardiovascular investigations, clinical risk factors, lifestyle factors, socio-economic status, and survey of cultural beliefs, health practices, and attitudes towards device therapy. Centre-level characteristics (case load, referral pattern, specialization, and infrastructure) are also obtained. Patients uniformly undergo standard 12-lead ECG and transthoracic echocardiography at baseline, and are followed over 3 years for outcomes of death or hospitalization. The mode of death and cause of hospitalization are adjudicated by a central event adjudication committee using pre-specified criteria.PerspectiveBy providing prospective data regarding the demographics, risk factors, and outcomes of Asian patients under treatment for HF, the ASIAN-HF registry is expected to advance fundamental understanding of the burden and predictors of death and hospitalization among these patients. The knowledge gained will be important for guiding resource allocation and planning preventive strategies to address the unmet and growing clinical needs of patients with cardiovascular disease in Asia. The Author 2013.","author":[{"dropping-particle":"","family":"Lam","given":"Carolyn S P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anand","given":"Inder","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhang","given":"Shu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shimizu","given":"Wataru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Narasimhan","given":"Calambur","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Park","given":"Sang Weon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yu","given":"Cheuk Man","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ngarmukos","given":"Tachapong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Omar","given":"Razali","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reyes","given":"Eugene B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Siswanto","given":"Bambang","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ling","given":"Lieng H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Richards","given":"A. Mark","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2013"]]},"page":"928-936","title":"Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry","type":"article-journal","volume":"15"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1093/eurheartj/ehw331","ISSN":"1522-9645","PMID":"27502121","abstract":"AIMS To characterize regional and ethnic differences in heart failure (HF) across Asia. METHODS AND RESULTS We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6 ± 13.1 years, 78.2% were men, and mean body mass index was 24.9 ± 5.1 kg/m2. Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions. CONCLUSIONS These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics. CLINICALTRIALSGOV IDENTIFIER NCT01633398.","author":[{"dropping-particle":"","family":"Lam","given":"Carolyn S P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Teng","given":"Tiew-Hwa Katherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tay","given":"Wan Ting","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anand","given":"Inder","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhang","given":"Shu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shimizu","given":"Wataru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Narasimhan","given":"Calambur","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Park","given":"Sang Weon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yu","given":"Cheuk-Man","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ngarmukos","given":"Tachapong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Omar","given":"Razali","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reyes","given":"Eugene B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Siswanto","given":"Bambang B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hung","given":"Chung-Lieh","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ling","given":"Lieng H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yap","given":"Jonathan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"MacDonald","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Richards","given":"A Mark","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European heart journal","id":"ITEM-2","issue":"41","issued":{"date-parts":[["2016"]]},"page":"3141-3153","title":"Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry.","type":"article-journal","volume":"37"},"uris":[""]}],"mendeley":{"formattedCitation":"^46,47","plainTextFormattedCitation":"46,47"},"properties":{"noteIndex":0},"schema":""}46,47ATTEND: Acute Decompensated Heart Failure Syndromes ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2010.03.019","ISBN":"1097-6744 (Electronic)\\n0002-8703 (Linking)","ISSN":"00028703","PMID":"20569705","abstract":"Acute heart failure syndromes (AHFS) are likely to increase in the future, and the high readmission rate of patients with AHFS is an important issue in Western countries. However, there are very few published epidemiological studies on AHFS in the Asia Pacific region. Because AHFS are heterogeneous, the characteristics, clinical profile, and management of AHFS should be clarified in an epidemiological study. The acute decompensated heart failure syndromes (ATTEND) registry is a prospective, observational, multicenter cohort study being performed in Japan and is the first epidemiological study of AHFS in the Asia Pacific region. This study is designed to investigate several aspects of AHFS as follows: (1) the registry allows patient-based data collection for precise evaluation of patient characteristics and short-term outcomes, including the readmission rate; (2) confirmation of clinical assessments can be performed, and new clinical assessments can be created; and (3) feedback allows the modification of guidelines for clinical management. The present report describes the clinical characteristics of patients with AHFS in Japan based on the preliminary data collected in this study, and the similarities and differences in characteristics of these patients compared with those in Western countries. Although most of the patient characteristics did not differ from those reported in Western studies, there are some unique findings in this study, including a high rate of treatment with carperitide (69.4%) and angiotensin II receptor blockers (53.9%) at discharge and a longer hospital stay (median 21 days). The ATTEND registry is designed to provide valuable information to clarify the characteristics of patients with AHFS to improve their management. ?? 2010 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asai","given":"Kuniya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Minami","given":"Yuichiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nagashima","given":"Michitaka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Murai","given":"Koji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Muanakata","given":"Ryo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yumino","given":"Dai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Meguro","given":"Tomomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kawana","given":"Masatoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nejima","given":"Jun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Satoh","given":"Toshihiko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Kyoichi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tanaka","given":"Keiji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2010"]]},"page":"949-955.e1","publisher":"Mosby, Inc.","title":"Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data","type":"article-journal","volume":"159"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1253/circj.CJ-13-0187","ISBN":"1347-4820 (Electronic)\r1346-9843 (Linking)","ISSN":"1346-9843","PMID":"23502987","abstract":"BACKGROUND: Hospitalized heart failure (HHF) is a critical issue in Japan. To improve its management and outcomes, the clinical features, in-hospital management, and outcomes should be analyzed to improve the guidelines for HHF., METHODS AND RESULTS: The acute decompensated heart failure syndromes (ATTEND) registry is the largest study of HHF in Japan. The present report covers the clinical features and in-hospital management of HHF patients. The data from 4,842 enrolled patients have demonstrated that most Japanese HHF patients are elderly, with new onset, and a history of hypertension and orthopnea on admission. During hospitalization, furosemide and carperitide were commonly used and the length of stay was extremely long (mean 30 days), with 6.4% in-hospital mortality., CONCLUSIONS: The findings of the present study suggest the following: (1) the focus for hypertensive elderly and diabetic patients should be on primary prevention of HHF,(2) more intensive management with noninvasive positive pressure ventilation should be performed at the urgent stage, (3) it is necessary to clarify the clinical benefit of carperitide and angiotensin-receptor blockers, because they are commonly used in Japan, and (4) it is necessary to clarify the relationship between in-hospital mortality and length of stay from the viewpoint of both outcome and cost of patient care.","author":[{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"Takehiko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Minami","given":"Yuichiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yumino","given":"Dai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asai","given":"Kuniya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Murai","given":"Koji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Muanakata","given":"Ryo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aokage","given":"Toshiyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Kyoichi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation Journal","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2013"]]},"page":"944-951","title":"Clinical Features and Outcome in Hospitalized Heart Failure in Japan (From the ATTEND Registry)","type":"article-journal","volume":"77"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.ijcard.2013.01.187","ISSN":"01675273","PMID":"23434007","author":[{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"Takehiko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asai","given":"Kuniya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-3","issue":"1","issued":{"date-parts":[["2013"]]},"page":"554-556","publisher":"Elsevier B.V.","title":"Association between length of stay, frequency of in-hospital death, and causes of death in Japanese patients with acute heart failure syndromes","type":"article-journal","volume":"168"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.ijcard.2013.07.226","ISSN":"01675273","PMID":"23962780","abstract":"Background Among patients with acute heart failure syndromes (AHFS), it has been reported that those with a reduced left ventricular ejection fraction (LVEF) tend to be hypotensive or normotensive, whereas those with a preserved LVEF tend to be hypertensive. However, it is unclear whether the systolic blood pressure (SBP) is actually associated with the LVEF in AHFS patients. Therefore, we evaluated the relationship between the SBP at admission and LVEF in patients hospitalized for AHFS. Methods Data from the Acute Decompensated Heart Failure Syndromes (ATTEND) registry were analyzed to investigate the relationship between the admission SBP and a preserved or reduced LEF in AHFS patients. Of the 4,842 patients enrolled in this registry, 4,831 patients (99.8%) were evaluated. They were divided into SBP quartiles (SBP < 120, 120 to < 140, 140 to < 160, and ≥ 160 mmHg), and LVEF was compared among the quartiles. Results Patients with an admission SBP < 120 mmHg were more likely to have a reduced LVEF than a preserved LVEF. In contrast, patients with an admission SBP ≥ 120 mmHg were equally likely to have a preserved or reduced LVEF, indicating that there was no relation between a higher admission SBP and the LVEF. Conclusions Our data indicated that an elevated SBP at admission may not be useful to distinguish between a preserved or reduced LVEF in the urgent phase of AHFS. However, taking geographical differences of AHFS into consideration, further investigations are needed to clarify the relationship between admission SBP and LVEF in patients hospitalized for AHFS. ? 2013 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-4","issue":"5","issued":{"date-parts":[["2013"]]},"page":"4790-4795","publisher":"Elsevier Ireland Ltd","title":"Relationship between systolic blood pressure and preserved or reduced ejection fraction at admission in patients hospitalized for acute heart failure syndromes","type":"article-journal","volume":"168"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.amjcard.2012.12.019","ISBN":"0002-9149","ISSN":"00029149","PMID":"23312128","abstract":"Hyponatremia is known to be a poor prognostic factor in patients hospitalized with heart failure (HF), however not well studied in Japan. The aims of this study were to characterize hyponatremic hospitalized patients with HF and to clarify the relations between hyponatremia and detailed in-hospital outcomes in Japan. Among 4,837 hospitalized patients with HF enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, patient characteristics and in-hospital mortality in those with hyponatremia were examined. Hyponatremia (sodium <135 mEq/L) was observed in 11.6% of patients. Patients with hyponatremia were of similar age, included fewer men, and had a higher proportion of previous hospitalizations for HF compared to those with normonatremia. On admission, lower heart rates and blood pressures and higher brain natriuretic peptide levels were observed in patients with hyponatremia. During hospitalization, inotrope levels and mechanical device use were significantly higher in patients with hyponatremia. Rates of all-cause and cardiac death were significantly higher in patients with hyponatremia, 15.0% and 11.4%, respectively, compared to 5.3% and 3.6%, respectively, in those with normonatremia. In hyponatremic hospitalized patients with HF, cardiac death accounted for 76.2% of all-cause death. In conclusion, the present study demonstrates that in Japan hyponatremia in patients hospitalized with HF is relatively common and is associated with a very high in-hospital mortality. ? 2013 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Munakata","given":"Ryo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Minami","given":"Yuichiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aokage","given":"Toshiyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asai","given":"Kuniya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yumino","given":"Dai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Kyoichi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-5","issue":"7","issued":{"date-parts":[["2013"]]},"page":"1019-1025","publisher":"Elsevier Inc.","title":"Hyponatremia and in-hospital mortality in patients admitted for heart failure (from the ATTEND Registry)","type":"article-journal","volume":"111"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1371/journal.pone.0105596","ISSN":"1932-6203","author":[{"dropping-particle":"","family":"Inohara","given":"Taku","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kohsaka","given":"Shun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"Takehiko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PLoS ONE","id":"ITEM-6","issue":"9","issued":{"date-parts":[["2014"]]},"page":"e105596","title":"Prognostic Impact of Renal Dysfunction Does Not Differ According to the Clinical Profiles of Patients: Insight from the Acute Decompensated Heart Failure Syndromes (ATTEND) Registry","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.ijcard.2013.12.174","ISSN":"01675273","PMID":"24447746","abstract":"Background Randomized controlled trials concerning pulmonary artery catheters (PACs) use have yielded little evidence of their beneficial effects on survival. This study aimed to evaluate the association between PACs and in-hospital mortality in patients with acute heart failure syndromes (AHFS). Methods The Acute Decompensated Heart Failure Syndromes (ATTEND) Registry is a prospective, observational, multicenter cohort study performed in Japan, since April 2007. We analyzed data from the ATTEND Registry and evaluated the effectiveness of PAC in AHFS treatment using propensity score-matching and the Cox proportional hazards model. Results Final follow-up examinations of the 4842 patients were conducted in December 2012. During the study period, 813 patients (16.8%) were managed with PACs, of which 502 patients (PAC group) were propensity score-matched with 502 controls (Control group). Of the 1004 score-matched patients, 22 (4.4%) patients from the Control group and 7 (1.4%) from the PAC group died. The risk of all-cause death was lower in the PAC group than that in the Control group [hazard ratio (HR), 0.3; 95% confidence interval (CI), 0.13-0.70; p = 0.006]. PAC-guided therapy decreased all-cause mortality in patients with lower systolic blood pressure (SBP ≤ 100 mm Hg; HR, 0.09; 95% CI, 0.01-0.70; p = 0.021) or inotropic therapy (HR, 0.22; 95% CI, 0.08-0.57; p = 0.002). Conclusions This study revealed that appropriate PAC use effectively decreases in-hospital mortality in AHFS patients, particularly those with lower SBP or receiving inotropic therapy, suggesting that real-world PAC use could improve AHFS management. ? 2014 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Sotomi","given":"Yohei","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Minami","given":"Yuichiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fujii","given":"Kenshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-7","issue":"1","issued":{"date-parts":[["2014"]]},"page":"165-172","publisher":"Elsevier Ireland Ltd","title":"Impact of pulmonary artery catheter on outcome in patients with acute heart failure syndromes with hypotension or receiving inotropes: From the ATTEND Registry","type":"article-journal","volume":"172"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1016/j.ijcard.2013.11.087","ISSN":"01675273","PMID":"24342405","author":[{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"Takehiko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asai","given":"Kuniya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-8","issue":"1","issued":{"date-parts":[["2014"]]},"page":"98-100","publisher":"Elsevier Ireland Ltd","title":"Low admission heart rate is a marker rather than a mediator of increased in-hospital mortality for patients with acute heart failure syndromes in sinus rhythm","type":"article-journal","volume":"171"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.2215/CJN.04400514","ISSN":"1555-9041","author":[{"dropping-particle":"","family":"Kajimoto","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Y.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical Journal of the American Society of Nephrology","id":"ITEM-9","issue":"11","issued":{"date-parts":[["2014"]]},"page":"1912-1921","title":"Associations of Anemia and Renal Dysfunction with Outcomes among Patients Hospitalized for Acute Decompensated Heart Failure with Preserved or Reduced Ejection Fraction","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1016/j.ijcard.2014.08.154","ISSN":"01675273","author":[{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Yasushi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Minami","given":"Yuichiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Munakata","given":"Ryo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"Nobuhisa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-10","issue":"3","issued":{"date-parts":[["2014"]]},"page":"1444-1446","publisher":"Elsevier Ireland Ltd","title":"Intra-aortic balloon counterpulsation for acute decompensated heart failure","type":"article-journal","volume":"176"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1177/2048872614554199","ISSN":"2048-8726","author":[{"dropping-particle":"","family":"Kajimoto","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal: Acute Cardiovascular Care","id":"ITEM-11","issued":{"date-parts":[["2014"]]},"title":"Association between anemia, clinical features and outcome in patients hospitalized for acute heart failure syndromes","type":"article-journal"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1111/ijcp.12603","ISSN":"13685031","author":[{"dropping-particle":"","family":"Minami","given":"Y.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aokage","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asai","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Munakata","given":"R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yumino","given":"D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Murai","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Clinical Practice","id":"ITEM-12","issued":{"date-parts":[["2014"]]},"page":"n/a-n/a","title":"Third heart sound in hospitalised patients with acute heart failure: insights from the ATTEND study","type":"article-journal"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"10.1016/j.ijcard.2015.04.258","ISSN":"01675273","author":[{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-13","issued":{"date-parts":[["2015"]]},"page":"100-106","publisher":"Elsevier Ireland Ltd","title":"Association of age and baseline systolic blood pressure with outcomes in patients hospitalized for acute heart failure syndromes","type":"article-journal","volume":"191"},"uris":[""]},{"id":"ITEM-14","itemData":{"DOI":"10.1016/j.amjcard.2014.11.007","ISSN":"00029149","author":[{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American Journal of Cardiology","id":"ITEM-14","issue":"3","issued":{"date-parts":[["2015"]]},"page":"334-340","publisher":"Elsevier Inc.","title":"Relation of Left Ventricular Ejection Fraction and Clinical Features or Co-morbidities to Outcomes Among Patients Hospitalized for Acute Heart Failure Syndromes","type":"article-journal","volume":"115"},"uris":[""]}],"mendeley":{"formattedCitation":"^{48,49,58–61,50–57}","plainTextFormattedCitation":"48,49,58–61,50–57","previouslyFormattedCitation":"^46–59"},"properties":{"noteIndex":0},"schema":""}48,49,58–61,50–57COHERE: Coreg (Carvedilol) Heart Failure Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1054/jcaf.2000.9675","ISBN":"1071-9164","ISSN":"10719164","PMID":"10997754","abstract":"BACKGROUND: The success of beta-blocking agents in clinical trials of heart failure (HF) has led to a widespread call for their increased use, which assumes these agents will perform as well in the usual care setting. Given the traditional contraindication of the use of beta-blocking agents in HF, and their perception as difficult to use in HF, observing how they perform in the usual care setting could be critical in accelerating their widespread application. Carvedilol is the only beta-blocking agent currently approved in the United States for use in HF. METHODS: The Coreg (brand of carvedilol; SmithKline Beecham Pharmaceuticals, Philadelphia, PA) Heart Failure Registry (COHERE) is intended to collect data on outcomes and other clinical variables in a typical HF population and to observe experience with carvedilol in the hands of community practitioners. COHERE does not include any specific patient selection or exclusion criteria. The decision to use carvedilol is entirely at the discretion of the participant physician, based on evidence of HF as judged by assessments the practitioner usually uses. All patients will be followed for 1 year, with information on outcomes and other clinical variables collected and analyzed at baseline, the end of titration, and at 6 and 12 months after reaching the maximum tolerated dose. About 600 participant physicians selected to be as representative as possible of the community practice setting will enroll approximately 6,000 patients. CONCLUSIONS: COHERE will be the first and largest prospective observational experience with a new treatment, ie, carvedilol, in patients with HF managed in the usual care setting and should provide valuable information about this new treatment in this environment compared with the more rigid clinical trials setting.","author":[{"dropping-particle":"","family":"Franciosa","given":"J a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"W T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"E M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"B M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chen","given":"T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"M a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"J J","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of cardiac failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2000"]]},"page":"264-271","title":"Rationale, design, and methods for a Coreg (carvedilol) Heart Failure Registry (COHERE). COHERE Participant Physicians.","type":"article-journal","volume":"6"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.ahj.2004.04.006","ISBN":"1097-6744 (Electronic)","ISSN":"00028703","PMID":"15459606","abstract":"Background β-Blockers reduce morbidity and mortality rates in heart failure (HF) clinical trials, but it is unknown whether these findings persist in the community setting. Methods A registry was created to survey tolerability and outcomes during initiation and 1-year follow-up of β-blocker treatment with carvedilol in patients with HF treated by cardiologists (CARD) and primary care physicians (PCP) in the community. Results A total 4280 patients were enrolled (3121 by 259 CARD, 1159 by 129 PCP). Patient age averaged 67 ± 13 years; 35% were women and 12% were black. The left ventricular ejection fraction averaged 31 ± 12; New York Heart Association class was II-III in 86% and IV in 3%. Patients of PCP had higher left ventricular ejection fraction, were older, and more frequently were female, black, diabetic, hypertensive, and in New York Heart Association class III/IV. Minimal difficulty titrating carvedilol was noted by >80% of CARD and PCP. Significantly more CARD-treated patients reached carvedilol doses of 25 mg twice daily (49% vs 27%). Kaplan-Meier all-cause mortality rate was 8.5% at 1 year and did not differ between CARD-treated and PCP-treated patients (8.2% vs 9.3%, P = .254). At least one HF hospitalization occurred in 11% of patients during follow-up, compared with 28% in the preceding year. Conclusions Community-based physicians use carvedilol with success approaching that of clinical trials. Overall mortality rates and HF hospitalizations were in the same low range as in clinical trials. Thus, it appears that results of clinical trials with carvedilol for HF can be translated to the community setting.","author":[{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2004"]]},"page":"718-726","title":"β-blocker therapy for heart failure outside the clinical trial setting: Findings of a community-based registry","type":"article-journal","volume":"148"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.amjcard.2006.06.050","ISSN":"00029149","PMID":"17126654","abstract":"Risk factors for outcomes in heart failure (HF) were derived from populations in clinical trials, at hospital discharge, or in localized geographic or socioeconomic strata before the widespread use of beta blockers. This study observed 4,280 patients in a community-based HF registry for 1 year after completing carvedilol titration. Independent risk factors for death, hospitalization for HF, or hospitalization for cardiovascular reasons other than HF were first identified by age-, gender-, and race-adjusted analyses, then by multivariate analysis adjusted simultaneously for all factors. Over this period, 7% of patients died, 11% were hospitalized for HF, 12% were hospitalized for other cardiovascular reasons, and 27% had > or =1 of these events. The most significant outcome predictors were New York Heart Association class III or IV, history of hospitalization for HF or other cardiovascular reasons, and angina pectoris, all associated with increased odds of having an adverse outcome (all p < or =0.001). The left ventricular ejection fraction was not a significant outcome predictor by multivariate analysis. The odds ratio for an adverse outcome was significantly reduced for patients with hypertensive or idiopathic causes of HF and for those whose physicians had graduated from medical school > or =24 years earlier compared with <14 years earlier (all p <0.005). In conclusion, easily obtained historical information predicts clinical outcomes in patients with HF in the year after initiating carvedilol. In this unselected community population, these historical factors were better predictors of risk than the left ventricular ejection fraction.","author":[{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-3","issue":"11","issued":{"date-parts":[["2006"]]},"page":"1480-1484","title":"Predictors of clinical outcomes in patients given carvedilol for heart failure.","type":"article-journal","volume":"98"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1111/j.1527-5299.2006.05804.x","ISSN":"1527-5299","abstract":"Women and the elderly are underrepresented in clinical trials of heart failure (HF). The authors analyzed, by sex and age groups, a registry of 4280 community patients initiating carvedilol for HF. Women (n=1485) were older than men (n=2793) and had worse functional class with higher left ventricular ejection fraction and blood pressure. Women also had more HF hospitalizations, less use of angiotensin-converting enzyme inhibitors, and lower doses of carvedilol. Nevertheless, during 1-year follow-up, both groups experienced greater than 40% reductions in HF hospitalizations (P<.001), with mortality of 7.3% in women vs 9.1% in men (P=.085). With increasing age, left ventricular ejection fraction, blood pressure, and functional class increased, whereas angiotensin-converting enzyme inhibitor use and carvedilol doses decreased. HF hospitalizations fell at least 40% in all age groups after starting carvedilol (P<.001). Characteristics of women and the elderly with HF in the community suggest increased risk, but both populations respond well after initiating carvedilol.","author":[{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-4","issue":"6","issued":{"date-parts":[["2006"]]},"page":"317-323","title":"Heart Failure in Community Practice: Relationship to Age and Sex in a Beta-Blocker Registry","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.amjcard.2006.12.056","ISBN":"0002-9149","ISSN":"00029149","PMID":"17478155","abstract":"Heart failure (HF) in the community differs meaningfully from that in clinical trials, particularly the higher prevalence of patients with preserved left ventricular (LV) ejection fraction (EF) typically excluded from clinical trials, thus limiting knowledge of their responsiveness to β-blocker therapy. From a community-based registry of 4,280 patients with HF starting treatment with the β blocker carvedilol, we compared characteristics, carvedilol titration, and outcomes of patients according to LVEF >40% or <40% (as in clinical trials) and across the spectrum of LVEF <21%, 21% to 30%, 31% to 40%, and >40%. Patients with preserved EF (LVEF >40%) were older and more often women and hypertensive. Lower LVEF was associated with worse functional class and more HF hospitalizations in the previous year. Carvedilol dose decreased with increasing LVEF. Hospitalization rates for HF related inversely to LVEF before starting carvedilol therapy and decreased from the previous year in all LVEF groups during follow-up. Although 1-year mortality rate decreased from 8% with LVEF ≤20% to 6% with LVEF >40%, adjusted hazard ratios were not significantly different across LVEF groups. Thus, characteristics of community patients with HF vary across the spectrum of LVEF. Patients with HF and preserved EF treated with carvedilol in the community improve symptomatically and experience fewer HF hospitalizations after initiating carvedilol. In conclusion, without a control group, the effect of carvedilol on outcomes is not conclusive and trials of carvedilol in patients with HF and preserved EF should be undertaken. ? 2007 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-5","issue":"9","issued":{"date-parts":[["2007"]]},"page":"1263-1268","title":"Comparison of Outcomes and Usefulness of Carvedilol Across a Spectrum of Left Ventricular Ejection Fractions in Patients With Heart Failure in Clinical Practice","type":"article-journal","volume":"99"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1111/j.1527-5299.2007.888111.x","ISSN":"1527-5299","abstract":"Heart failure (HF) clinical trials suggest different responses of blacks and whites to beta-blockers. Differences between clinical trial and community settings may also have an impact. The Carvedilol Heart Failure Registry (COHERE) observed experience with carvedilol in 4280 patients with HF in a community setting. This analysis compares characteristics, outcomes, and carvedilol dosing of blacks and whites in COHERE. Compared with whites (n=3433), blacks (n=523) had more severe HF symptoms despite similar systolic function. At similar carvedilol maintenance doses, symptoms improved in 33% of blacks vs 28% of whites, while worsening in 10% and 11%, respectively (both nonsignificant), and HF hospitalization rates were reduced comparably in both groups (-58% vs -56%, respectively; both P<.001). Incidence and hazard ratios of death were similar in blacks and whites (6.9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-6","issue":"1","issued":{"date-parts":[["2007"]]},"page":"16-21","title":"Tolerability, Safety, and Efficacy of Beta-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective Beta-Blocker Registry","type":"article-journal","volume":"13"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.ahj.2007.03.010","ISSN":"00028703","abstract":"Background: Community patients with heart failure (HF) are older, less often treated by HF specialists, and have more comorbidity than those in randomized clinical trials. These differences might affect β-blocker prescribing in HF. Methods: To explore patterns of β-blocker prescribing for HF in the community and their association with outcomes, we determined carvedilol doses at end titration in 4113 patients from a community-based β-blocker HF registry according to physician and patient characteristics, HF severity, and rates of hospitalization and death. Results: Female sex, age ≥65 years, and left ventricular ejection fraction ≥35% were associated with lower β-blocker doses. Average daily dose of β-blocker was lower with worse baseline New York Heart Association class. More patients of cardiologists achieved carvedilol doses ≥25 mg twice daily, whereas in those of noncardiologists lower doses were more common. Relative risk of HF hospitalizations or all-cause death was significantly lower with higher doses of β-blocker. Conclusions: β-Blocker dosing in community HF appears lower than in randomized clinical trials, especially when prescribed by noncardiologists. At all doses, patients taking the β-blocker carvedilol have a lower incidence of death and HF hospitalization than those discontinuing it, regardless of physician type in the community setting. ? 2007.","author":[{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-7","issue":"6","issued":{"date-parts":[["2007"]]},"page":"1029-1036","title":"β-Blocker dosing in community-based treatment of heart failure","type":"article-journal","volume":"153"},"uris":[""]}],"mendeley":{"formattedCitation":"^62–68","plainTextFormattedCitation":"62–68","previouslyFormattedCitation":"^60–66"},"properties":{"noteIndex":0},"schema":""}62–68EFICA: Etude Francaise de l’Insuffisance Cardiaque Aigue ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejheart.2006.01.001","ISSN":"13889842","PMID":"16516552","abstract":"Background: Little is known about the epidemiology of acute decompensated heart failure (ADHF) in patients admitted to intensive and coronary care units (ICU/CCU). Observational data may improve disease management and guide the design of clinical trials. Aims: EFICA is an observational study of the clinical profile, management and survival of ADHF patients admitted to ICU/CCU. Methods: The study included 599 patients admitted to 60 ICU/CCUs across France. Relevant data was recorded during hospitalisation. Survival was assessed at 4 weeks and 1 year. Results: The main cause of ADHF was ischaemic heart disease (61%); 29% of patients had cardiogenic shock. Mortality was 27.4% at 4 weeks and 46.5% at 1 year, increasing to 43.2% and 62.5%, respectively, when including pre-admission deaths. Shock patients had the highest [57.8% vs. 15.2% without shock (p < 0.001)] and patients with hypertension and pulmonary oedema had the lowest 4-week mortality: (7%). Pre-admission NYHA class III-IV heart failure, not initial clinical presentation, influenced 1-year mortality. Conclusion: ADHF is a heterogeneous syndrome. Based on initial clinical presentation, three entities with distinct features and outcome may be described: cardiogenic shock, pulmonary oedema with hypertension, and 'decompensated' chronic heart failure. This should be taken into account in future observational studies, guidelines and clinical trials. ? 2006 European Society of Cardiology.","author":[{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Juillière","given":"Yves","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cohen-Solal","given":"Alain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guize","given":"Louis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alla","given":"Fran?ois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rougé","given":"Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Blin","given":"Patrick","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Barlet","given":"Marie Hélène","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paolozzi","given":"Laurence","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vincent","given":"Catherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Desnos","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Samii","given":"Kamran","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2006"]]},"page":"697-705","title":"Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study","type":"article-journal","volume":"8"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1007/s10741-006-9484-x","ISBN":"1382-4147","ISSN":"13824147","PMID":"16937032","abstract":"Acute heart failure syndromes (AHFS) is a broad spectrum of heterogeneous conditions including pulmonary oedema, hypertensive crisis, worsening exacerbated CHF and cardiogenic shock. HF hospitalizations have steadily risen with more than one million in 2004 in the United States and a similar number has been reported in Europe. Each year heart failure accounts for 6.5 million days spent in hospital in the USA and 1.4 million days in France. Mortality data are derived from registries or clinical trials. Registry data in patients admitted to general or cardiology wards such as in Euroheart Failure Survey and ADHERE provide a far more optimistic picture compared with data from consecutive unselected patients in the most acute situation. such as in EFICA. Four-week mortality was higher than 25% in this case. A great pathophysiologic understanding of the different features of the various AHFS is needed in order to identify targets for therapy and research. This includes hemodynamics, the role of myocardial injury, neurohormonal and cytokine abnormalities and the cardiorenal syndromes. So far, very little progress has been made in developing new, effective therapies and implementing management guidelines in this patient population. Future clinical trial endpoints should be better designed and tailored to the various pathophysiological conditions of this complex syndrome. The goal of AHFS therapy is not only to prevent disease progression but also to have a beneficial effect on an acute event that exacerbates disease progression. A combined endpoint assessing survival and rehospitalisation rates is becoming increasingly popular for acute therapies. Specific trials may also need to be designed according to the time of access to the patient.","author":[{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Adamopoulos","given":"Chris","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart Failure Reviews","id":"ITEM-2","issue":"2","issued":{"date-parts":[["2006"]]},"page":"135-139","title":"The challenge of acute decompensated heart failure","type":"article-journal","volume":"11"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.ejheart.2007.06.001","ISBN":"1388-9842 (Print)\\r1388-9842 (Linking)","ISSN":"13889842","PMID":"17627880","abstract":"Background: In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and mean arterial pressure (MAP) are independent risk factors in patients with AHFS. Methods and results: The EFICA study enrolled 581 AHFS patients admitted to 60 CCU/ICUs. Survival at 4?weeks was analyzed for all cases with echocardiographic LVEF available on admission (n = 355). Four-week mortality was 23%. Multivariable analysis identified lower LVEF, lower MAP and serum creatinine > 1.5?mg/dl as independent correlates of mortality (respectively, OR: 1.27?per 10% decrease, CI: 1.05-1.53, p = 0.012; OR: 1.30?per 10?mmHg decrease, CI: 1.15-1.48, p < 0.0001; OR: 2.84, CI: 1.64-4.93, p = 0.0002). LVEF interacted significantly with MAP (p < 0.0001) and the subgroup analysis showed that reduced LVEF was a strong risk factor in patients with MAP ≤ 90?mmHg (OR: 2.73, CI: 1.23-5.98, p = 0.01) but did not reach statistical significance in patients with MAP > 90?mmHg. Conclusions: Both LVEF and MAP are important predictors of death in severe AHFS. LVEF can provide additional prognostic information on top of MAP but mainly in patients with low MAP (≤ 90?mmHg) at admission. ? 2007 European Society of Cardiology.","author":[{"dropping-particle":"","family":"Adamopoulos","given":"Chris","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fay","given":"Renaud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cohen-Solal","given":"Alain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guize","given":"Louis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Juillière","given":"Yves","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alla","given":"Fran?ois","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-3","issue":"9","issued":{"date-parts":[["2007"]]},"page":"935-941","title":"Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure","type":"article-journal","volume":"9"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1093/eurjhf/hfp180","ISSN":"13889842","PMID":"20028696","abstract":"AIMS: In patients with chronic heart failure (CHF), left bundle branch block (LBBB) is associated with an increased risk of cardiovascular mortality. We aimed to investigate the association of LBBB with short- and long-term outcome in patients discharged after a de novo episode of acute heart failure (AHF) or AHF complicating a mild CHF.\\n\\nMETHODS AND RESULTS: Patients with no history of New York Heart Association class III and IV CHF, who were admitted for a severe AHF episode and enrolled in the prospective observational EFICA study (n = 403), were included. Left bundle branch block prevalence was 16%. Patients with LBBB had a higher prevalence of dilated cardiomyopathy (23 vs. 10%, P < 0.005), a higher percentage of AHF episodes without identified precipitating factor (15 vs. 2%, P < 0.001), and were less likely to present increased markers of cardiac injury (41 vs. 56%, P = 0.04). The 4-week mortality was 24.8% with no difference between LBBB and no LBBB patients. Left bundle branch block was however an independent predictor of 1-year mortality in the 4-week survivors [hazards ratio (95% confidence interval) = 2.01 (1.12-3.64), P = 0.02].\\n\\nCONCLUSION: Long-term outcome of patients surviving a severe episode of de novo AHF or AHF complicating a mild CHF is worsened by LBBB. These patients may constitute a subgroup at high risk in whom specific therapeutic solutions should be investigated.","author":[{"dropping-particle":"","family":"Huvelle","given":"Etienne","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fay","given":"Renaud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alla","given":"Franois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cohen Solal","given":"Alain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-4","issue":"2","issued":{"date-parts":[["2010"]]},"page":"156-163","title":"Left bundle branch block and mortality in patients with acute heart failure syndrome: A substudy of the EFICA cohort","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"^69–72","plainTextFormattedCitation":"69–72","previouslyFormattedCitation":"^67–70"},"properties":{"noteIndex":0},"schema":""}69–72EHFS II: EuroHeart Failure Survey II ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/ehl193","ISBN":"0195-668X; 1522-9645","ISSN":"0195668X","PMID":"17000631","abstract":"AIMS: The objective of the EuroHeart Failure Survey II (EHFS II) was to assess patient characteristics, aetiology, treatment, and outcome of acute heart failure (AHF) in Europe in relation to the guidelines on the diagnosis and treatment of AHF published by the European Society of Cardiology. METHODS AND RESULTS: Patients hospitalized for AHF were recruited by 133 centres in 30 European countries. Three thousand five hundred and eighty patients were entered into the database by the end of August 2005. Mean age was 70 years, and 61% of patients were male. New-onset AHF (de novo AHF) was diagnosed in 37%, of which 42% was due to acute coronary syndromes (ACS). Clinical classification according to the guidelines divided AHF patients into (i) decompensated HF (65%), (ii) pulmonary oedema (16%), (iii) HF and hypertension (11%), (iv) cardiogenic shock (4%), and (v) right HF (3%). Coronary heart disease, hypertension, and atrial fibrillation were the most common underlying conditions. Arrhythmias, valvular dysfunction, and ACS were each present as precipitating factor in one-third of cases. Preserved left ventricular ejection fraction (> or =45%) was observed in 34%. Valvular disorders were common, especially mitral regurgitation (MR) which was reported on echocardiography in 80% of patients. Median length of stay was 9 days, and in-hospital mortality 6.7%. At discharge, 80% of patients were on angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers, whereas 61% were taking beta-blocker medication. CONCLUSION: Decompensated HF is the most common clinical presentation of AHF patients. More than one-third of AHF patients do not have a previous history of HF, and new-onset HF is often caused by ACS. Preserved systolic function is found in a substantial proportion of the patients. The prevalence of valvular dysfunction is strikingly high and contributes to the clinical presentation. The EHFS II on AHF verified that the use of evidence-based HF medication was well adopted to clinical practice.","author":[{"dropping-particle":"","family":"Nieminen","given":"Markku S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harjola","given":"Veli Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lassus","given":"Johan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose Luis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-1","issue":"22","issued":{"date-parts":[["2006"]]},"page":"2725-2736","title":"EuroHeart Failure Survey II (EHFS II): A survey on hospitalized acute heart failure patients: Description of population","type":"article-journal","volume":"27"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.ejheart.2007.12.012","ISSN":"1388-9842","PMID":"18279769","abstract":"This analysis evaluates the gender differences in patients hospitalised for acute heart failure (AHF) in the EuroHeart Failure Survey II (EHFS).","author":[{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose Luis","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-2","issue":"2","issued":{"date-parts":[["2008"]]},"page":"140-148","title":"Gender related differences in patients presenting with acute heart failure. Results from EuroHeart Failure Survey II.","type":"article-journal","volume":"10"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1093/eurjhf/hfq002","ISSN":"1879-0844","PMID":"20156940","abstract":"Acute heart failure (AHF) has a poor prognosis. We evaluated 3- and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II.","author":[{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-3","issue":"3","issued":{"date-parts":[["2010"]]},"page":"239-248","title":"Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure.","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"^73–75","plainTextFormattedCitation":"73–75","previouslyFormattedCitation":"^71–73"},"properties":{"noteIndex":0},"schema":""}73–75ESC-HF: European Society of Cardiology Heart Failure Pilot Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/ehq282","ISBN":"1522-9645 (Electronic)\\r0195-668X (Linking)","ISSN":"0195-668X","PMID":"20860072","author":[{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European heart journal","id":"ITEM-1","issue":"18","issued":{"date-parts":[["2010"]]},"page":"2184-2186","title":"Heart Failure Pilot protocol.","type":"article-journal","volume":"31"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1093/eurjhf/hfq154","ISBN":"1879-0844","ISSN":"13889842","PMID":"20805094","abstract":"The primary objective of the new ESC-HF Pilot Survey was to describe the clinical epidemiology of outpatients and inpatients with heart failure (HF) and the diagnostic/therapeutic processes applied across 12 participating European countries. This pilot study was specifically aimed at validating the structure, performance, and quality of the data set, for continuing the survey into a permanent registry.","author":[{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Leiro","given":"Marisa Crespo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drozdz","given":"Jaroslaw","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fruhwald","given":"Friedrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gullestad","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Logeart","given":"Damien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Persson","given":"Hans","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rauchhaus","given":"Mathias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nielsen","given":"Olav Wendelboe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-2","issue":"10","issued":{"date-parts":[["2010"]]},"page":"1076-1084","title":"EURObservational research programme: The heart failure Pilot survey (ESC-HF Pilot)","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1093/eurjhf/hft050","ISBN":"1879-0844","ISSN":"13889842","PMID":"23537547","abstract":"AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.\\n\\nMETHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.\\n\\nCONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.","author":[{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Leiro","given":"Marisa Crespo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drozdz","given":"Jaroslaw","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fruhwald","given":"Friedrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gullestad","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Logeart","given":"Damien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fabbri","given":"Gianna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Persson","given":"Hans","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rauchhaus","given":"Mathias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nielsen","given":"Olav Wendelboe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-3","issue":"7","issued":{"date-parts":[["2013"]]},"page":"808-817","title":"EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)","type":"article-journal","volume":"15"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1093/eurjhf/hft134","ISSN":"13889842","PMID":"23978433","abstract":"AIMS: To evaluate how recommendations of European guidelines regarding pharmacological and non-pharmacological treatments for heart failure (HF) are adopted in clinical practice.\\n\\nMETHODS AND RESULTS: The ESC-HF Long-Term Registry is a prospective, observational study conducted in 211 Cardiology Centres of 21 European and Mediterranean countries, members of the European Society of Cardiology (ESC). From May 2011 to April 2013, a total of 12 440 patients were enrolled, 40.5% with acute HF and 59.5% with chronic HF. Intravenous treatments for acute HF were heterogeneously administered, irrespective of guideline recommendations. In chronic HF, with reduced EF, renin-angiotensin system (RAS) blockers, beta-blockers, and mineralocorticoid antagonists (MRAs) were used in 92.2, 92.7, and 67.0% of patients, respectively. When reasons for non-adherence were considered, the real rate of undertreatment accounted for 3.2, 2.3, and 5.4% of the cases, respectively. About 30% of patients received the target dosage of these drugs, but a documented reason for not achieving the target dosage was reported in almost two-thirds of them. The more relevant reasons for non-implantation of a device, when clinically indicated, were related to doctor uncertainties on the indication, patient refusal, or logistical/cost issues.\\n\\nCONCLUSION: This pan-European registry shows that, while in patients with acute HF, a large heterogeneity of treatments exists, drug treatment of chronic HF can be considered largely adherent to recommendations of current guidelines, when the reasons for non-adherence are taken into account. 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M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Asserlund","given":"B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Olsson","given":"L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"U.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Afzelius","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Karlstr?m","given":"P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tengvall","given":"L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wiklund","given":"P. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Olsson","given":"B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Temizhan","given":"a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kalayci","given":"S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bozkurt","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Taraktas","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cavusoglu","given":"Y.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gunes","given":"H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Birhan Yilmaz","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Demir","given":"B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gencer","given":"E.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-4","issue":"10","issued":{"date-parts":[["2013"]]},"page":"1173-1184","title":"Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12 440 patients of the ESC Heart Failure Long-Term Registry","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"^76–79","plainTextFormattedCitation":"76–79","previouslyFormattedCitation":"^74–77"},"properties":{"noteIndex":0},"schema":""}76–79GWTG-HF: Get With the Guidelines - Heart Failure ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1097/01.hpc.0000243588.00012.79","ISSN":"1535-2811","PMID":"18340235","author":[{"dropping-particle":"","family":"Hong","given":"Yuling","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Critical pathways in cardiology","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2006"]]},"page":"179-186","title":"Overview of the American Heart Association \"Get with the Guidelines\" programs: coronary heart disease, stroke, and heart failure.","type":"article-journal","volume":"5"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1001/jama.298.13.1525","ISSN":"1538-3598","PMID":"17911497","abstract":"CONTEXT: Practice guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for patients with heart failure and left ventricular ejection fraction of 30% or less. The influence of sex and race on ICD use among eligible patients is unknown. OBJECTIVE: To examine sex and racial differences in the use of ICD therapy. DESIGN, SETTING, AND PATIENTS: Observational analysis of 13,034 patients admitted with heart failure and left ventricular ejection fraction of 30% or less and discharged alive from hospitals in the American Heart Association's Get With the Guidelines-Heart Failure quality-improvement program. Patients were treated between January 2005 and June 2007 at 217 participating hospitals. MAIN OUTCOME MEASURES: Use of ICD therapy or planned ICD therapy at discharge. RESULTS: Among patients eligible for ICD therapy, 4615 (35.4%) had ICD therapy at discharge (1614 with new ICDs, 527 with planned ICDs, and 2474 with prior ICDs). ICDs were used in 375 of 1329 eligible black women (28.2%), 754 of 2531 white women (29.8%), 660 of 1977 black men (33.4%), and 2356 of 5403 white men (43.6%) (P < .001). After adjustment for patient characteristics and hospital factors, the adjusted odds of ICD use were 0.73 (95% confidence interval, 0.60-0.88) for black men, 0.62 (95% confidence interval, 0.56-0.68) for white women, and 0.56 (95% confidence interval, 0.44-0.71) for black women, compared with white men. The differences were not attributable to the proportions of women and black patients at participating hospitals or to differences in the reporting of left ventricular ejection fraction. CONCLUSIONS: Less than 40% of potentially eligible patients hospitalized for heart failure received ICD therapy, and rates of use were lower among eligible women and black patients than among white men.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-2","issue":"13","issued":{"date-parts":[["2007"]]},"page":"1525-1532","title":"Sex and racial differences in the use of implantable cardioverter-defibrillators among patients hospitalized with heart failure.","type":"article-journal","volume":"298"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.ahj.2008.05.028","ISBN":"1097-6744","ISSN":"00028703","PMID":"18946892","abstract":"Background: Both heart failure (HF) and chronic kidney disease (CKD) are highly prevalent conditions that often coexist; however, the quality of care received by hospitalized patients with both is not known. Methods: The Get With the Guidelines-HF registry and performance improvement program prospectively collects data on patients hospitalized with HF. Performance measures to improve treatment of patients with HF and inhospital mortality were examined by kidney function based on glomerular filtration rate (GFR) categorized as normal (GFR ≥ 90), mild (60 ≤ GFR < 90), moderate (30 ≤ GFR < 60), severe (15 ≤ GFR < 30), and kidney failure (GFR < 15 or dialysis). Results: Nearly two thirds of hospitalized patients with HF (15,560 patients from 137 hospitals) also had CKD: moderate CKD (43.9%), severe CKD (14.2%), and kidney failure (6.6%). Inpatient mortality was higher for patients with more severe renal dysfunction. Those with kidney failure were significantly less likely to receive nearly all guidelines-based therapies. In contrast, those with moderate or severe CKD often received similar care when compared with those with normal kidney function, except for lower use of angiotensin-converting enzyme inhibitors or receptor blockers (odds ratio 0.19 [0.13-0.28] and 0.47 [0.36-0.62], respectively) and lower proportions with blood pressure control (odds ratio 0.70 [0.58-0.85] and 0.52 [0.42-0.63], respectively). Conclusions: In a large contemporary cohort of patients hospitalized with HF, we found that renal dysfunction was a highly prevalent comorbidity. Despite higher mortality rates, patients with increased severity of renal dysfunction were less likely to receive important guideline-recommended therapies. Further efforts are needed to improve the care of patients with HF and CKD. ? 2008 Mosby, Inc.","author":[{"dropping-particle":"","family":"Patel","given":"Uptal D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ellrodt","given":"Gray","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-3","issue":"4","issued":{"date-parts":[["2008"]]},"page":"674-681","title":"Quality of care and outcomes among patients with heart failure and chronic kidney disease: A Get With the Guidelines-Heart Failure Program study","type":"article-journal","volume":"156"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.amjcard.2008.08.015","ISBN":"1879-1913 (Electronic)\r0002-9149 (Linking)","ISSN":"00029149","PMID":"19064026","abstract":"Adherence to treatment guidelines during hospital admissions for heart failure impacts readmissions and mortality. However, the relation between guideline adherence and heart failure hospital length of stay (LOS) has not been well studied. Whether quality of care delivered to patients with heart failure is impacted on by hospital LOS was assessed. Data were analyzed from 209 hospitals participating in the Get With the Guidelines heart failure program. From January 2005 to September 2006, a total of 36,078 admissions were recorded and stratified by a median heart failure hospitalization LOS of <5 or ≥5 days. Comparisons of baseline patient characteristics and quality measures were analyzed using generalized estimating equations. Patients with LOS ≥5 days were slightly older, more likely to be seen at a larger hospital, and had higher ejection fractions and increased rates of such co-morbidities as diabetes, anemia, renal insufficiency, and pulmonary disease. After adjustment, longer LOS was associated with an increased odds ratio (OR) per each additional day for providing discharge instructions (OR 1.027, 95% confidence interval [CI] 1.017 to 1.038) and left ventricular ejection fraction documentation (OR 1.049, 95% CI 1.031 to 1.067). However, LOS ≥5days was independently associated with modestly decreased use of life-prolonging medications at hospital discharge for patients with left ventricular systolic dysfunction: angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (OR 0.977, 95% CI 0.967 to 0.987) and β blockers (OR 0.990, 95% CI 0.982 to 0.997). In conclusion, in Get With the Guidelines participating institutions, hospital LOS had only a modest influence on quality-of-care measures. Overall, excellent adherence to guideline-based medical therapy was observed, even in patients with a shorter hospital LOS. ? 2008 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tanner","given":"Justin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horwich","given":"Tamara B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-4","issue":"12","issued":{"date-parts":[["2008"]]},"page":"1693-1697","publisher":"Elsevier Inc.","title":"Influence of Hospital Length of Stay for Heart Failure on Quality of Care","type":"article-journal","volume":"102"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.ahj.2008.07.004","ISBN":"1097-6744 (Electronic)\r0002-8703 (Linking)","ISSN":"00028703","PMID":"19033015","abstract":"Background: In chronic heart failure (HF), lower total cholesterol (TC) levels have been associated with increased mortality. However, the relationship between lipid levels and outcomes in acute HF has not been studied. This study investigates the relationship between cholesterol levels and in-hospital mortality in patients hospitalized with acute HF. Methods: The Get With the Guidelines-Heart Failure registry prospectively collects data on patients hospitalized with HF. We analyzed data on 17,791 patients admitted between January 2005 and June 2007 at 236 participating hospitals who had TC levels recorded. Baseline patient characteristics, treatment regimens, and in-hospital mortality were examined by TC level (mg/dL) quartiles (Q) as follows: Q1 (TC ≤118), Q2 (TC 119-145), Q3 (TC 146-179), and Q4 (TC ≥180). Results: Mean TC level was 150 ± 47 mg/dL. Patients with lower TC were older and had higher prevalence of ischemic heart disease. Of the patients, 46% were on a lipid-lowering drug, including 58%, 50%, 43%, and 34% of patients in TC Q1 to Q4, respectively. In-hospital mortality in TC Q1 to Q4 was 3.3%, 2.5%, 2.0%, and 1.3%, respectively (P < .0001). On multivariable adjusted analyses, each 10-mg/dL increase in TC level was associated with 4% decreased risk of in-hospital mortality (odds ratio 0.96, 95% CI 0.93-0.98). Conclusions: In patients hospitalized with HF, lower TC levels independently predict increased in-hospital mortality risk. Further evaluation of optimal cholesterol levels and influence of lipid-lowering medication use on outcomes in this population is warranted. ? 2008 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Horwich","given":"Tamara B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-5","issue":"6","issued":{"date-parts":[["2008"]]},"page":"1170-1176","publisher":"Mosby, Inc.","title":"Cholesterol levels and in-hospital mortality in patients with acute decompensated heart failure","type":"article-journal","volume":"156"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1161/CIRCULATIONAHA.108.773838","ISSN":"00097322","PMID":"18697821","abstract":"BACKGROUND: The frequency and characterization of patients receiving cardiac resynchronization therapy (CRT) are largely unknown since the publication of pivotal clinical trials and subsequent incorporation of CRT into the American College of Cardiology/American Heart Association guidelines for heart failure. METHODS AND RESULTS: We analyzed 33,898 patients admitted from January 2005 through September 2007 to 228 hospitals participating in the American Heart Association's Get With the Guidelines-Heart Failure program. There were 4201 patients (12.4%) discharged alive with CRT, including 811 new implants. Patients discharged with CRT were older (median age, 75 versus 72 years) and had lower median left ventricular ejection fraction (30% versus 38%), more frequent ischemic cardiomyopathy (58% versus 45%), more history of atrial fibrillation (38% versus 27%), and higher rates of beta-blocker and aldosterone antagonist use (P<0.0001 for all) than those without CRT. We found that 4.8% of patients with left ventricular ejection fraction <or=35% were discharged with a new CRT implant, which varied greatly by hospital. Ten percent of patients discharged with a new CRT implant had a left ventricular ejection fraction >35%. Major factors associated with lower rates of new CRT placement were treatment in the northeast (odds ratio, 0.40; 95% confidence interval, 0.30 to 0.53), black race (odds ratio, 0.45; 95% confidence interval, 0.36 to 0.57), increasing left ventricular ejection fraction per 10% (odds ratio, 0.56; 95% confidence interval, 0.52 to 0.60), and increasing age per 10 years in those >70 years of age (odds ratio, 0.56; 95% confidence interval, 0.48 to 0.65). CONCLUSIONS: Although CRT is a recent evidence-based therapy for heart failure, patterns of use differ significantly from clinical trials and published guidelines. Important variations also exist for CRT therapy based on race, geographic region, comorbidities, and age and need to be addressed through further study and/or quality-of-care initiatives.","author":[{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thomas","given":"Kevin L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lewis","given":"William R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-6","issue":"9","issued":{"date-parts":[["2008"]]},"page":"926-933","title":"Use of cardiac resynchronization therapy in patients hospitalized with heart failure","type":"article-journal","volume":"118"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.jacc.2009.04.091","ISBN":"1558-3597","ISSN":"07351097","PMID":"19778670","abstract":"Objectives: This study sought to examine quality of care and warfarin use at discharge in patients with atrial fibrillation (AF) and heart failure (HF). Background: Atrial fibrillation is common in HF, and national guidelines recommend discharge on warfarin for stroke prophylaxis. However, the frequency and factors associated with the guideline adherence are poorly described. Methods: We analyzed 72,534 HF admissions from January 2005 through March 2008 at 255 hospitals participating in the American Heart Association's Get With The Guidelines HF program. Multivariable logistic regression was used to identify independent factors associated with warfarin use at discharge. Results: In this HF population, 20.5% (n = 14,901) had AF on admission, whereas another 13.7% (n = 9,918) had a prior history of AF but were in a regular rhythm at admission. Contraindications to warfarin therapy were documented in 9.2%. Among eligible HF patients without contraindications, the median prevalence of warfarin therapy at discharge was 64.9% (interquartile range 55.5 to 73.4) and did not improve during the 3.5 years of study. After adjustment, major factors associated with no warfarin use at discharge included increasing age, nonwhite race, anemia, and treatment in the south. Warfarin use also varied inversely with CHADS2 (congestive heart failure, hypertension, age >75, diabetes, and prior stroke or transient ischemic attack) risk (70.9% to 59.5% for CHADS2 score 1 to 6, p < 0.0001). Conclusions: Guideline-recommended warfarin use in patients with AF and HF is less than optimal, has not improved over time, and varies significantly according to age, race, risk profile, region, and hospital site. ? 2009 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Patel","given":"Manesh R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lewis","given":"William R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-7","issue":"14","issued":{"date-parts":[["2009"]]},"page":"1280-1289","publisher":"Elsevier Inc.","title":"Quality of Care for Atrial Fibrillation Among Patients Hospitalized for Heart Failure","type":"article-journal","volume":"54"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1016/j.ahj.2009.06.025","ISBN":"1097-6744 (Electronic)\r0002-8703 (Linking)","ISSN":"00028703","PMID":"19699870","abstract":"Background: Although hospital admissions during weekends have been associated with worse quality of care and worse outcomes in some but not all medical conditions, the impact of weekend versus weekday admission and discharge for heart failure (HF) has not been well studied. This study investigates the association of (1) weekend compared to weekday HF admissions and discharges with quality of care and (2) weekend versus weekday HF admissions with length of stay (LOS) and mortality in the hospital. Methods: Data were analyzed for 81,810 HF admissions at 241 sites participating in Get With the Guidelines (GWTG)-HF from January 2005 to September 2008. The cohort was stratified by weekend versus weekday admission and discharge. Generalized estimating equations adjusted for patient and hospital characteristics and clustering. Results: Mean age was 72 ± 14 years; left ventricular ejection fraction (LVEF) was 39±17%. Inhospital mortality was 3.0% and median LOS 4 days. Weekend admission was associated with decreased odds of LVEF documentation. Weekend discharge was associated with decreased odds of LVEF documentation and completed discharge instructions. Weekend HF admission compared to weekday admission was associated with slightly higher risk-adjusted odds of longer inhospital LOS (1.03 [1.01-1.05] and increased inhospital mortality (1.13 [1.02-1.27]). Conclusions: Among GWTG-HF hospitals, weekend admission and discharge for HF were associated with similar quality of care in many but not all measures. Risk-adjusted LOS was slightly longer and mortality moderately higher for weekend HF admissions. ? 2009 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Horwich","given":"Tamara B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-8","issue":"3","issued":{"date-parts":[["2009"]]},"page":"451-458","publisher":"Mosby, Inc.","title":"Weekend hospital admission and discharge for heart failure: Association with quality of care and clinical outcomes","type":"article-journal","volume":"158"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1016/j.ahj.2009.07.034","ISSN":"00028703","PMID":"19781426","abstract":"Background: Medication and dietary nonadherence are precipitating factors for heart failure (HF) hospitalization; however, the characteristics, outcomes, and quality of care of patients with nonadherence are unknown. Recognizing features of nonadherent patients may provide a means to reduce rehospitalization for this population. Methods: GWTG-HF registry data were collected from 236 hospitals and 54,322 patients from January 1, 2005 to December 30, 2007. Demographics, clinical characteristics, in-hospital outcomes, and quality of care were stratified by precipitating factor for HF admission. Multivariate logistic regression analysis was used to determine the association of nonadherence with length of stay (LOS) and in-hospital mortality. Results: Clinicians documented dietary and/or medication nonadherence as the reason for admission in 5576 (10.3%) of HF hospitalizations. Nonadherent patients were younger and more likely to be male, minority, uninsured, and have nonischemic HF. These patients had lower ejection fractions (34.9% vs 39.6%, P < .0001), more frequent previous HF hospitalizations, higher brain natriuretic peptide levels (1813 vs 1371 pg/mL, P < .0001), and presented with greater signs of congestion. Despite this, nonadherent patients had shorter LOS (odds ratio 0.94, 95% CI 0.92-0.97) and lower in-hospital mortality (odds ratio 0.65, 95% CI 0.51-0.83) in multivariate analysis. Although nonadherent patients received high rates of Joint Commission core measures, rates of other evidence-based treatments were less optimal. Conclusions: Nonadherence is a common precipitant for HF admission. Despite a higher risk profile, nonadherent patients had lower in-hospital mortality and LOS, suggesting that it may be easier to stabilize nonadherent patients by reinstituting sodium and/or fluid restriction and resuming medical therapy. ? 2009 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pan","given":"Wenqin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-9","issue":"4","issued":{"date-parts":[["2009"]]},"page":"644-652","publisher":"Mosby, Inc.","title":"Characteristics and in-hospital outcomes for nonadherent patients with heart failure: Findings from Get With The Guidelines-Heart Failure (GWTG-HF)","type":"article-journal","volume":"158"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1001/jama.2009.1493","ISBN":"1538-3598 (Electronic)\\n0098-7484 (Linking)","ISSN":"0098-7484","PMID":"19843900","abstract":"CONTEXT: Aldosterone antagonists are recommended for patients with moderate to severe heart failure (HF) and systolic dysfunction. Prior studies suggest underuse of aldosterone antagonists in eligible patients as well as overuse in settings in which therapy may be harmful. OBJECTIVE: To examine aldosterone antagonist prescription based on HF management guideline criteria, investigator-defined appropriateness criteria, and trends over time in patients hospitalized with heart failure. DESIGN, SETTING, AND PATIENTS: Observational analysis of 43,625 patients admitted with HF and discharged home from 241 hospitals participating in the Get With The Guidelines-HF quality improvement registry between January 2005 and December 2007. MAIN OUTCOME MEASURES: Prescription and predictors of use of aldosterone antagonists, based on guideline criteria. RESULTS: Among 12,565 patients eligible for aldosterone antagonist therapy, 4087 (32.5%) received an aldosterone antagonist at discharge, and treatment increased modestly from 28% to 34% over the study period. There was also wide variation in aldosterone antagonist use among hospitals (0%-90.6%). Aldosterone antagonist use in eligible patients was associated with younger age (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.82-0.88), African American race/ethnicity (adjusted OR, 1.17; 95% CI, 1.04-1.32), lower systolic blood pressure (adjusted OR, 0.94; 95% CI, 0.92-0.95), history of implantable cardioverter-defibrillator use (adjusted OR, 1.51; 95% CI, 1.34-1.69), depression (adjusted OR, 1.15; 95% CI, 1.01-1.30), alcohol use (adjusted OR, 1.23; 95% CI, 1.02-1.50), and pacemaker implantation (adjusted OR, 1.21; 95% CI, 1.06-1.38), and with having no history of renal insufficiency (adjusted OR, 0.85; 95% CI, 0.75-0.96). Applying serum creatinine and potassium appropriateness criteria, inappropriate and potentially inappropriate use of aldosterone antagonist therapy was low and did not change over the 3-year study period. CONCLUSIONS: Less than one-third of eligible patients hospitalized for HF and participating in a quality improvement registry received HF guideline-recommended aldosterone antagonist therapy. Use of aldosterone antagonist therapy among patients with documented contraindications was low.","author":[{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cannon","given":"Christopher P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-10","issue":"15","issued":{"date-parts":[["2009"]]},"page":"1658-1665","title":"Use of aldosterone antagonists in heart failure.","type":"article-journal","volume":"302"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1016/j.ahj.2009.03.010","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"19464411","abstract":"Background Heart failure (HF) is common among elderly adults. Although multiple studies demonstrate age-related declines in the utilization of evidence-based therapies for coronary artery disease, there are few analyses of HF patients to distinguish possible age-related management differences. Methods We analyzed 57,937 HF admissions from January 2005 through April 2007 in 257 hospitals participating in the American Heart Association's Get With The Guidelines-Heart Failure program. Patient characteristics and management were stratified by age groups =65, 66-75, 76-85, and >85 years. Multivariable regression analyses were used to assess the influence of age on use of therapies and inhospital mortality. Results The mean patient age was 73 ± 14 years; 18.7% were >85 years of age. Prescriptions of most HF therapies were relatively reduced with age but still remained high overall. Although 88.6% of patients ≤65 years of age with left ventricular systolic dysfunction were prescribed angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and 90.9% were prescribed ?-blockers, among those >85 years of age with left ventricular systolic dysfunction, 79% were prescribed angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and 82.7% were prescribed ?-blockers. Regression analysis that accounted for typical confounders demonstrated that older age was associated with diminished utilization of most evidence-based treatment measures as well as increased mortality. Conclusions Get With The Guidelines-Heart Failure data demonstrate that guidelines recommended therapies are frequently utilized for older patients with HF, including patients >85 years old. Nonetheless, age-related differences in therapy persist, suggesting that opportunities to improve care still remain. ? 2009, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Forman","given":"Daniel E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cannon","given":"Christopher P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-11","issue":"6","issued":{"date-parts":[["2009"]]},"page":"1010-1017","publisher":"Mosby, Inc.","title":"Influence of age on the management of heart failure: Findings from Get with the Guidelines-Heart Failure (GWTG-HF)","type":"article-journal","volume":"157"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1016/j.ahj.2009.07.031","ISBN":"1097-6744 (Electronic)\r0002-8703 (Linking)","ISSN":"00028703","PMID":"19781413","abstract":"Background: Many hospitals enrolled in the American Heart Association's Get With The Guidelines (GWTG) Program achieve high levels of recommended care for heart failure, acute myocardial infarction (MI) and stroke. However, it is unclear if outcomes are better in those hospitals recognized by the GWTG program for their processes of care. Methods: We compared hospitals enrolled in GWTG and receiving achievement awards for high levels of recommended processes of care with other hospitals using data on risk-adjusted 30-day survival for heart failure and acute MI reported by the Center for Medicare and Medicaid Services. Results: Among the 3,909 hospitals with 30-day data reported by Center for Medicare and Medicaid Services 355 (9%) received GWTG achievement awards. Risk-adjusted mortality for hospitals receiving awards was lower for both heart failure (11.0% vs 11.2%, P = .0005) and acute MI (16.1% vs 16.5%, P < .0001) compared to those not receiving awards. After additional adjustment for hospital characteristics and noncardiac performance measures, the reduction in mortality remained significantly lower for GWTG award hospitals for acute myocardial infraction (-0.19%, 95% CI -0.33 to -0.05), but not for heart failure (-0.11%, 95% CI -0.25 to 0.02). Additional adjustment for cardiac processes of care reduced the benefit of award hospitals by 28% for heart failure mortality and 43% for acute MI mortality. Conclusions: Hospitals receiving achievement awards from the GWTG program have modestly lower risk adjusted mortality for acute MI and to a lesser extent, heart failure, explained in part by better process of care.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lewis","given":"William R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-12","issue":"4","issued":{"date-parts":[["2009"]]},"page":"546-553","publisher":"Elsevier B.V.","title":"Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure","type":"article-journal","volume":"158"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"10.1016/j.jacc.2008.09.045","ISBN":"1558-3597","ISSN":"07351097","PMID":"19179199","abstract":"Objectives: The aim of this study was to describe hospital variation and factors associated with adherence to guidelines for implantable cardioverter-defibrillator (ICD) therapy. Background: Studies have shown incomplete application of ICD therapy in eligible heart failure (HF) patients. Methods: New or discharge prescription rates for ICD therapy (ejection fraction ≤30% without documented ICD contraindications) for hospitals were calculated from participants in the GWTG-HF (Get With The Guidelines-Heart Failure) registry during January 2005 to June 2007. With hierarchical modeling, hospitals' patient case-mix adjusted ICD rate and hospital factors associated with ICD use were determined. The association of ICD rate and other quality of care indicators and procedure use was determined. Results: Overall use of ICD in-hospital or planned implantation rate was 20%. This rate ranged widely among hospitals, from 1% among the lowest tertile to 35% among the top tertile (p < 0.01). After adjusting for patient case mix, independent hospital characteristics associated with higher ICD use were percutaneous coronary intervention, coronary artery bypass grafting, and heart transplant capability as well as larger hospital bed size (p < 0.01). Hospital Centers for Medicare and Medicaid Services/Joint Commission on the Accreditation of Healthcare Organizations performance measures (discharge instructions, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use, smoking cessation; p ≥ 0.05) were similar across ICD, whereas higher ICD-rate hospitals had higher adherence to GWTG-HF performance measures (beta-blocker use, evidence-based beta-blocker use, aldosterone-antagonist, hydralazine/nitrate; p < 0.05) except warfarin in patients with atrial fibrillation (p = 0.18). Conclusions: There is significant unexplained hospital variation in the use of ICD therapy among potentially eligible HF patients. However, hospitals that use ICD therapy more often also have more rapidly adopted other newer evidence-based HF therapies. ? 2009 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Shah","given":"Bimal","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-13","issue":"5","issued":{"date-parts":[["2009"]]},"page":"416-422","publisher":"American College of Cardiology Foundation","title":"Hospital Variation and Characteristics of Implantable Cardioverter-Defibrillator Use in Patients With Heart Failure. Data From the GWTG-HF (Get With The Guidelines-Heart Failure) Registry","type":"article-journal","volume":"53"},"uris":[""]},{"id":"ITEM-14","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.109.884395","ISSN":"19413289","PMID":"20009044","abstract":"BACKGROUND: The clinical effectiveness of implantable cardioverter-defibrillators (ICDs) in older patients with heart failure has not been established, and older patients have been underrepresented in previous studies. METHODS AND RESULTS: We identified patients with heart failure who were aged 65 years or older and were eligible for an ICD, had left ventricular ejection fraction of 35% or less, and were discharged alive from hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure and the Get With the Guidelines-Heart Failure quality-improvement programs during the period January 1, 2003, through December 31, 2006. We matched the patients to Medicare claims to examine long-term outcomes. The main outcome measure was all-cause mortality over 3 years. The study population included 4685 patients who were discharged alive and were eligible for an ICD. Mean age was 75.2 years, 60% of the patients were women, mean ejection fraction was 25%, and 376 (8.0%) patients received an ICD before discharge. Mortality was significantly lower among patients who received an ICD compared with those who did not (19.8% versus 27.6% at 1 year, 30.9% versus 41.9% at 2 years, and 38.1% versus 52.3% at 3 years; P<0.001 for all comparisons). The inverse probability-weighted adjusted hazard of mortality at 3 years for patients receiving an ICD was 0.71 (95% CI, 0.56 to 0.91). CONCLUSIONS: Medicare beneficiaries hospitalized with heart failure and left ventricular ejection fraction of 35% or less who were selected for ICD therapy had lower risk-adjusted long-term mortality compared with those who did not receive an ICD. Clinical Trial Registration- . Identifier: NCT00344513.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schulman","given":"Kevin a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-14","issue":"1","issued":{"date-parts":[["2010"]]},"page":"7-13","title":"Clinical effectiveness of implantable cardioverter-defibrillators among Medicare beneficiaries with heart failure","type":"article-journal","volume":"3"},"uris":[""]},{"id":"ITEM-15","itemData":{"DOI":"10.1016/S0735-1097(10)61205-3","ISBN":"1538-3598 (Electronic) 0098-7484 (Linking)","ISSN":"07351097","PMID":"20442387","abstract":"CONTEXT: Readmission after hospitalization for heart failure is common. Early outpatient follow-up after hospitalization has been proposed as a means of reducing readmission rates. However, there are limited data describing patterns of follow-up after heart failure hospitalization and its association with readmission rates. OBJECTIVE: To examine associations between outpatient follow-up within 7 days after discharge from a heart failure hospitalization and readmission within 30 days. DESIGN, SETTING, AND PATIENTS: Observational analysis of patients 65 years or older with heart failure and discharged to home from hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure and the Get With the Guidelines-Heart Failure quality improvement program from January 1, 2003, through December 31, 2006. MAIN OUTCOME MEASURE: All-cause readmission within 30 days after discharge. RESULTS: The study population included 30,136 patients from 225 hospitals. Median length of stay was 4 days (interquartile range, 2-6) and 21.3% of patients were readmitted within 30 days. At the hospital level, the median percentage of patients who had early follow-up after discharge from the index hospitalization was 38.3% (interquartile range, 32.4%-44.5%). Compared with patients whose index admission was in a hospital in the lowest quartile of early follow-up (30-day readmission rate, 23.3%), the rates of 30-day readmission were 20.5% among patients in the second quartile (risk-adjusted hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.78-0.93), 20.5% among patients in the third quartile (risk-adjusted HR, 0.87; 95% CI, 0.78-0.96), and 20.9% among patients in the fourth quartile (risk-adjusted HR, 0.91; 95% CI, 0.83-1.00). CONCLUSIONS: Among patients who are hospitalized for heart failure, substantial variation exists in hospital-level rates of early outpatient follow-up after discharge. Patients who are discharged from hospitals that have higher early follow-up rates have a lower risk of 30-day readmission. TRIAL REGISTRATION: Identifier: NCT00344513.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-15","issue":"17","issued":{"date-parts":[["2010"]]},"page":"1716-1722","title":"Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure.","type":"article-journal","volume":"303"},"uris":[""]},{"id":"ITEM-16","itemData":{"DOI":"10.1016/j.cardfail.2011.04.005","ISBN":"1532-8414 (Electronic)\\r1071-9164 (Linking)","ISSN":"10719164","PMID":"21807326","abstract":"Background: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. Methods and Results: A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With The Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r 2 of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation. Conclusions: Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-16","issue":"8","issued":{"date-parts":[["2011"]]},"page":"649-656","publisher":"Elsevier Inc","title":"Predictors of hospital length of stay in heart failure: Findings from get with the guidelines","type":"article-journal","volume":"17"},"uris":[""]},{"id":"ITEM-17","itemData":{"DOI":"10.1016/j.amjcard.2011.05.032","ISBN":"1879-1913 (Electronic)\\n0002-9149 (Linking)","ISSN":"00029149","PMID":"21791327","abstract":"Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF <65 years at 225 hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE) registry or the Get With The Guidelines-Heart Failure (GWTG-HF) registry from January 1, 2003 through December 31, 2006. We linked these clinical data to Medicare claims data for longitudinal follow-up. Using logistic regression models with site-level random effects, we identified predictors of physician follow-up within 7 days of hospital discharge. Overall 11,420 patients (37.9%) had early physician follow-up. Patients residing in hospital referral regions with higher physician concentration were significantly more likely to have early follow-up (odds ratio 1.29, 95% confidence interval 1.12 to 1.48, for highest vs lowest quartile). Patients in rural areas (0.84, 0.78 to 0.91) and patients with lower socioeconomic status (0.79, 0.74 to 0.85) were less likely to have early follow-up. Women (0.87, 0.83 to 0.91) and black patients (0.84, 0.77 to 0.92) were less likely to receive early follow-up. Patients with greater co-morbidity were less likely to receive early follow-up. In conclusion, physician follow-up within 7 days after discharge from a HF hospitalization varied according to regional physician density, rural location, socioeconomic status, gender, race, and co-morbid conditions. Strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-17","issue":"7","issued":{"date-parts":[["2011"]]},"page":"985-991","publisher":"Elsevier Inc.","title":"Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure","type":"article-journal","volume":"108"},"uris":[""]},{"id":"ITEM-18","itemData":{"DOI":"10.1016/j.amjcard.2011.02.322","ISBN":"1879-1913 (Electronic) 0002-9149 (Linking)","ISSN":"00029149","PMID":"21482418","abstract":"Hospitalized patients with heart failure and decreased ejection fraction are at substantial risk for mortality and rehospitalization, yet no acute therapies are proven to decrease this risk. Therefore, in-hospital use of medications proved to decrease long-term mortality is a critical strategy to improve outcomes. Although endorsed in guidelines, predictors of initiation and continuation of angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), β blockers, and aldosterone antagonists have not been well studied. We assessed noncontraindicated use patterns for the 3 medications using the Get With the GuidelinesHeart Failure (GWTG-HF) registry from February 2009 through March 2010. Medication continuation was defined as treatment on admission and discharge. Multivariable logistic regression using generalized estimating equations was used to determine factors associated with discharge use. In total 9,474 patients were enrolled during the study period. Of those treated before hospitalization, overall continuation rates were 88.5% for ACE inhibitors/ARBs, 91.6% for β blockers, and 71.9% for aldosterone-antagonists. Of patients untreated before admission, 87.4% had ACE inhibitors/ARBs and 90.1% had β blocker initiated during hospitalization or at discharge, whereas only 25.2% were started on an aldosterone antagonist. In multivariate analysis, admission therapy was most strongly associated with discharge use (adjusted odds ratios 7.4, 6.0, and 20.9 for ACE inhibitors/ARBs, β blockers, and aldosterone antagonists, respectively). Western region, younger age, and academic affiliation were also associated with higher discharge use. Although ACE inhibitor/ARB and β-blocker continuation rates were high, aldosterone antagonist use was lower despite potential eligibility. In conclusion, being admitted on evidence-based medications is the most powerful, independent predictor of discharge use. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kaltenbach","given":"Lisa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-18","issue":"12","issued":{"date-parts":[["2011"]]},"page":"1818-1823","publisher":"Elsevier Inc.","title":"Patterns and predictors of evidence-based medication continuation among hospitalized heart failure patients (from get with the guidelines-heart failure)","type":"article-journal","volume":"107"},"uris":[""]},{"id":"ITEM-19","itemData":{"DOI":"10.1016/j.ahj.2011.01.012","ISSN":"00028703","PMID":"21473975","abstract":"Background: Black and Hispanic populations are at increased risk for developing heart failure (HF) at a younger age and experience differential morbidity and possibly differential mortality compared with whites. Yet, there have been insufficient data characterizing the clinical presentation, quality of care, and outcomes of patients hospitalized with HF as a function of race/ethnicity. Methods: We analyzed 78,801 patients from 257 hospitals voluntarily participating in the American Heart Association's Get With The Guidelines-HF Program from January 2005 thru December 2008. There were 56,266 (71.4%) white, 17,775 (22.6%) black, and 4,760 (6.0%) Hispanic patients. In patients hospitalized with HF, we sought to assess clinical characteristics, adherence to core and other guideline-based HF care measures, and in-hospital mortality as a function of race and ethnicity. Results: Relative to white patients, Hispanic and black patients were significantly younger (median age 78.0, 63.0, 64.0 years, respectively), had lower left ventricular ejection fractions, and had more diabetes mellitus and hypertension. With few exceptions, the provision of guideline-based care was comparable for black, Hispanic, and white patients. Black and Hispanic patients had lower in-hospital mortality than white patients: black/white odds ratio 0.69, 95% CI 0.62-0.78, P < .001 and Hispanic/white odds ratio 0.81, 95% CI 0.67-0.98, P = .03. Conclusions: Hispanic and black patients hospitalized with HF have more cardiovascular risk factors than white patients; however; they have similar or better in-hospital mortality rates. Within the context of a national HF quality improvement program, HF care was equitable and improved in all racial/ethnic groups over time. ? 2011, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Thomas","given":"Kevin L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-19","issue":"4","issued":{"date-parts":[["2011"]]},"page":"746-754","publisher":"Mosby, Inc.","title":"Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure","type":"article-journal","volume":"161"},"uris":[""]},{"id":"ITEM-20","itemData":{"DOI":"10.1161/CIRCULATIONAHA.111.026088","ISBN":"1524-4539 (Electronic)\\r0009-7322 (Linking)","ISSN":"00097322","PMID":"21788585","abstract":"Background- Process and outcome measures are often used to quantify quality of care in hospitals. Whether these quality measures correlate with one another and the degree to which hospital provider rankings shift on the basis of the performance metric is uncertain. Methods and Results- Heart failure patients ≥65 years of age hospitalized in the Get With the Guidelines-Heart Failure registry of the American Heart Association were linked to Medicare claims from 2005 to 2006. Hospitals were ranked by (1) composite adherence scores for 5 heart failure process measures, (2) composite adherence scores for emerging quality measures, (3) risk-adjusted 30-day death after admission, and (4) risk-adjusted 30-day readmission after discharge. Hierarchical models using shrinkage estimates were performed to adjust for case mix and hospital volume. There were 19 483 patients hospitalized from 2005 to 2006 from 153 hospitals. The overall median composite adherence rate to heart process measures was 85.8% (25th, 75th percentiles 77.5, 91.4). Median 30-day risk-adjusted mortality was 9.0% (7.9, 10.4). Median risk-adjusted 30-day readmission was 22.9% (22.1, 23.5). The weighted κ for remaining within the top 20th percentile or bottom 20th percentile was ≤0.15 and the Spearman correlation overall was ≤0.21 between the different measures of quality of care. The average shift in ranks was 33 positions (13, 68) when criteria were changed from 30-day mortality to readmission and 51 positions (22, 76) when ranking metric changed from 30-day mortality to composite process adherence. Conclusions- Agreement between different methods of ranking hospital-based quality of care and 30-day mortality or readmission rankings was poor. Profiling quality of care will require multidimensional ranking methods and/or additional measures.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-20","issue":"6","issued":{"date-parts":[["2011"]]},"page":"712-719","title":"The need for multiple measures of hospital quality: Results from the get with the guidelines-heart failure registry of the american heart association","type":"article-journal","volume":"124"},"uris":[""]},{"id":"ITEM-21","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-21","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]},{"id":"ITEM-22","itemData":{"DOI":"10.1016/j.cardfail.2010.12.005","ISBN":"1071-9164","ISSN":"10719164","PMID":"21549302","abstract":"Background: Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. Methods and Results: Get With the Guidelines (GWTG) program data was used to analyze 57,969 patients hospitalized with HF from January 2005 through January 2010 from 235 sites. Factors associated with referral to HFDM and rates of HF quality measures by referral status were studied. Mean age of patients was 69.7 ± 14.5 years, 52% were men, and 65% were white. HFDM referral occurred in 11,150 (19.2%) patients. The median rate of HFDM referral among all hospitals was 3.5% (25th-75th percentiles 0%-16.7%) and 8.7% (2.8%-27.7%) among hospitals with at least one previous HFDM referral. Quality and performance measures were higher in patients referred to HFDM. HFDM referral was associated with atrial fibrillation, implanted cardiac device, depression, and treatment at larger hospitals. Patients at higher 90-day mortality risk were paradoxically less likely to receive HFDM referral. Conclusions: HFDM referral occurred in less than one-fifth of hospitalized HF patients and was more frequently recommended to lower-risk patients. Increasing use and optimizing selection of patients for HFDM referral is a potential target for quality improvement. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Gharacholou","given":"S. Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-22","issue":"5","issued":{"date-parts":[["2011"]]},"page":"431-439","publisher":"Elsevier Inc","title":"Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: Insights from the get with the guidelines program","type":"article-journal","volume":"17"},"uris":[""]},{"id":"ITEM-23","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.960484","ISSN":"19413289","PMID":"21862732","abstract":"Although women account for a significant proportion of heart failure (HF) hospitalizations, data on the quality of care and in-hospital outcomes in women are limited.","author":[{"dropping-particle":"","family":"Klein","given":"Liviu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bonow","given":"Robert O.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Williams","given":"Mark","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-23","issue":"5","issued":{"date-parts":[["2011"]]},"page":"589-598","title":"Quality of care and outcomes in women hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]},{"id":"ITEM-24","itemData":{"DOI":"10.1161/CIRCULATIONAHA.111.080770","ISSN":"00097322","PMID":"22615345","abstract":"BACKGROUND: Heart failure with preserved ejection fraction (EF) is a common syndrome, but trends in treatments and outcomes are lacking.\\n\\nMETHODS AND RESULTS: We analyzed data from 275 hospitals in Get With the Guidelines-Heart Failure from January 2005 to October 2010. Patients were stratified by EF as reduced EF (EF <40% [HF-reduced EF]), borderline EF (40%≤EF<50% [HF-borderline EF]), or preserved (EF ≥50% [HF-preserved EF]). Using multivariable models, we examined trends in therapies and outcomes. Among 110 621 patients, 50% (55 083) had HF-reduced EF, 14% (15 184) had HF-borderline EF, and 36% (40 354) had HF-preserved EF. From 2005 to 2010, the proportion of hospitalizations for HF-preserved EF increased from 33% to 39% (P<0.0001). In multivariable analyses, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at discharge decreased in all EF groups, and β-blocker use increased. Patients with HF-preserved EF less frequently achieved blood pressure control (adjusted odds ratio, 0.44 versus HF-reduced EF; P<0.001) and were more likely discharged to skilled nursing (adjusted odds ratio, 1.16 versus HF-reduced EF; P<0.001). In-hospital mortality for HF-preserved EF decreased from 3.32% in 2005 to 2.35% in 2010 (adjusted odds ratio, 0.89 per year; P=0.01) but was stable for patients with HF-reduced EF (3.03%-2.83%; adjusted odds ratio, 0.93 per year; P=0.10).\\n\\nCONCLUSIONS: Hospitalization for HF-preserved EF is increasing relative to HF-reduced EF. Although in-hospital mortality for patients with HF-preserved EF declined over the study period, an important opportunity remains for identifying evidence-based therapies in patients with HF-preserved EF.","author":[{"dropping-particle":"","family":"Steinberg","given":"Benjamin a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cannon","given":"Christopher P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-24","issue":"1","issued":{"date-parts":[["2012"]]},"page":"65-75","title":"Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: Prevalence, therapies, and outcomes","type":"article-journal","volume":"126"},"uris":[""]},{"id":"ITEM-25","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.112.967406","ISBN":"1941-3297 (Electronic)\\n1941-3289 (Linking)","ISSN":"19413289","PMID":"22933525","abstract":"BACKGROUND: Reducing 30-day heart failure readmission rates is a national priority. Yet, little is known about how hospitals address the problem and whether hospital-based processes of care are associated with reductions in readmission rates. METHODS AND RESULTS: We surveyed 100 randomly selected hospitals participating in the Get With the Guidelines-Heart Failure quality improvement program regarding common processes of care aimed at reducing readmissions. We grouped processes into 3 domains (ie, inpatient care, discharge and transitional care, and general quality improvement) and scored hospitals on the basis of survey responses using processes selected a priori. We used linear regression to examine associations between these domain scores and 30-day risk-standardized readmission rates. Of the 100 participating sites, 28% were academic centers and 64% were community hospitals. The median readmission rate among participating sites (24.0%; 95% CI, 22.6%-25.7%) was comparable with the national average (24.6%; 23.5-25.9). Sites varied substantially in care processes used for inpatient care, education, discharge process, care transitions, and quality improvement. Overall, neither inpatient care nor general quality improvement domains were associated with 30-day readmission rates. Hospitals in the lowest readmission rate quartile had modestly higher discharge and transitional care domain scores (P=0.03). CONCLUSIONS: A variety of strategies are used by hospitals in an attempt to improve 30-day readmission rates for patients hospitalized with heart failure. Although more complete discharge and transitional care processes may be modestly associated with lower 30-day readmission rates, most current strategies are not associated with lower readmission rates.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Flynn","given":"Kathryn E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pi?a","given":"Ileana L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lytle","given":"Barbara L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-25","issue":"6","issued":{"date-parts":[["2012"]]},"page":"680-687","title":"National survey of hospital strategies to reduce heart failure readmissions findings from the get with the guidelines-heart failure registry","type":"article-journal","volume":"5"},"uris":[""]},{"id":"ITEM-26","itemData":{"DOI":"10.1016/j.ahj.2011.10.008","ISBN":"0002-8703 1097-6744","ISSN":"00028703","PMID":"22305842","abstract":"Background: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare and Medicaid Services) and the main hospital accrediting organization (The Joint Commission). Methods: We used data from Get With The Guidelines Program for patients hospitalized with heart failure. Eligibility for receiving care based on the Center for Medicare and Medicaid Services performance measures was determined for assessment of left ventricular ejection fraction (LVEF; n = 60,601), use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) if LVEF<40% and no contraindications (24,130), discharge instructions (49,383), and smoking cessation counseling (10,152). Patient and hospital characteristics that were significantly associated with performance measures in univariate analyses were entered into multivariate logistic regression models. Results: Overall, documentation for LVEF assessment was noted in 95%, ACEi/ARB use in 87%, discharge instruction in 82%, and smoking cessation counseling in 91% of eligible patients. In adjusted analyses, older patients and those with evidence of renal failure were significantly less likely to receive each care measure except for discharge instructions (no age effect). Patients with higher body mass index were more likely to receive ACEi/ARB and discharge instructions but less likely to have LVEF documented or to receive smoking cessation counseling. Small hospitals (<200 beds) were less likely to provide each of the performance measures compared with larger hospitals. Conclusion: Recommended heart failure care is less likely in patients with certain characteristics (older age and abnormal renal function) and those cared for in smaller hospitals. Programs to improve evidence-based care for heart failure should consider interventions specifically targeting and tailored to smaller facilities and patients who are older with comorbidities. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-26","issue":"2","issued":{"date-parts":[["2012"]]},"page":"239-245.e3","publisher":"Elsevier B.V.","title":"Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure","type":"article-journal","volume":"163"},"uris":[""]},{"id":"ITEM-27","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.111.963546","ISBN":"1941-3289\\n1941-3297","ISSN":"19413289","PMID":"22414939","abstract":"BACKGROUND: Although individuals of Hispanic ethnicity are at high risk for developing heart failure (HF), little is known about differences between Hispanic HF patients stratified by left ventricular ejection fraction (EF). We compared characteristics, quality of care, and outcomes between Hispanic and non-Hispanic white patients hospitalized for HF with preserved EF (PEF) or reduced EF (REF).\\n\\nMETHODS AND RESULTS: From 247 hospitals in Get With The Guidelines-Heart Failure between 2005-2010, 6117 Hispanics were compared with 71 859 non-Hispanic whites. Forty-six percent of Hispanics had PEF (EF >40%), whereas 54% had REF (EF <40%); 55% and 45% of non-Hispanic whites had PEF and REF, respectively. Relative to non-Hispanic whites, Hispanics with PEF or REF were more likely to be younger and to have diabetes, hypertension, and overweight/obesity. In multivariate analysis, a lower mortality risk was observed among Hispanics with PEF (odds ratio, 0.50; 95% confidence interval, 0.31-0.81; P=0.005) but not in Hispanics with REF (odds ratio, 0.94; 95% confidence interval, 0.62-1.43; P=0.784) compared with non-Hispanic whites. In all groups, composite performance improved within the study period (Hispanics PEF: 75.2-95.1%; non-Hispanic whites PEF: 79.0-92.7%; Hispanics REF: 67.7-88.4%; non-Hispanic whites REF: 60.8-85.6%, P<0.0001).\\n\\nCONCLUSIONS: Hispanic HF patients with PEF had better in-hospital survival than non-Hispanic whites with PEF. Inpatient mortality was similar between groups with REF. Quality of care was similar and improved over time irrespective of ethnicity, highlighting the potential benefit of performance improvement programs in promoting equitable care.","author":[{"dropping-particle":"","family":"Vivo","given":"Rey P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"Selim R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"Nassim R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pina","given":"Ileana L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-27","issue":"2","issued":{"date-parts":[["2012"]]},"page":"167-175","title":"Care and outcomes of hispanic patients admitted with heart failure with preserved or reduced ejection fraction findings from get with the guidelines-heart failure","type":"article-journal","volume":"5"},"uris":[""]},{"id":"ITEM-28","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.111.965681","ISSN":"19413289","PMID":"22361078","abstract":"It is unclear if the presence of atrial fibrillation (AF) on admission is associated with worse in-hospital outcomes in patients hospitalized with heart failure (HF). This study evaluated the clinical characteristics, management, length of stay, and mortality of HF patients with and without AF.","author":[{"dropping-particle":"","family":"Mountantonakis","given":"Stavros E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-28","issue":"2","issued":{"date-parts":[["2012"]]},"page":"191-201","title":"Presence of atrial fibrillation is independently associated with adverse outcomes in patients hospitalized with heart failure an analysis of get with the guidelines-heart failure","type":"article-journal","volume":"5"},"uris":[""]},{"id":"ITEM-29","itemData":{"DOI":"10.1016/j.cardfail.2012.02.006","ISSN":"10719164","PMID":"22633304","abstract":"Background: Guidelines recommend hospice care as a treatment option for end-stage heart failure (HF) patients. Little is known regarding utilization of hospice care in a contemporary cohort of patients hospitalized with HF and how this may vary by estimated mortality risk. Methods: We analyzed HF patients ≥65 years (n = 58,330) from 214 hospitals participating in the Get With the Guidelines-HF program. Univariate analysis comparing patients discharged to hospice versus other patients was performed. Hospice utilization was evaluated for deciles of estimated 90-day mortality risk using a validated model. Multivariate analysis using admission patient and hospital characteristics was also performed to determine factors associated with hospice discharge. Results: There were 1,442 patients discharged to hospice, and rates of referral varied widely by hospital (interquartile range 0-3.7%) as shown in the univariate analysis. Patients discharged to hospice were significantly older and more often white, had lower left ventricular ejection fraction, higher B-type natriuretic peptide, and lower systolic blood pressure on admission. Utilization rates for each decile of 90-day estimated mortality risk ranged from 0.3% to 8.6%. Multivariable analysis found that factors associated with hospice utilization included increased age, low systolic blood pressure on admission, and increased blood urea nitrogen. Conclusions: Hospice utilization remains low among HF patients, even those with the highest predicted risk of death. ? 2012 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-29","issue":"6","issued":{"date-parts":[["2012"]]},"page":"471-477","publisher":"Elsevier Inc","title":"Utilization of hospice and predicted mortality risk among older patients hospitalized with heart failure: Findings from GWTG-HF","type":"article-journal","volume":"18"},"uris":[""]},{"id":"ITEM-30","itemData":{"DOI":"10.1161/CIRCULATIONAHA.111.066605","ISBN":"1524-4539 (Electronic)\\r0009-7322 (Linking)","ISSN":"00097322","PMID":"22287589","abstract":"BACKGROUND: Prior studies have demonstrated low use of implantable cardioverter defibrillators (ICDs) as primary prevention, particularly among women and blacks. The degree to which the overall use of ICD therapy and disparities in use have changed is unclear.\\n\\nMETHODS AND RESULTS: We examined 11 880 unique patients with a history of heart failure and left ventricular ejection fraction ≤35% who were ≥65 years old and enrolled in the Get With the Guidelines-Heart Failure (GWTG-HF) program from January 2005 through December 2009. We determined the rate of ICD use by year for the overall population and for sex and race groups. From 2005 to 2007, overall ICD use increased from 30.2% to 42.4% and then remained unchanged in 2008 to 2009. After adjustment for potential confounders, ICD use increased significantly in the overall study population during 2005 to 2007 (odds ratio, 1.28; 95% confidence interval, 1.11-1.48 per year; P=0.0008) and in black women (odds ratio, 1.82; 95% confidence interval, 1.28-2.58 per year; P=0.0008), white women (odds ratio, 1.30; 95% confidence interval, 1.06-1.59 per year; P=0.010), black men (odds ratio, 1.54; 95% confidence interval, 1.19-1.99 per year; P=0.0009), and white men (odds ratio, 1.25; 95% confidence interval, 1.06-1.48 per year; P=0.0072). The increase in ICD use was greatest among blacks.\\n\\nCONCLUSIONS: In the GWTG-HF quality improvement program, a significant increase in ICD therapy use was observed over time in all sex and race groups. The previously described racial disparities in ICD use were no longer present by the end of the study period; however, sex differences persisted.","author":[{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thomas","given":"Kevin L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khalidi","given":"Hussein R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-30","issue":"9","issued":{"date-parts":[["2012"]]},"page":"1094-1101","title":"Trends in use of implantable cardioverter-defibrillator therapy among patients hospitalized for heart failure: Have the previously observed sex and racial disparities changed over time?","type":"article-journal","volume":"125"},"uris":[""]},{"id":"ITEM-31","itemData":{"DOI":"10.1161/CIRCOUTCOMES.110.959122","ISSN":"19417713","PMID":"22235067","abstract":"BACKGROUND: Hospitals enrolled in the American Heart Association's Get With The Guidelines Program for heart failure (GWTG-HF) have improved their process of care. However, it is unclear if process of care and outcomes are better in the GWTG-HF hospitals compared with hospitals not enrolled. METHODS AND RESULTS: We compared hospitals enrolled in GWTG-HF from 2006 to 2007 with other hospitals using data on 4 process of heart failure care measures, 5 noncardiac process measures, risk-adjusted 30-day mortality, and 30-day all-cause readmission after a heart failure hospitalization, as reported by the Center for Medicare and Medicaid Services (CMS). Among the 4460 hospitals reporting data to CMS, 215 (5%) were enrolled in GWTG-HF. Of the 4 CMS heart failure performance measures, GWTG-HF hospitals had significantly higher documentation of the left ventricular ejection fraction (93.4% versus 88.8%), use of angiotensin-converting enzyme inhibitor or angiotensin receptor antagonist (88.3% versus 86.6%), and discharge instructions (74.9% versus 70.5%) (P<0.005 for all). Smoking cessation counseling rates were similar (94.1% versus 94.0%; P=0.51). There was no significant difference in compliance with noncardiac process of care. After heart failure discharge, all-cause readmission at 30 days was 24.5% and mortality at 30 days after admission was 11.1%. After adjustment for hospital characteristics, 30-day mortality rates were no different (P=0.45). However, 30-day readmission was lower for GWTG hospitals (-0.33%; 95% CI, -0.53% to -0.12%; P=0.002). CONCLUSIONS: Although there was evidence that hospitals enrolled in the GTWG-HF program demonstrated better processes of care than other hospitals, there were few clinically important differences in outcomes. Further identification of opportunities to improve outcomes, and inclusion of these metrics in GTWG-HF, may further support the value of GTWG-HF in improving care for patients with HF.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Cardiovascular Quality and Outcomes","id":"ITEM-31","issue":"1","issued":{"date-parts":[["2012"]]},"page":"37-43","title":"Get with the guidelines program participation, process of care, and outcome for medicare patients hospitalized with heart failure","type":"article-journal","volume":"5"},"uris":[""]},{"id":"ITEM-32","itemData":{"DOI":"10.1016/j.ahj.2011.12.013","ISSN":"00028703","PMID":"22424014","abstract":"Background: There are no sex-specific survival comparisons between patients with heart failure (HF) with reduced and those with preserved ejection fraction. Large registries noting women have better survival than men combined HF patients with reduced and preserved EF. Other registries that compared patients with reduced and preserved EF did not analyze their data by sex. We sought to evaluate sex/EF differences in mortality and risk factors for survival in hospitalized patients with HF. Methods: We included hospitals fully participating in Get With The Guidelines-Heart Failure that admitted HF patients with reduced (EF <40%) or preserved (EF ≥50%) EF. The primary end point was in-hospital mortality. Multivariate generalized estimating equation logistic models were used to compute odds ratios accounting for hospital clustering. Results: The study cohort consisted of 51,428 patients with EF <40% (36% women, 64% men) and 37,699 patients with EF ≥50% (65% women, 35% men). Women compared with men with reduced and preserved EF were older and more likely to have hypertension, depression, or valvular heart disease and less likely to have coronary artery disease or peripheral vascular disease. There were no sex differences in in-hospital mortality (EF <40%, 2.69% women vs 2.89% men, P =.20; EF ≥50%, 2.61% women vs 2.62% men, P =.96), and risk factors such as age, systolic blood pressure, heart rate, and history of renal failure/dialysis were highly predictive of death for each sex/EF subgroup. Conclusions: In a large, multicenter registry, we found that despite differences in baseline characteristics, women and men with reduced and preserved EF have similar in-hospital mortality and risk factors predicting death. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Hsich","given":"Eileen M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-32","issue":"3","issued":{"date-parts":[["2012"]]},"page":"430-437.e3","publisher":"Mosby, Inc.","title":"Sex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction","type":"article-journal","volume":"163"},"uris":[""]},{"id":"ITEM-33","itemData":{"DOI":"10.1016/j.ahj.2013.08.029","ISSN":"00028703","PMID":"24268222","abstract":"Background In heart failure (HF), there are known differences in plasma B-type natriuretic peptide (BNP) levels between reduced and preserved ejection fraction (EF), but few HF studies have explored sex differences. We sought to evaluate the relationship between sex, EF, and BNP in HF patients and determine prognostic significance of BNP as it relates to sex and EF. Methods We included hospitals in Get With The Guidelines-Heart Failure that admitted 99,930 HF patients with reduced (EF <40%), borderline (EF 40%-49%), or preserved (EF ≥50%) EF. The primary end point was inhospital mortality. Multivariate models were used to compute odds ratios while accounting for hospital clustering. Results There were 47,025 patients with reduced (37% female), 13,950 with borderline (48% female), and 38,955 with preserved (65% female) EF. Women compared with men had higher admission median BNP levels with the greatest difference among reduced EF and smallest difference among preserved EF (median BNP in women vs men: EF reduced 1,259 vs 1,113 pg/mL, borderline 821 vs 732 pg/mL, and preserved 559 vs 540 pg/mL; P <.001 all comparisons). Ejection fraction and sex were independently associated with BNP. Inhospital mortality was 2.7%, and patients above the median BNP level had higher mortality than those below. After adjusting for over 20 clinical variables, the ability of BNP to predict inhospital mortality was similar among all subgroups (P for heterogeneity =.47). Conclusions In a large registry, we found that despite sex/EF differences in BNP values, there was no significant difference in the ability of BNP to predict inhospital mortality among these subgroups. ? 2013 Mosby, Inc.","author":[{"dropping-particle":"","family":"Hsich","given":"Eileen M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Xian","given":"Ying","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-33","issue":"6","issued":{"date-parts":[["2013"]]},"page":"1063-1071.e3","publisher":"Mosby, Inc.","title":"Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get with the Guideline-Heart Failure Registry","type":"article-journal","volume":"166"},"uris":[""]},{"id":"ITEM-34","itemData":{"DOI":"10.1016/j.jchf.2013.01.008","ISBN":"22131779 (ISSN)","ISSN":"22131779","PMID":"24621877","abstract":"Objectives: The study sought to derive and validate risk-prediction tools from a large nationwide registry linked with Medicare claims data. Background: Few clinical models have been developed utilizing data elements readily available in electronic health records (EHRs) to facilitate \" real-time\" risk estimation. Methods: Heart failure (HF) patients ≥65 years of age hospitalized in the GWTG-HF (Get With The Guidelines-Heart Failure) program were linked with Medicare claims from January 2005 to December 2009. Multivariable models were developed for 30-day mortality after admission, 30-day rehospitalization after discharge, and 30-day mortality/rehospitalization after discharge. Candidate variables were selected based on availability in EHRs and prognostic value. The models were validated in a 30% random sample and separately in patients with reduced and preserved ejection fraction (EF). Results: Among 33,349 patients at 160 hospitals, 3,002 (9.1%) died within 30 days of admission, 7,020 (22.8%) were rehospitalized within 30 days of discharge, and 8,374 (27.2%) died or were rehospitalized within 30 days of discharge. Compared with patients classified as low risk, high-risk patients had significantly higher odds of death (odds ratio [OR]: 8.82, 95% confidence interval [CI]: 7.58 to 10.26), rehospitalization (OR: 1.99, 95% CI: 1.86 to 2.13), and death/rehospitalization (OR: 2.65, 95% CI: 2.44 to 2.89). The 30-day mortality model demonstrated good discrimination (c-index 0.75) while the rehospitalization and death/rehospitalization models demonstrated more modest discrimination (c-indices of 0.59 and 0.62), with similar performance in the validation cohort and for patients with preserved and reduced EF. Conclusions: These predictive models allow for risk stratification of 30-day outcomes for patients hospitalized with HF and may provide a validated, point-of-care tool for clinical decision making. ? 2013 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JACC: Heart Failure","id":"ITEM-34","issue":"3","issued":{"date-parts":[["2013"]]},"page":"245-251","title":"Validated, electronic health record deployable prediction models for assessing patient risk of 30-day rehospitalization and mortality in older heart failure patients","type":"article-journal","volume":"1"},"uris":[""]},{"id":"ITEM-35","itemData":{"DOI":"10.1016/j.jchf.2013.07.001","ISBN":"9925199255","ISSN":"22131779","PMID":"24621978","abstract":"Objectives: This study sought to examine the associations of hospitalist and cardiologist care of patients with heart failure with outcomes and adherence to quality measures. Background: The hospitalist model of inpatient care has grown nationally, but its associations with quality of care and outcomes of patients hospitalized with heart failure are not known. Methods: We analyzed data from the Get With the Guidelines-Heart Failure registry linked to Medicare claims for 2005 through 2008. For each hospital, we calculated the percentage of heart failure hospitalizations for which a hospitalist was the attending physician. We examined outcomes and care quality for patients stratified by rates of hospitalist use. Using multivariable models, we estimated associations between hospital-level use of hospitalists and cardiologists and 30-day risk-adjusted outcomes and adherence to measures of quality care. Results: The analysis included 31,505 Medicare beneficiaries in 166 hospitals. Across hospitals, the use of hospitalists varied from 0% to 83%. After multivariable adjustment, a 10% increase in the use of hospitalists was associated with a slight increase in mortality (risk ratio: 1.03; 95% confidence interval [CI]: 1.00 to 1.06) and decrease in length of stay (0.09 days; 95% CI: 0.02 to 0.16). There was no association with 30-day readmission. Increased use of hospitalists in hospitals with high use of cardiologists was associated with improved defect-free adherence to a composite of heart failure performance measures (risk ratio: 1.03; 95% CI: 1.01 to 1.06). Conclusions: Hospitalist care varied significantly across hospitals for heart failure admissions and was not associated with improved 30-day outcomes. Comanagement by hospitalists and cardiologists may help to improve adherence to some quality measures, but it remains unclear what care model improves 30-day clinical outcomes. ? 2013 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Go","given":"Alan S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JACC: Heart Failure","id":"ITEM-35","issue":"5","issued":{"date-parts":[["2013"]]},"page":"445-453","title":"Associations between use of the hospitalist model and quality of care and outcomes of older patients hospitalized for heart failure","type":"article-journal","volume":"1"},"uris":[""]},{"id":"ITEM-36","itemData":{"DOI":"10.1016/j.ahj.2013.01.007","ISSN":"00028703","PMID":"23537974","abstract":"Background Prior studies have suggested an association between higher heart rate and higher mortality, particularly in chronic heart failure (HF). Whether this relationship holds true in patients hospitalized with HF and differs between patients in sinus rhythm (SR) and atrial fibrillation (AF) has not been well studied. Methods We examined 145,221 admissions for HF from 295 hospitals enrolled in Get With The Guidelines-Heart Failure from January 2005 through September 2011. The associations of admission heart rate with in-hospital outcomes were evaluated overall and by heart rhythm. Results Patients presenting at higher heart rate tended to be younger and have less comorbidities. In-hospital mortality had a J-shaped relationship with heart rate, with the lowest mortality rate associated with heart rates between 70 and 75. However, the relationship differed between patients presenting in SR and AF: at heart rates above 100, the mortality curve for AF plateaued, whereas that for SR continued to rise. Higher heart rate was independently associated with higher mortality (SR adjusted OR 1.21, 95% CI 1.15-1.28 per 10 beat per minute increase in heart rate between 70-105; AF adjusted OR 1.20, 95% CI 1.14-1.27). Findings were similar when stratifying patients by ischemic etiology, diabetes, ejection fraction, blood pressure, and β-blocker use. Conclusions Higher admission heart rate is independently associated with worse outcomes in patients admitted for HF, including those in SR and AF. Whether early heart rate reduction improves outcomes in patients hospitalized with HF is worthy of investigation. ? 2013 Mosby, Inc.","author":[{"dropping-particle":"","family":"Bui","given":"Anh L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-36","issue":"4","issued":{"date-parts":[["2013"]]},"page":"567-574.e6","publisher":"Mosby, Inc.","title":"Admission heart rate and in-hospital outcomes in patients hospitalized for heart failure in sinus rhythm and in atrial fibrillation","type":"article-journal","volume":"165"},"uris":[""]},{"id":"ITEM-37","itemData":{"DOI":"10.1111/jce.12100","ISSN":"10453873","PMID":"23437793","abstract":"INTRODUCTION: Practice guidelines recommend the use of ICDs in patients with heart failure (HF) and a left ventricular ejection fraction (LVEF) of ≤ 35% in the absence of contraindications. METHODS AND RESULTS: We performed an analysis of ICD use among patients admitted with HF with LVEF of ≤ 35% and discharged alive from 251 hospitals participating in the American Heart Association's Get With The Guidelines-HF Program between January 2005 and September 2011. Among 35,772 guideline-eligible patients, 17,639 received an ICD prior to hospitalization (10,886), during hospitalization (4,876), or were discharged with plans to undergo ICD placement after hospitalization (1,877). After adjustment, increasing age was associated with lower ICD use (odds ratio [OR] 0.89, 95% confidence interval [CI] 0.87-0.91 per 5-year increase in age, P < 0.0001). Compared with patient age < 55 years, older age groups ≥ 65 years were less likely to receive an ICD (P < 0.003). Compared with men in the same age group, women were significantly less likely to receive an ICD; this difference was more marked with increasing age (P value for interaction = 0.006). There was a temporal increase in ICD use (adjusted OR 1.23, 95% CI 1.15-1.31 of ICD use per year) that was similar in each age group (P value for interaction = 0.665). CONCLUSIONS: Eligible older HF patients age ≥ 65 years were significantly less likely to receive an ICD. With increasing age, women were less likely to receive an ICD than men. ICD use significantly increased over time in all age groups; however, age-related differences in ICD use persisted.","author":[{"dropping-particle":"","family":"Hess","given":"Paul L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Electrophysiology","id":"ITEM-37","issue":"6","issued":{"date-parts":[["2013"]]},"page":"664-671","title":"Age differences in the use of implantable cardioverter-defibrillators among older patients hospitalized with heart failure","type":"article-journal","volume":"24"},"uris":[""]},{"id":"ITEM-38","itemData":{"DOI":"10.1161/JAHA.113.000200","ISSN":"2047-9980","PMID":"24072530","abstract":"BACKGROUND: The intersection of heart failure (HF) and atrial fibrillation (AF) is common, but the burden of AF among black patients with HF is poorly characterized. We sought to determine the prevalence of AF, characteristics, in-hospital outcomes, and warfarin use associated with AF in patients hospitalized with HF as a function of race.\\n\\nMETHODS AND RESULTS: We analyzed data on 135 494 hospitalizations from January 2006 through January 2012 at 276 hospitals participating in the American Heart Association's Get With The Guidelines HF Program. Multivariable logistic regression models using generalized estimating equations approach for risk-adjusted comparison of AF prevalence, in-hospital outcomes, and warfarin use. In this HF population, 53 389 (39.4%) had AF. Black patients had markedly less AF than white patients (20.8% versus 44.8%, P < 0.001). Adjusting for risk factors and hospital characteristics, black race was associated with significantly lower odds of AF (adjusted odds ratio 0.52, 95% CI 0.48 to 0.55, P < 0.0001). There were no racial differences in in-hospital mortality; however, black patients had a longer length of stay relative to white patients. Black patients compared with white patients with AF were less likely to be discharged on warfarin (adjusted odds ratio 0.76, 95% CI 0.69 to 0.85, P < 0.001).\\n\\nCONCLUSIONS: Despite having many risk factors for AF, black patients, relative to white patients hospitalized for HF, had a lower prevalence of AF and lower prescription of guideline-recommended warfarin therapy.","author":[{"dropping-particle":"","family":"Thomas","given":"Kevin L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-38","issue":"5","issued":{"date-parts":[["2013"]]},"page":"e000200","title":"Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure.","type":"article-journal","volume":"2"},"uris":[""]},{"id":"ITEM-39","itemData":{"DOI":"10.1016/j.ahj.2013.03.007","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"23708170","abstract":"Background Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. Methods We identified patients with heart failure and reduced ejection fraction who were =65 years old, eligible for aldosterone antagonist therapy, and discharged home from hospitals in the Get With the Guidelines-Heart Failure registry between January 1, 2005, and December 31, 2008. We used Medicare prescription drug event data to measure adherence. Main outcome measures were prescription at discharge, outpatient prescription claim within 90 days, discontinuation, and adherence as measured with the medication possession ratio. We used the cumulative incidence function to estimate rates of initiation and discontinuation. Results Among 2,086 eligible patients, 561 (26.9%) were prescribed an aldosterone antagonist at discharge. Within 90 days, 78.6% of eligible patients with a discharge prescription filled a prescription for the therapy, compared with 13.0% of eligible patients without a discharge prescription (P >.001). The median medication possession ratio was 0.63 over 1 year of follow-up. Among 634 patients who filled a prescription within 90 days of discharge, 7.9% discontinued therapy within 1 year. Conclusion Most eligible patients were not prescribed aldosterone antagonist therapy at discharge from a heart failure hospitalization. Eligible patients without a discharge prescription seldom initiated therapy as outpatients. Most patients who were prescribed an aldosterone antagonist at discharge filled the prescription within 90 days and remained on therapy. (Am Heart J 2013;165:979-986.e1.).? 2013, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mi","given":"Xiaojuan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"Laura G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Check","given":"Devon K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Setoguchi","given":"Soko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-39","issue":"6","issued":{"date-parts":[["2013"]]},"page":"979-986.e1","publisher":"Mosby, Inc.","title":"Heart failure: Transitional adherence and persistence in the use of aldosterone antagonist therapy in patients with heart failure","type":"article-journal","volume":"165"},"uris":[""]},{"id":"ITEM-40","itemData":{"DOI":"10.1016/j.ahj.2013.02.006","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"23708171","abstract":"Background Hospitals are challenged to reduce length of stay (LOS), yet simultaneously reduce readmissions for patients with heart failure (HF). This study investigates whether 30-day rehospitalization or an alternative measure of total inpatient days over an episode of care (EOC) is the best indicator of resource use, HF quality, and outcomes. Methods Using data from the American Heart Association's Get With The Guidelines-Heart Failure Registry linked to Medicare claims, we ranked and compared hospitals by LOS, 30-day readmission rate, and overall EOC metric, defined as all hospital days for an HF admission and any subsequent admissions within 30 days. We divided hospitals into quartiles by 30-day EOC and 30-day readmission rates. We compared performance by EOC and readmission rate quartiles with respect to quality of care indicators and 30-day postdischarge mortality. Results The population had a mean age of 80 ± 7.95 years, 45% were male, and 82% were white. Hospital-level unadjusted median index LOS and overall EOC were 4.9 (4.2-5.6) and 6.2 (5.3-7.4) days, respectively. Median 30-day readmission rate was 23.2%. Hospital HF readmission rate was not associated with initial hospital LOS, only slightly associated with total EOC rank (r = 0.26, P = .001), and inversely related to HF performance measures. After adjustment, there was no association between 30-day readmission and decreased 30-day mortality. In contrast, better performance on the EOC metric was associated with decreased odds of 30-day mortality. Conclusions Although hospital 30-day readmission rate was poorly correlated with LOS, quality measures, and 30-day mortality, better performance on the EOC metric was associated with better 30-day survival. Total inpatient days during a 30-day EOC may more accurately reflect overall resource use and better serve as a target for quality improvement efforts. (Am Heart J 2013;165:987-994.e1.). ? 2013, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-40","issue":"6","issued":{"date-parts":[["2013"]]},"page":"987-994.e1","publisher":"Mosby, Inc.","title":"Are we targeting the right metric for heart failure? comparison of hospital 30-day readmission rates and total episode of care inpatient days","type":"article-journal","volume":"165"},"uris":[""]},{"id":"ITEM-41","itemData":{"DOI":"10.1161/JAHA.113.000214","ISSN":"2047-9980","PMID":"23966379","abstract":"BACKGROUND: Hydralazine-isosorbide dinitrate (H-ISDN) therapy is recommended for African American patients with moderate to severe heart failure with reduced ejection fraction (<40%) (HFrEF), but use, temporal trends, and clinical characteristics associated with H-ISDN therapy in clinical practice are unknown.\\n\\nMETHODS AND RESULTS: An observational analysis of 54 622 patients admitted with HFrEF and discharged home from 207 hospitals participating in the Get With The Guidelines-Heart Failure registry from April 2008 to March 2012 was conducted to assess prescription, trends, and predictors of use of H-ISDN among eligible patients. Among 11 185 African American patients eligible for H-ISDN therapy, only 2500 (22.4%) received H-ISDN therapy at discharge. In the overall eligible population, 5115 of 43 498 (12.6%) received H-ISDN at discharge. Treatment rates increased over the study period from 16% to 24% among African Americans and from 10% to 13% among the entire HFrEF population. In a multivariable model, factors associated with H-ISDN use among the entire cohort included younger age; male sex; African American/Hispanic ethnicity; and history of diabetes, hypertension, anemia, renal insufficiency, higher systolic blood pressure, and lower heart rate. In African American patients, these factors were similar; in addition, being uninsured was associated with lower use.\\n\\nCONCLUSIONS: Overall, few potentially eligible patients with HFrEF are treated with H-ISDN, and among African-Americans fewer than one-fourth of eligible patients received guideline-recommended H-ISDN therapy. Improved ways to facilitate use of H-ISDN therapy in African American patients with HFrEF are needed.","author":[{"dropping-particle":"","family":"Golwala","given":"Harsh B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thadani","given":"Udho","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stavrakis","given":"Stavros","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Butler","given":"Javed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-41","issue":"4","issued":{"date-parts":[["2013"]]},"page":"e000214","title":"Use of hydralazine-isosorbide dinitrate combination in African American and other race/ethnic group patients with heart failure and reduced left ventricular ejection fraction.","type":"article-journal","volume":"2"},"uris":[""]},{"id":"ITEM-42","itemData":{"DOI":"10.1016/j.jchf.2013.04.008","ISSN":"22131779","PMID":"24621938","abstract":"Objectives: This study sought to determine if there were differences in B-type natriuretic peptide (BNP) levels across racial/ethnic groups and in their association with quality of care and in-hospital outcomes among patients with heart failure (HF). Background: It remains unclear whether BNP levels and their associations with quality of care and prognosis vary by race/ethnicity among patients hospitalized with HF. Methods: Using Get With The Guidelines-Heart Failure (GWTG-HF), patient characteristics and BNP levels at admission were compared among 4 racial/ethnic populations: white, black, Hispanic, and Asian. The associations between BNP, quality of care, in-hospital mortality, and length of stay (LOS) across these groups were analyzed. Results: A total of 92,072 patients (65,037 white, 19,092 black, 6,747 Hispanic, and 1,196 Asian) from 264 hospitals were included. Median BNP levels were higher in Asian (1,066 pg/ml) and black (866 pg/ml) patients than in white (776pg/ml) and Hispanic (737 pg/ml) patients, and race/ethnicity was independently associated with BNP levels (p< 0.0001). Irrespective of race/ethnicity, patients in higher BNP quartiles (Q3, Q4) were more likely to be older and male and have lower body mass index, reduced ejection fraction, and renal insufficiency, whereas those in the lowest quartile (Q1) were more likely to have diabetes. With some exceptions, there were no significant racial/ethnic differences in the association of BNP levels with performance measure adherence. In multivariate analysis, elevated BNP levels remained associated with longer LOS and increased mortality in all racial/ethnic groups. Conclusions: Asian and black patients with HF had higher BNP levels at admission compared with white and Hispanic patients. BNP levels at admission provided prognostic value for in-hospital mortality and hospital LOS irrespective of race/ethnicity. ? 2013 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Krim","given":"Selim R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vivo","given":"Rey P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"Nassim R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qian","given":"Feng","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ventura","given":"Hector","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JACC: Heart Failure","id":"ITEM-42","issue":"4","issued":{"date-parts":[["2013"]]},"page":"345-352","title":"Racial/ethnic differences in b-type natriuretic peptide levels and their association with care and outcomes among patients hospitalized with heart failure: Findings from get with the guidelines-heart failure","type":"article-journal","volume":"1"},"uris":[""]},{"id":"ITEM-43","itemData":{"DOI":"10.1016/j.amjcard.2013.11.014","ISSN":"1879-1913","PMID":"24484862","abstract":"Despite significant advances in therapies for patients with heart failure with reduced ejection fraction (HFrEF), there are no evidence-based therapies for heart failure with preserved ejection fraction (HFpEF), also known as diastolic heart failure (HF). Differences in pathophysiologic mechanisms are touted as to why patients with HFpEF purportedly do not derive similar therapeutic benefits compared with HFrEF. Similarly, the relative frequencies of HFpEF and HFrEF may differ between hospitalized and ambulatory settings. There are limited data on the prevalence, characteristics, treatment, and short-term outcomes of patients hospitalized with HFpEF. We sought to investigate these in patients hospitalized with HFpEF in an urban, hospitalized setting using the Get With The Guidelines registry. We retrospectively reviewed all consecutive discharges (n = 1,701) with a diagnosis of acute decompensated HF from December 1, 2006 to September 30, 2008. Patients with HFpEF (n = 499) were older, overweight, predominantly women, and had underlying hypertension and dyslipidemia. Presenting blood pressure and levels of creatinine were higher, with lower brain natriuretic peptide levels compared with patients with HFrEF (n = 598). Length of stay and 30-day mortality were comparable between patients with HFpEF and HFrEF. Thirty-day readmission was initially lower in patients with HFpEF. However 30-day mortality from any cause after the index HF hospitalization and survival curve at 1-year was no different between patients with HFpEF and HFrEF. In conclusion, lower 30-day readmissions do not translate into improved long-term outcome in patients with HFpEF.","author":[{"dropping-particle":"","family":"Quiroz","given":"Rene","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Doros","given":"Gheorghe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaw","given":"Peter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Chang-Seng","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gauthier","given":"Diane F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sam","given":"Flora","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-43","issue":"4","issued":{"date-parts":[["2014"]]},"page":"691-6","publisher":"Elsevier Inc.","title":"Comparison of characteristics and outcomes of patients with heart failure preserved ejection fraction versus reduced left ventricular ejection fraction in an urban cohort.","type":"article-journal","volume":"113"},"uris":[""]},{"id":"ITEM-44","itemData":{"DOI":"10.1016/j.ahj.2014.07.008","ISSN":"00028703","PMID":"25440801","author":[{"dropping-particle":"","family":"Cheng","given":"Richard K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Neely","given":"Megan L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-44","issue":"5","issued":{"date-parts":[["2014"]]},"page":"721-730.e3","publisher":"Elsevier Inc.","title":"Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population","type":"article-journal","volume":"168"},"uris":[""]},{"id":"ITEM-45","itemData":{"DOI":"10.1016/j.ijcard.2013.12.161","ISSN":"01675273","PMID":"24444488","author":[{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-45","issue":"2","issued":{"date-parts":[["2014"]]},"page":"e322-e323","publisher":"Elsevier Ireland Ltd","title":"Prescribing warfarin at discharge for heart failure patients: Findings from the Get with the Guidelines-Heart Failure Registry","type":"article-journal","volume":"172"},"uris":[""]},{"id":"ITEM-46","itemData":{"DOI":"10.1161/JAHA.114.000950","ISSN":"2047-9980","author":[{"dropping-particle":"","family":"Heidenreich","given":"P. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"X.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"a. F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"C. W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"L. H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"N. M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"G. C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-46","issue":"5","issued":{"date-parts":[["2014"]]},"page":"e000950-e000950","title":"Impact of an Expanded Hospital Recognition Program for Heart Failure Quality of Care","type":"article-journal","volume":"3"},"uris":[""]},{"id":"ITEM-47","itemData":{"DOI":"10.1016/j.cardfail.2013.11.006","ISSN":"10719164","PMID":"24275703","abstract":"Background Postdischarge adherence and long-term persistence in the use of warfarin among patients with heart failure and atrial fibrillation without contraindications have not been fully described. Methods and Results We identified patients with heart failure and atrial fibrillation who were ≥65 years old, eligible for warfarin, and discharged home from hospitals in the Get With the Guidelines-Heart Failure registry from January 1, 2006, to December 31, 2009. We used linked Medicare prescription drug event data to measure adherence and persistence. The main outcome measures were rates of prescription at discharge, outpatient dispensing, discontinuation, and adherence as measured by the medication possession ratio. We hypothesized that adherence to warfarin would differ according to whether patients received the prescription at discharge. Among 2,691 eligible patients, 1,856 (69.0%) were prescribed warfarin at discharge. Patients prescribed warfarin at discharge had significantly higher prescription fill rates within 90 days (84.5% vs 12.3%; P <.001) and 1 year (91.6% vs 16.8%; P <.001) and significantly higher medication possession ratios (0.78 vs 0.63; P <.001). Among both previous nonusers and existing users, fill rates at 90 days and 1 year and possession ratios were significantly higher among those prescribed warfarin at discharge. Conclusions One-third of eligible patients with heart failure and atrial fibrillation were not prescribed warfarin at discharge from a heart failure hospitalization, and few started therapy as outpatients. In contrast, most patients who were prescribed warfarin at discharge filled the prescription within 90 days and remained on therapy at 1 year. ? 2014 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mi","given":"Xiaojuan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"Laura G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Turakhia","given":"Mintu P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-47","issue":"1","issued":{"date-parts":[["2014"]]},"page":"23-30","publisher":"Elsevier Inc","title":"Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation","type":"article-journal","volume":"20"},"uris":[""]},{"id":"ITEM-48","itemData":{"DOI":"10.1161/CIRCEP.114.001878","ISSN":"1941-3149","author":[{"dropping-particle":"","family":"Pokorney","given":"S. D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"a. S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"C. W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"L. H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"S. C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"E. D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"F. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"D. L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khalidi","given":"H. R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"P. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anstrom","given":"K. J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"G. C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"S. M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Arrhythmia and Electrophysiology","id":"ITEM-48","issue":"1","issued":{"date-parts":[["2014"]]},"page":"145-151","title":"Primary Prevention Implantable Cardioverter-Defibrillators in Older Racial and Ethnic Minority Patients","type":"article-journal","volume":"8"},"uris":[""]},{"id":"ITEM-49","itemData":{"DOI":"10.1001/jama.2014.5310","ISBN":"1538-3598","ISSN":"1538-3598","PMID":"24893088","abstract":"IMPORTANCE: Clinical trials of prophylactic implantable cardioverter-defibrillators (ICDs) have included a minority of patients with a left ventricular ejection fraction (LVEF) between 30% and 35%. Because a large number of ICDs in the United States are implanted in such patients, it is important to study survival associated with this therapy.\\n\\nOBJECTIVE: To characterize patients with LVEF between 30% and 35% and compare the survival of those with and without ICDs.\\n\\nDESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of Medicare beneficiaries in the National Cardiovascular Data Registry ICD registry (January 1, 2006, through December 31, 2007) with an LVEF between 30% and 35% who received an ICD during a heart failure hospitalization and similar patients in the Get With The Guidelines-Heart Failure (GWTG-HF) database (January 1, 2005, through December 31, 2009) with no ICD. The analysis was repeated in patients with an LVEF less than 30%. There were 3120 patients with an LVEF between 30% and 35% (816 in matched cohorts) and 4578 with an LVEF less than 30% (2176 in matched cohorts). Propensity score matching and Cox models were applied.\\n\\nMAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality; data were obtained from Medicare claims through December 31, 2011.\\n\\nRESULTS: There were no significant differences in the baseline characteristics of the matched groups (n?=?408 for both groups). Among patients with an LVEF between 30% and 35%, there were 248 deaths in the ICD Registry group, within a median follow-up of 4.4 years (interquartile range, 2.7-4.9) and 249 deaths in the GWTG HF group, within a median follow-up of 2.9 years (interquartile range, 2.1-4.4). The risk of all-cause mortality in patients with an LVEF between 30% and 35% and an ICD was significantly lower than that in matched patients without an ICD (3-year mortality rates: 51.4% vs 55.0%; hazard ratio, 0.83 [95% CI, 0.69-0.99]; P?=?.04). Presence of an ICD also was associated with better survival in patients with an LVEF less than 30% (3-year mortality rates: 45.0% vs 57.6%; 634 and 660 total deaths; hazard ratio, 0.72 [95% CI, 0.65-0.81]; P?<?.001) (P?=?.20 for interaction).\\n\\nCONCLUSIONS AND RELEVANCE: Among Medicare beneficiaries hospitalized for heart failure and with an LVEF between 30% and 35% and less than 30%, survival at 3 years was better in patients who received a prophylactic ICD than in comparable patients with no ICD. These findings support gui…","author":[{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mark","given":"Daniel B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anstrom","given":"Kevin J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sanders","given":"Gillian D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khalidi","given":"Hussein R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-49","issue":"21","issued":{"date-parts":[["2014"]]},"page":"2209-15","title":"Association between prophylactic implantable cardioverter-defibrillators and survival in patients with left ventricular ejection fraction between 30% and 35%.","type":"article-journal","volume":"311"},"uris":[""]},{"id":"ITEM-50","itemData":{"DOI":"10.1016/j.jchf.2013.11.002","ISBN":"2213-1779","ISSN":"22131779","PMID":"24622118","abstract":"Objectives: This study sought to examine the long-term outcomes of patients hospitalized with heart failure and atrial fibrillation. Background: Atrial fibrillation is common among patients hospitalized with heart failure. Associations of pre-existing and new-onset atrial fibrillation with long-term outcomes are unclear. Methods: We analyzed 27,829 heart failure admissions between 2006 and 2008 at 281 hospitals in the American Heart Association's Get With The Guidelines-Heart Failure program linked with Medicare claims. Patients were classified as having pre-existing, new-onset, or no atrial fibrillation. Cox proportional hazards models were used to identify factors that were independently associated with all-cause mortality, all-cause readmission, and readmission for heart failure, stroke, and other cardiovascular disease at 1 and 3 years. Results: After multivariable adjustment, pre-existing atrial fibrillation was associated with greater 3-year risks of all-cause mortality (hazard ratio [HR]: 1.14 [99% confidence interval (CI): 1.08 to 1.20]), all-cause readmission (HR: 1.09 [99% CI: 1.05 to 1.14]), heart failure readmission (HR: 1.15 [99% CI: 1.08 to 1.21]), and stroke readmission (HR: 1.20 [99% CI: 1.01 to 1.41]), compared with no atrial fibrillation. There was also a greater hazard of mortality at 1 year among patients with new-onset atrial fibrillation (HR: 1.12 [99% CI: 1.01 to 1.24]). Compared with no atrial fibrillation, new-onset atrial fibrillation was not associated with a greater risk of the readmission outcomes. Stroke readmission rates at 1 year were just as high for patients with preserved ejection fraction as for patients with reduced ejection fraction. Conclusions: Both pre-existing and new-onset atrial fibrillation were associated with greater long-term mortality among older patients with heart failure. Pre-existing atrial fibrillation was associated with greater risk of readmission. ? 2014 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Khazanie","given":"Prateeti","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"Laura G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JACC: Heart Failure","id":"ITEM-50","issue":"1","issued":{"date-parts":[["2014"]]},"page":"41-48","title":"Outcomes of Medicare Beneficiaries With Heart Failure and Atrial Fibrillation","type":"article-journal","volume":"2"},"uris":[""]},{"id":"ITEM-51","itemData":{"DOI":"10.1161/JAHA.114.001134","ISSN":"2047-9980","author":[{"dropping-particle":"","family":"Vivo","given":"R. P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"S. R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Neely","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"a. F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eapen","given":"Z. J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"E. D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"D. 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C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-51","issue":"5","issued":{"date-parts":[["2014"]]},"page":"e001134-e001134","title":"Short- and Long-term Rehospitalization and Mortality for Heart Failure in 4 Racial/Ethnic Populations","type":"article-journal","volume":"3"},"uris":[""]},{"id":"ITEM-52","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.113.000761","ISSN":"19413297","PMID":"24488983","abstract":"BACKGROUND: Prior claims analyses suggest that the use of intravenous inotropic therapy for patients hospitalized with heart failure varies substantially by hospital. Whether differences in the clinical characteristics of the patients explain observed differences in the use of inotropic therapy is not known.\\n\\nMETHODS AND RESULTS: We sought to characterize institutional variation in inotrope use among patients hospitalized with heart failure before and after accounting for clinical factors of patients. Hierarchical generalized linear regression models estimated risk-standardized hospital-level rates of inotrope use within 209 hospitals participating in Get With The Guidelines-Heart Failure (GWTG-HF) registry between 2005 and 2011. The association between risk-standardized rates of inotrope use and clinical outcomes was determined. Overall, an inotropic agent was administered in 7691 of 126 564 (6.1%) heart failure hospitalizations: dobutamine 43%, dopamine 24%, milrinone 17%, or a combination 16%. Patterns of inotrope use were stable during the 7-year study period. Use of inotropes varied significantly between hospitals even after accounting for patient and hospital characteristics (median risk-standardized hospital rate, 5.9%; interquartile range, 3.7%-8.6%; range, 1.3%-32.9%). After adjusting for case-mix and hospital structural differences, model intraclass correlation indicated that 21% of the observed variation in inotrope use was potentially attributable to random hospital effects (ie, institutional preferences). Hospitals with higher risk-standardized inotrope use had modestly longer risk-standardized length of stay (P=0.005) but had no difference in risk-standardized inpatient mortality (P=0.12).\\n\\nCONCLUSIONS: Use of intravenous inotropic agents during hospitalization for heart failure varies significantly among US hospitals even after accounting for patient and hospital factors.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Pamela N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Partovian","given":"Chohreh","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Li","given":"Shu Xia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krumholz","given":"Harlan M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-52","issue":"2","issued":{"date-parts":[["2014"]]},"page":"251-260","title":"Hospital variation in intravenous inotrope use for patients hospitalized with heart failure insights from get with the guidelines","type":"article-journal","volume":"7"},"uris":[""]},{"id":"ITEM-53","itemData":{"DOI":"10.1016/j.ijcard.2015.03.400","ISSN":"01675273","author":[{"dropping-particle":"","family":"Qian","given":"Feng","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"Selim R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vivo","given":"Rey P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hannan","given":"Edward L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaw","given":"Benjamin 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Program","type":"article-journal","volume":"189"},"uris":[""]},{"id":"ITEM-54","itemData":{"DOI":"10.1016/j.jchf.2014.09.006","ISSN":"22131779","author":[{"dropping-particle":"","family":"Zeitler","given":"Emily P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khalidi","given":"Hussein 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C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-55","issue":"4","issued":{"date-parts":[["2015"]]},"page":"e001626-e001626","title":"Heart Rate at Hospital Discharge in Patients With Heart Failure Is Associated With Mortality and Rehospitalization","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"^{80,81,90–99,82,100–109,83,110–119,84,120–129,85,130–134,86–89}","plainTextFormattedCitation":"80,81,90–99,82,100–109,83,110–119,84,120–129,85,130–134,86–89","previouslyFormattedCitation":"^78–132"},"properties":{"noteIndex":0},"schema":""}80,81,90–99,82,100–109,83,110–119,84,120–129,85,130–134,86–89HIJC-HF: Heart Institute of Japan Department of Cardiology Heart Failure Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1346-9843","PMID":"18931450","abstract":"BACKGROUND: Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.","author":[{"dropping-particle":"","family":"Kawashiro","given":"Naomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogawa","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsuda","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"Nobuhisa","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2008"]]},"page":"2015-2020","title":"Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry.","type":"article-journal","volume":"72"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³⁵","plainTextFormattedCitation":"135","previouslyFormattedCitation":"¹³³"},"properties":{"noteIndex":0},"schema":""}135IMPACT-HF: Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy in Heart Failure ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1159/000065939","ISBN":"1530-6550 (Print)","ISSN":"14229528","PMID":"12447162","abstract":"The IMPACT-HF trial is testing a treatment strategy focused on improving the use of β-blockers in the heart failure population. This trial is expected to yield important information about the safety and tolerability of β-blockers, as well as about titration patterns of dosing and response to therapy in patients admitted with heart failure. The results of the IMPACT-HF trial were presented at a satellite symposium at the 2002 American Heart Association Annual Scientific Session.","author":[{"dropping-particle":"","family":"Gattis","given":"Wendy A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Reviews in Cardiovascular Medicine","id":"ITEM-1","issue":"3 Suppl","issued":{"date-parts":[["2002"]]},"page":"S48-S54","title":"Rationale and design of the initiation management predischarge: Process for assessment of carvedilol therapy for heart failure (IMPACT-HF) study: design and implications","type":"article-journal","volume":"3"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1159/000065939","ISBN":"1530-6550 (Print)","ISSN":"14229528","PMID":"12594455","abstract":"The IMPACT-HF trial is testing a treatment strategy focused on improving the use of β-blockers in the heart failure population. This trial is expected to yield important information about the safety and tolerability of β-blockers, as well as about titration patterns of dosing and response to therapy in patients admitted with heart failure. The results of the IMPACT-HF trial were presented at a satellite symposium at the 2002 American Heart Association Annual Scientific Session.","author":[{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis","given":"Wendy A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-2","issue":"2 (Suppl)","issued":{"date-parts":[["2003"]]},"page":"S60-S61","title":"Rationale and design of the initiation management predischarge: Process for assessment of carvedilol therapy for heart failure (IMPACT-HF) study","type":"article-journal","volume":"145"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.jacc.2003.12.040","ISBN":"0735-1097","ISSN":"07351097","PMID":"15120808","abstract":"Objectives The Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy in Heart Failure (IMPACT-HF) trial was an investigator-initiated study to evaluate if predischarge carvedilol initiation in stabilized patients hospitalized for heart failure (HF) increased the number of patients treated with beta-blockade at 60 days after randomization without increasing side effects or length of hospital stay. Background Beta-blockers are underused in HF. Predischarge initiation may improve the use of evidence-based beta-blockade. Methods The IMPACT-HF was a prospective, randomized open-label trial conducted in 363 patients hospitalized for HF. Patients were randomized to carvedilol initiation pre-hospital discharge or to postdischarge initiation (>2 weeks) of beta-blockade at the physicians' discretion. The primary end point of the study was the number of patients treated with beta-blockade at 60 days after randomization. Secondary end points included the number of patients discontinuing beta-blockade, median dose achieved, and a composite of death, rehospitalization, unscheduled visit for HF, or ≥50% increase in oral diuretic, new oral diuretic, or any intravenous therapy with diuretics, inotropes, or other vasoactive agents. Results At 60 days 165 patients (91.2%) randomized to predischarge carvedilol initiation were treated with a beta-blocker, compared with 130 patients (73.4%) randomized to initiation postdischarge (p < 0.0001). Predischarge initiation was not associated with an increased risk of serious adverse events. The median length of stay was five days in both groups. Conclusions Predischarge initiation of carvedilol in stabilized patients hospitalized for HF improved the use of beta-blockade at 60 days without increasing side effects or length of stay. Predischarge initiation may be one approach to improve beta-blocker use in this population. ? 2004 by the American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Gattis","given":"Wendy a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gallup","given":"Dianne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hasselblad","given":"Vic","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-3","issue":"9","issued":{"date-parts":[["2004"]]},"page":"1534-1541","title":"Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure: Results of the initiation management predischarge: Process for assessment of carvedilol therapy in heart failure (IMPACT-HF) trial","type":"article-journal","volume":"43"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.amjcard.2004.01.019","ISBN":"0002-9149","ISSN":"00029149","PMID":"15144943","abstract":"The use of β-blockers for the treatment of heart failure in the United States is inadequate, despite available data and current guidelines that support their use. The Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy for Heart Failure (IMPACT-HF) study was designed to determine whether initiation of β-blockade before hospital discharge is safe and effective in improving the 60-day use of β-blockers in patients with heart failure. IMPACT-HF compared the strategy of the initiation of carvedilol before patients were discharged versus usual care (Heart Failure Society of America guidelines recommend waiting 2 to 4 weeks after hospitalization for heart failure before initiating β-blocker therapy) in 363 randomized patients with heart failure. The entry criteria were nonrestrictive to ensure inclusion of patients reflective of the general heart failure population. The primary end point of the study (the number of patients treated with any β-blocker at 60 days) was statistically significantly higher in the predischarge group versus the postdischarge group (91.2% vs 73.4%, respectively). Based on the study's results, predischarge initiation may be a successful strategy to improve the use of β-blocker therapy for patients with heart failure. ? 2004 by Excerpta Medica Inc.","author":[{"dropping-particle":"","family":"Gattis","given":"Wendy a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-4","issue":"9 SUPPL. 1","issued":{"date-parts":[["2004"]]},"page":"74-76","title":"Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure","type":"article-journal","volume":"93"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.cardfail.2004.08.160","ISBN":"1071-9164","ISSN":"10719164","PMID":"15812748","abstract":"Background: Hospitalizations for decompensated heart failure are frequent. The Initiation Management Pre-discharge Assessment of Carvedilol Heart Failure (IMPACT-HF) registry collected observational data in patients hospitalized for worsening heart failure to characterize an unselected group of patients and to confirm the generalizability of the IMPACT-HF main trial population. Methods and Results: The IMPACT-HF registry was conducted concurrently with the IMPACT-HF study, a randomized trial of in-hospital initiation of carvedilol compared with the standard practice of postdischarge β-blocker initiation. Patients were eligible for registry enrollment if they were hospitalized for heart failure regardless of ejection fraction. There were no exclusions to participation. Patients were followed for 60 days. The IMPACT-HF Registry enrolled 567 patients. The mean age was 71 years, 52% of the patients were men and 82% were Caucasian. At discharge, 71% received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 41% received digoxin, and 62% received β-blockers. The 60-day rate of rehospitalization or death was 31%. Conclusion: The IMPACT-HF registry enrolled elderly patients admitted for worsening heart failure primarily resulting from progressive volume overload. The 60-day rate of death or rehospitalization was high despite the use of evidence-based therapies. New treatments for this population are needed to decrease the morbidity and mortality associated with decompensated heart failure. ? 2005 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gallup","given":"Dianne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hasselblad","given":"Vic","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-5","issue":"3","issued":{"date-parts":[["2005"]]},"page":"200-205","title":"Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: Observations from the IMPACT-HF registry","type":"article-journal","volume":"11"},"uris":[""]}],"mendeley":{"formattedCitation":"^136–140","plainTextFormattedCitation":"136–140","previouslyFormattedCitation":"^134–138"},"properties":{"noteIndex":0},"schema":""}136–140IMPROVE-HF: The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2007.03.030","ISBN":"0002-8703","ISSN":"00028703","PMID":"17584548","abstract":"Evidence-based consensus treatment guidelines are available to assist physicians with the management of chronic heart failure (HF). Although it has been generally presumed that physicians incorporate these treatment guidelines into clinical practice, the actual assimilation of evidence-based strategies and guidelines has been demonstrated to be less than ideal. Studies of HF care show that treatment guidelines are slowly adopted and inconsistently applied and, thus, often fail to lead to improvements in patient care and outcomes. There are a number of ongoing, large, national quality improvement registries that are following the clinical care and outcomes of inpatient HF treatment. However, to date, there have been no similar quality improvement registries in the outpatient arena. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) is the first large, comprehensive performance improvement registry designed to characterize the current outpatient management of systolic HF and assess the effect of practice-specific process improvement interventions consisting of education, specific clinical guidelines, reminder systems, benchmarked quality reports, and structured academic detailing on the use of evidence-based HF therapies. Seven performance measures to quantify the quality of outpatient HF care were explicitly developed by the IMPROVE HF Steering Committee. The primary objective is to observe, over the aggregate of IMPROVE HF practice sites, a relative ≥20% improvement in at least 2 of the 7 performance measures at 24 months, compared with baseline. Deidentified clinical data from the medical records of a planned 43 000 patients from 160 US cardiology practices will be included in this study. ? 2007.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2007"]]},"page":"12-38","title":"Improving the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting: The IMPROVE HF performance improvement registry","type":"article-journal","volume":"154"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.ahj.2008.12.016","ISSN":"00028703","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2009"]]},"page":"754-762.e2","publisher":"Mosby, Inc.","title":"Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: Findings from IMPROVE HF","type":"article-journal","volume":"157"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.amjcard.2009.12.016","ISBN":"1879-1913 (Electronic)\r0002-9149 (Linking)","ISSN":"00029149","PMID":"20381667","abstract":"Guidelines have been established for the treatment of patients with heart failure (HF) and left ventricular dysfunction, but renal dysfunction might limit adherence to these guidelines. Few data have characterized the use of guideline-recommended therapy for patients with HF, left ventricular dysfunction, and renal dysfunction who are treated in outpatient settings. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) was a prospective study of patients receiving treatment as outpatients in cardiology practices in the United States. The rates of adherence to 7 guideline-recommended therapies were evaluated for patients with a left ventricular ejection fraction of < or = 35%. The estimated glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula for 13,164 patients who were categorized as having stage 1 through stage 4/5 chronic kidney disease (CKD). More than 1/2 (52.2%) of the patients had stage 3 or 4/5 CKD. Older patients and women were at increased risk of higher stage CKD, and the rates of co-morbid health conditions were significantly greater among patients with more severe CKD. The patients with more severe CKD were significantly less likely to receive all interventions except cardiac resynchronization therapy. However, multivariate analysis controlling for patient characteristics revealed that the severity of CKD was an independent predictor of adherence to angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy but not to any of the 6 other guideline-recommended measures. In conclusion, these results confirm that CKD is common in patients with HF and left ventricular dysfunction but is not independently associated with adherence to guideline-recommended therapy in outpatient cardiology practices, with the exception of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy.","author":[{"dropping-particle":"","family":"Heywood","given":"J Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-3","issue":"8","issued":{"date-parts":[["2010"]]},"page":"1140-1146","publisher":"Elsevier Inc.","title":"Influence of renal function on the use of guideline-recommended therapies for patients with heart failure.","type":"article-journal","volume":"105"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.ahj.2009.11.022","ISBN":"0009-7322","ISSN":"00028703","abstract":"Background: National guidelines recommend heart failure (HF) disease management programs to facilitate adherence to evidence-based practices. This study examined the influence of dedicated HF clinics on delivery of guideline-recommended therapies for cardiology practice outpatients with HF and reduced left ventricular ejection fraction. Methods: IMPROVE HF, a prospective cohort study, enrolled 167 cardiology practices to characterize outpatient management of 15,381 patients with chronic systolic HF. Adherence to guideline-recommended HF therapies was recorded, and the presence of a dedicated HF clinic was assessed by survey. Multivariate models identified contributions to delivery of guideline-recommended HF therapies. Results: Of practices, 41.3% had a dedicated HF clinic. Practices with a dedicated HF clinic had greater adherence to 3 of 7 guideline-recommended HF therapy measures: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (P = .02), β-blocker (P = .025), and HF education (P = .009). After adjustment, use of a dedicated HF clinic was associated with greater conformity in 2 of 7 measures: cardiac resynchronization therapy (P = .036) and HF education (P = .005) but not angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, β-blocker, aldosterone antagonist, implantable cardioverter-defibrillator therapy, and anticoagulation for atrial fibrillation. Conclusions: Use of dedicated HF clinics varied in cardiology outpatient practices and was associated with greater use of cardiac resynchronization therapy and HF education but not other guideline-recommended therapies. ? 2010 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-4","issue":"2","issued":{"date-parts":[["2010","2"]]},"page":"238-244","publisher":"Mosby, Inc.","title":"Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: Findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF)","type":"article-journal","volume":"159"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.amjcard.2010.01.360","ISBN":"0002-9149","ISSN":"00029149","PMID":"20538129","abstract":"National guidelines recommend a team model of care to facilitate adherence to evidence-based practices; however, previous studies suggesting benefit may have limited generalizability. The aim of this study was to examine the influence of advanced practice nurse (APN) and physician assistant (PA) staffing on the delivery of guideline-recommended therapies for outpatients with heart failure (HF). The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF), a prospective cohort study, enrolled 167 cardiology practices to characterize outpatient management of 15,381 patients with chronic HF and left ventricular ejection fractions ≤35%. Adherence to guideline-recommended HF therapies was recorded, and the presence of APN and PA staffing was assessed by survey. Multivariate models identified contributions to the delivery of guideline-recommended HF therapies. Of cardiology outpatient practices, 66.0% had APNs and PAs. Practices with 0, >0 to <2, and ≥2.0 APN and PA staffing had similar adherence to the 7 guideline-recommended HF therapies. After adjustment, staffing with ≥2 APNs or PAs was associated with greater conformity with 2 of 7 measures (implantable cardioverter-defibrillator therapy and delivery of HF education, p ≤0.01 for both) and similar conformity to angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy, β-blocker therapy, aldosterone antagonist therapy, anticoagulation for atrial fibrillation, and cardiac resynchronization therapy. In conclusion, staffing with APNs and PAs varied in cardiology outpatient practices. Compared to no APNs or PAs, ≥2.0 APNs or PAs per cardiology practice was associated with the greater use of implantable cardioverter-defibrillator therapy and delivery of HF education and equivalent use of drug and cardiac resynchronization therapies. ? 2010 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-5","issue":"12","issued":{"date-parts":[["2010"]]},"page":"1773-1779","publisher":"Elsevier Inc.","title":"Outpatient Cardiology Practices With Advanced Practice Nurses and Physician Assistants Provide Similar Delivery of Recommended Therapies (Findings from IMPROVE HF)","type":"article-journal","volume":"105"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1161/CIRCULATIONAHA.109.934471","ISBN":"0009-7322","ISSN":"00097322","PMID":"20660805","abstract":"Background: National guidelines recommend heart failure (HF) disease management programs to facilitate adherence to evidence-based practices. This study examined the influence of dedicated HF clinics on delivery of guideline-recommended therapies for cardiology practice outpatients with HF and reduced left ventricular ejection fraction. Methods: IMPROVE HF, a prospective cohort study, enrolled 167 cardiology practices to characterize outpatient management of 15,381 patients with chronic systolic HF. Adherence to guideline-recommended HF therapies was recorded, and the presence of a dedicated HF clinic was assessed by survey. Multivariate models identified contributions to delivery of guideline-recommended HF therapies. Results: Of practices, 41.3% had a dedicated HF clinic. Practices with a dedicated HF clinic had greater adherence to 3 of 7 guideline-recommended HF therapy measures: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (P = .02), β-blocker (P = .025), and HF education (P = .009). After adjustment, use of a dedicated HF clinic was associated with greater conformity in 2 of 7 measures: cardiac resynchronization therapy (P = .036) and HF education (P = .005) but not angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, β-blocker, aldosterone antagonist, implantable cardioverter-defibrillator therapy, and anticoagulation for atrial fibrillation. Conclusions: Use of dedicated HF clinics varied in cardiology outpatient practices and was associated with greater use of cardiac resynchronization therapy and HF education but not other guideline-recommended therapies. ? 2010 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Johnson Inge","given":"Patches","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-6","issue":"6","issued":{"date-parts":[["2010"]]},"page":"585-596","title":"Improving evidence-based care for heart failure in outpatient cardiology practices: Primary results of the registry to improve the use of evidence-based heart failure therapies in the outpatient setting (IMPROVE HF)","type":"article-journal","volume":"122"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.amjcard.2010.09.012","ISBN":"9196817755","ISSN":"00029149","PMID":"21211602","abstract":"Diverse factors are associated with variations in evidence-based treatment of outpatients with heart failure (HF). However, patient and practice characteristics associated with improved use of guideline-recommended therapies over time have not been well studied. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) is a prospective evaluation of a performance improvement initiative conducted at 167 practices treating outpatients with diagnosed HF or previous myocardial infarction and left ventricular ejection fraction ≤35%. Patient characteristics and care practice data were collected by chart abstraction at baseline and 24 months for 14,236 patients. Seven individual care measures and a composite measure were assessed. Practices were stratified by tertiles of composite measure improvement, and significant, independent patient and practice factors associated with improvement in the composite measure at 24 months were examined. The baseline composite performance measure was 68.4%, which increased to 80.1% at 24 months (+11.6%, p <0.001). The composite measure improvement tertiles were ≤8%, >8% to 15%, and >15%. Multivariate analyses revealed greater improvements associated only with lower practice baseline composite measure rates (p <0.001). Logistic regression showed that 2 additional variables were inversely associated with practices in the highest tertile in composite measure improvement (>15%): southern practice location (p = 0.0239) and edema (p = 0.0047). In conclusion, few patient and practice factors were associated with greater or lesser overall improvements over time in the use of guideline-recommended HF therapies. Other factors may be more important determinates of the magnitude of care improvements over time among cardiology practices participating in a performance improvement initiative. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Inge","given":"Patches Johnson","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-7","issue":"2","issued":{"date-parts":[["2011"]]},"page":"250-258","publisher":"Elsevier Inc.","title":"Patient and practice factors associated with improvement in use of guideline-recommended therapies for outpatients with heart failure (from the IMPROVE HF Trial)","type":"article-journal","volume":"107"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1111/j.1751-7133.2011.00250.x","ISBN":"1751-7133 (Electronic)\\r1527-5299 (Linking)","ISSN":"15275299","PMID":"22277172","abstract":"Eligible outpatients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF) frequently do not receive target doses of HF medications. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) evaluated the effect of a practice-based performance improvement intervention on treatment of outpatients with LVEF ≤35%. Specific agent and dose were collected at baseline and 24?months for angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), β-blockers, and aldosterone antagonists. Changes in dosing over time were analyzed for each medication class. Data were available for 7605 patients. At baseline, target dose treatment rates were 36.1%, 20.5%, and 74.4%, respectively. Absolute and relative improvements of 9.8% and 47.7% (?P<.001) were achieved for β-blocker dosing at 24?months. The IMPROVE HF intervention was associated with significantly increased treatment of eligible patients with target doses of β-blockers but not ACE inhibitors/ARBs or aldosterone antagonists. Additional research to determine barriers to use of target doses of HF medications may be necessary.","author":[{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thomas Heywood","given":"J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Inge","given":"Patches Johnson","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-8","issue":"1","issued":{"date-parts":[["2012"]]},"page":"9-17","title":"Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: Findings from IMPROVE HF","type":"article-journal","volume":"18"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1002/clc.21971","ISBN":"0160-9289","ISSN":"01609289","PMID":"22328100","abstract":"Electronic health record systems (EHR) are expected to facilitate higher quality patient care; however, studies evaluating EHR effectiveness in improving care have yielded mixed results.","author":[{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liu","given":"Yang","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical Cardiology","id":"ITEM-9","issue":"3","issued":{"date-parts":[["2012"]]},"page":"187-196","title":"Lack of association between electronic health record systems and improvement in use of evidence-based heart failure therapies in outpatient cardiology practices","type":"article-journal","volume":"35"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.2459/JCM.0b013e328353128c","ISSN":"1558-2027","author":[{"dropping-particle":"","family":"Ambrosy","given":"Andrew P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O’Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Medicine","id":"ITEM-10","issue":"6","issued":{"date-parts":[["2012"]]},"page":"360-367","title":"B-type natriuretic peptide assessment in ambulatory heart failure patients","type":"article-journal","volume":"13"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1111/pace.12090","ISBN":"1540-8159 (Electronic)\\n0147-8389 (Linking)","ISSN":"01478389","PMID":"23380000","abstract":"BACKGROUND: There is a well-recognized gap between the number of patients in whom cardiac resynchronization therapy (CRT) is indicated based on current guidelines and its actual utilization. In the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) study, there was a significant increase in the use of CRT at 24 months in patients with heart failure (HF) in comparison to baseline. This study evaluated patient, physician, and practice factors associated with this increase in CRT utilization.\\n\\nMETHODS: Patients with reduced left ventricular ejection fraction and chronic HF who met the eligibility criteria for CRT at baseline and 24 months were analyzed. Multivariate analyses using patient, physician, and practice characteristics were performed to evaluate factors associated with increased CRT utilization at 24 months.\\n\\nRESULTS: There were 440 patients eligible for CRT both at baseline and 24 months, with 217 (49.3%) treated at baseline and 374 (85%) treated at 24 months, leading to an absolute increase in use of CRT of 35.7%, P < 0.001. Although serum sodium and the absence of rales had modest associations, none of the patient, physician, or practice characteristics had any significant association with the extent of increase in CRT utilization. There was a significant reduction in the variation of CRT utilization across practice sites after the implementation of the performance improvement initiative.\\n\\nCONCLUSIONS: The performance improvement initiative in IMPROVE HF was the most important factor associated with an increase in guideline-recommended CRT utilization. This improvement in CRT utilization and reduced practice variability was found across a variety of cardiology and multispecialty practice sites.","author":[{"dropping-particle":"","family":"Shukla","given":"Ashish","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liu","given":"Yang","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PACE - Pacing and Clinical Electrophysiology","id":"ITEM-11","issue":"4","issued":{"date-parts":[["2013"]]},"page":"433-443","title":"Factors associated with improvement in utilization of cardiac resynchronization therapy in eligible heart failure patients: Findings from IMPROVE HF","type":"article-journal","volume":"36"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1016/j.jacc.2014.05.060","ISSN":"07351097","PMID":"25145524","abstract":"BACKGROUND: Clinical trials have demonstrated benefit for cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillator (ICD) therapies in patients with heart failure with reduced ejection fraction (HFrEF); yet, questions have been raised with regard to the benefit of device therapy for minorities.\\n\\nOBJECTIVES: The purpose of this study was to determine the clinical effectiveness of CRT and ICD therapies as a function of race/ethnicity in outpatients with HFrEF (ejection fraction?≤35%).\\n\\nMETHODS: Data from IMPROVE HF (Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting) were analyzed by device status and race/ethnicity among guideline-eligible patients for mortality at 24 months. Multivariate Generalized Estimating Equations analyses were conducted, adjusting for patient and practice characteristics.\\n\\nRESULTS: The ICD/cardiac resynchronization defibrillator (CRT-D)-eligible cohort (n?= 7,748) included 3,391 (44%) non-Hispanic white, 719 (9%) non-Hispanic black, and 3,638 (47%) other racial/ethnic minorities or race-not-documented patients. The cardiac resynchronization pacemaker (CRT-P)/CRT-D-eligible cohort (n?= 1,188) included 596 (50%) non-Hispanic white, 99 (8%) non-Hispanic black, and 493 (41%) other/not-documented patients. There was clinical benefit associated with ICD/CRT-D therapy (adjusted odds ratio: 0.64, 95% confidence interval: 0.52 to 0.79, p?= 0.0002 for 24-month mortality), which was of similar proportion in white, black, and other minority/not-documented patients (device-race/ethnicity interaction p?= 0.7861). For CRT-P/CRT-D therapy, there were also associated mortality benefits (adjusted odds ratio: 0.55, 95% confidence interval: 0.33 to 0.91, p?= 0.0222), and the device-race/ethnicity interaction was not significant (p?= 0.5413).\\n\\nCONCLUSIONS: The use of guideline-directed CRT and ICD therapy was associated with reduced 24-month mortality without significant interaction by racial/ethnic group. Device therapies should be offered to eligible heart failure patients, without modification based on race/ethnicity.","author":[{"dropping-particle":"","family":"Ziaeian","given":"Boback","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhang","given":"Yan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O’Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-12","issue":"8","issued":{"date-parts":[["2014"]]},"page":"797-807","title":"Clinical Effectiveness of CRT and ICD?Therapy in Heart Failure Patients by?Racial/Ethnic Classification","type":"article-journal","volume":"64"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.113.000789","ISBN":"1941-3289","ISSN":"19413297","PMID":"24178311","abstract":"BACKGROUND: Many clinical trials have demonstrated a benefit for cardiac resynchronization (CRT) and implantable cardioverter-defibrillator (ICD) therapies in patients with heart failure and reduced ejection fraction, yet questions have been raised with regard to the benefit of ICDs for women. The purpose of this study was to determine the clinical effectiveness of CRT and ICD therapy as a function of sex in outpatients with heart failure and reduced ejection fraction (≤35%). METHODS AND RESULTS: Data from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) were analyzed by device status and sex among guideline-eligible patients for vital status (alive/dead) at 24 months. Multivariate generalized estimating equation analyses were conducted adjusting for baseline patient and practice characteristics. In the ICD/CRT-defibrillator (CRT-D) eligible cohort (n=7748), there were 5485 (71%) men and 2261 (29%) women. In the CRT-pacemaker (CRT-P)/CRT-D eligible cohort (n=1188), there were 824 (69%) men and 364 (31%) women. The clinical benefit associated with ICD/CRT-D therapy was similar in both men and women (men adjusted odds ratio, 0.71; 95% confidence interval, 0.57-0.87; P=0.0012; and women adjusted odds ratio, 0.65; 95% confidence interval, 0.49-0.85; P=0.0019). For CRT-P/CRT-D, the associated benefits showed no significant heterogeneity (men adjusted odds ratio, 0.59; 95% confidence interval, 0.33-1.06; P=0.0793; and women adjusted odds ratio, 0.44; 95% confidence interval, 0.22-0.90; P=0.0243). The device-by-sex interactions were not significant (P=0.4441 for CRT-P/CRT-D and P=0.5966 for ICD/CRT-D). CONCLUSIONS: The use of guideline-directed CRT and ICD therapy was associated with substantially reduced 24-month mortality in eligible men and women with heart failure and reduced ejection fraction. Device therapies should be offered to all eligible patients with heart failure, without modification based on sex.","author":[{"dropping-particle":"","family":"Wilcox","given":"Jane E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhang","given":"Yan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-13","issue":"1","issued":{"date-parts":[["2014"]]},"page":"146-153","title":"Clinical effectiveness of cardiac resynchronization and implantable cardioverter-defibrillator therapy in men and women with heart failure findings from IMPROVE HF","type":"article-journal","volume":"7"},"uris":[""]}],"mendeley":{"formattedCitation":"^{141,142,151–153,143–150}","plainTextFormattedCitation":"141,142,151–153,143–150","previouslyFormattedCitation":"^139–151"},"properties":{"noteIndex":0},"schema":""}141,142,151–153,143–150 IN-HF:Italian Network on Heart Failure Outcome Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfs117","ISBN":"1388-9842\\r1879-0844","ISSN":"13889842","PMID":"22833614","abstract":"AIMS: Registries and surveys improve knowledge of the 'real world'. This paper aims to describe baseline clinical profiles, management strategies, and the in-hospital outcome of patients admitted to hospital for an acute heart failure (AHF) episode.\\n\\nMETHODS AND RESULTS: IN-HF Outcome is a nationwide, prospective, multicentre, observational study conducted in 61 Cardiology Centres in Italy. Up to December 2009, 5610 patients had been enrolled, 1855 (33%) with AHF and 3755 (67%) with chronic heart failure (CHF). Baseline and in-hospital outcome data of AHF patients are presented. Mean age was 72 ± 12 years, and 39.8% were female. Hospital admission was due to new-onset heart failure (HF) in 43% of cases. Co-morbid conditions were observed more frequently in the worsening HF group, while those with de novo HF showed a higher heart rate, blood pressure, and more preserved left ventricular ejection fraction (LVEF). Electrical devices were previously implanted in 13.3% of the entire group. Inotropes were administered in 19.4% of the patients. The median duration of hospital stay was 10 days (interquartile range 7-15). All-cause in-hospital death was 6.4%, similar in worsening and de novo HF. Older age, hypotension, cardiogenic shock, pulmonary oedema, symptoms of hypoperfusion, hyponatraemia, and elevated creatinine were independent predictors of all-cause death.\\n\\nCONCLUSION: Our registry confirms that in-hospital mortality in AHF is still high, with a long length of stay. Pharmacological treatment seems to be practically unchanged in the last decades, and the adherence to HF guidelines concerning implantable cardioverter defibrillators/cardiac resynchronization therapy is still very low. Some AHF phenotypes are characterized by worst prognosis and need specific research projects.","author":[{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cacciatore","given":"Giuseppe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chinaglia","given":"Alessandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2012"]]},"page":"1208-1217","title":"Acute heart failure patient profiles, management and in-hospital outcome: Results of the Italian Registry on Heart Failure Outcome","type":"article-journal","volume":"14"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.ijcard.2013.06.020","ISBN":"0167-5273","ISSN":"01675273","PMID":"23850320","abstract":"Background Chronic renal dysfunction (RD) frequently coexists with heart failure (HF) and influences outcome. Patients with acute HF (AHF) and severe RD are frequently excluded in the trials. We characterized these subjects and assessed incidence and predictors of in-hospital and one-year mortalities. Methods We selected the 455 patients included in the \"IN-HF Outcome\" Italian registry belonging to the lowest quartile of estimated glomerular filtration rate (eGFR < 40 ml/min/1.73 m2). Results Mean eGFR at entry in severe RD patients was 28 ?? 9 ml/min/1.73 m2. Compared to 1368 patients with more preserved eGFR, they were older, with more co-morbidities and more frequently ischemic etiology of HF. In-hospital and one-year all-cause mortality rates were 14% and 44% respectively, twice higher than the entire population. Predictors of in-hospital mortality were an abnormal status of consciousness, older age, hyponatremia, lower systolic blood pressure and eGFR. The same conditions (except eGFR) predicted one-year mortality together with the absence of diabetes and no treatment with beta-blockers or diuretics. Conclusions In patients with AHF and severe RD, in-hospital and one-year all-cause mortality rates are very high. Independent predictors such as older age, and signs of hypoperfusion and hyponatremia may be identified but preventing and reversing RD remain the key targets for the clinical management of these patients. ?? 2013 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Cioffi","given":"Giovanni","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cacciatore","given":"Giuseppe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chinaglia","given":"Alessandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tarantini","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"Pietro","family":"Maggioni","given":"Aldo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2013"]]},"page":"3691-3697","title":"Clinical features, and in-hospital and 1-year mortalities of patients with acute heart failure and severe renal dysfunction. Data from the Italian Registry IN-HF Outcome","type":"article-journal","volume":"168"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.112.000161","ISSN":"19413289","PMID":"23476054","abstract":"BACKGROUND: Clinical observational studies on heart failure (HF) deal mostly with hospitalized patients, few with chronic outpatients, all with no or limited longitudinal observation. METHODS AND RESULTS: This is a multicenter, nationwide, prospective observational trial on a population of 5610 patients, 1855 hospitalized for acute HF (AHF) and 3755 outpatients with chronic HF (CHF), followed up for 1 year. The cumulative total mortality rate at 1 year was 24% in AHF (19.2% in 797 patients with de novo HF and 27.7% in 1058 with worsening HF) and 5.9% in CHF. Cardiovascular deaths accounted for 73.1% and 65.3% and HF deaths for 42.4% and 40.5% of total deaths in AHF and CHF patients, respectively. One-year hospitalization rates were 30.7% in AHF and 22.7% in CHF patients. Among the independent predictors of 1-year all-cause death, age, low systolic blood pressure, anemia, and renal dysfunction were identified in both acute and chronic patients. A few additional variables were significant only in AHF (signs of cerebral hypoperfusion, low serum sodium, chronic obstructive pulmonary disease, and acute pulmonary edema), whereas others were observed only in CHF patients (lower body mass index, higher heart rate, New York Heart Association class, large QRS, and severe mitral regurgitation). CONCLUSIONS: In this contemporary data set, patients with CHF had a relatively low mortality rate compared with those with AHF. Rates of adverse outcomes in patients admitted for AHF remain very high either in-hospital or after discharge. Most deaths were cardiovascular in origin and ≈40% of deaths were directly related to HF.","author":[{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cacciatore","given":"Giuseppe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chinaglia","given":"Alessandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"Di","family":"Lenarda","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-3","issue":"3","issued":{"date-parts":[["2013"]]},"page":"473-481","title":"Multicenter prospective observational study on acute and chronic heart failure one-year follow-up results of in-hf (italian network on heart failure) outcome registry","type":"article-journal","volume":"6"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.healun.2014.05.015","ISSN":"10532498","author":[{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Carbonieri","given":"Emanuele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Midi","given":"Paolo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Journal of Heart and Lung Transplantation","id":"ITEM-4","issue":"10","issued":{"date-parts":[["2014"]]},"page":"1056-1065","publisher":"Elsevier","title":"Treatment with inotropes and related prognosis in acute heart failure: Contemporary data from the Italian Network on Heart Failure (IN-HF) Outcome registry","type":"article-journal","volume":"33"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.ijcard.2014.02.018","ISSN":"18741754","PMID":"24630337","abstract":"Background To investigate the outcomes of hospitalized patients with both de-novo and worsening heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HFpEF) (LVEF ??? 50%), compared to those with reduced LVEF (HFrEF). Methods and results We studied 1669 patients (22.6% HFpEF) hospitalized for acute HF in the prospective multi-center nationwide Italian Network on Heart Failure (IN-HF) Outcome Registry. In all patients LVEF was assessed during hospitalization. De-novo HF presentations constituted 49.6% of HFpEF and 43.1% of HFrEF hospitalizations. All-cause mortality during hospitalization was lower in HFpEF than HFrEF (2.9% vs 6.5%, p = 0.01), but this mortality difference was not significant at 1 year (19.6% vs 24.4%, p = 0.06), even after adjusting for clinical covariates. Similarly, there were no differences in 1-year mortality between HFpEF and HFrEF when compared by cause of death (cardiovascular vs non-cardiovascular) or mode of presentation (worsening HF vs de novo). Rehospitalization rates (all-cause, non-cardiovascular, cardiovascular, HF-related) at 90 days and 1 year were also similar. Mode of presentation influenced rehospitalizations in HFpEF, where those presenting with worsening HFpEF had higher all-cause (36.8% vs 21.6%, p = 0.001), cardiovascular (28.1% vs 14.9%, p = 0.002), and HF-related (21.1% vs 7.7%, p = 0.0003) rehospitalization rates at 1 year compared to those with de novo presentations. Conclusions Outcomes at 1 year following hospitalization for HFpEF are as poor as that of HFrEF. A prior history of HF decompensation or hospitalization identifies patients with HFpEF at particularly high risk of recurrent events. These findings may have implications for clinical practice, quality and process improvements and trial design. ?? 2014 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gavazzi","given":"Antonello","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pozzoli","given":"Massimo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gonzini","given":"Lucio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cirrincione","given":"Vincenzo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Montagna","given":"Laura","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-5","issue":"2","issued":{"date-parts":[["2014"]]},"page":"163-169","publisher":"Elsevier Ireland Ltd","title":"In-hospital and 1-year outcomes of acute heart failure patients according to presentation (de novo vs. worsening) and ejection fraction. Results from IN-HF Outcome Registry","type":"article-journal","volume":"173"},"uris":[""]}],"mendeley":{"formattedCitation":"^154–158","plainTextFormattedCitation":"154–158","previouslyFormattedCitation":"^152–156"},"properties":{"noteIndex":0},"schema":""}154–158JCARE: Japanese Cardiac Registry of Heart Failure in Cardiology ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1346-9843","PMID":"17127810","abstract":"BACKGROUND: Heart failure (HF), defined as a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood, is a leading cause of mortality and hospitalization for adults older than 65 years in the industrialized countries. The characteristics and outcome of patients with HF have been described by several epidemiological studies and large scale clinical trials, performed mainly in the United States and Europe. Very little information is available on this issue in Japan. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) is designed to prospectively study the characteristics, treatment, and outcomes of a broad sample of patients hospitalized with HF at teaching hospitals throughout Japan between January 2004 to June 2005 and the outcomes, including death and hospital readmission, will be followed through 2006 (mean follow-up at least 1 year). Participating cardiologists identify patients admitted for worsening of HF symptoms. Demographics, medical history, severity, treatment, and outcome data are collected and entered into a database via secure web browser technology. As of June 2005, baseline data for 2,676 patients with HF have been registered from 164 participating hospitals. CONCLUSIONS: The JCARE-CARD will provide important insights into the management of patients with HF in routine clinical practice in Japan, thus providing the framework for improved management strategies for these patients.","author":[{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2006"]]},"page":"1617-1623","title":"Clinical characteristics and outcome of hospitalized patients with heart failure in Japan.","type":"article-journal","volume":"70"},"uris":[""]},{"id":"ITEM-2","itemData":{"ISSN":"1346-9843","PMID":"17384441","abstract":"BACKGROUND: The characteristics and outcomes of patients discharged from hospitals with a diagnosis of heart failure (HF) have been described by a number of previous epidemiological studies. However, very little information is available on this issue in general practice in Japan. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in General Practice (JCARE-GENERAL) is designed to study the characteristics, treatment and outcomes prospectively in a broad sample of outpatients with HF who were managed by cardiologists in hospital (Hospital-HF) and primary care physicians in general practice (GP-HF). Out of 2,685 patients with HF, 1,280 patients were Hospital-HF and 1,405 GP-HF. Compared to the Hospital-HF patients, GP-HF patients were more likely to be elderly and female, and they had a higher prevalence of hypertensive heart disease as a cause of HF. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers were more prescribed to Hospital-HF than GP-HF patients. At the follow-up of 1.2 year, after adjustment, the mortality was comparable between the Hospital-HF and GP-HF groups, whereas HF-related admission was higher in the Hospital-HF group than in in the GP-HF group. CONCLUSIONS: Based on the JCARE-GENERAL, the characteristics, treatment and outcomes of GP-HF patients differed from those of Hospital-HFpatients in Japan.","author":[{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2007"]]},"page":"449-454","title":"Characteristics and outcomes of patients with heart failure in general practices and hospitals.","type":"article-journal","volume":"71"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"JST.JSTAGE/circj/CJ-09-0254 [pii]","ISBN":"1347-4820 (Electronic)\\n1346-9843 (Linking)","ISSN":"1347-4820","PMID":"19644216","abstract":"BACKGROUND: Heart failure (HF) with preserved ejection fraction (EF) is common. We compared the characteristics, treatments, and outcomes in HF patients with reduced vs preserved EF by using the national registry database in Japan. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) is a prospective observational study in a broad sample of patients hospitalized with worsening HF. The study enrolled 2,675 patients from 164 hospitals with an average of 2.4 years of follow-up. Patients with preserved EF (EF >or=50% by echocardiography; n=429) were more likely to be older, female, have hypertension and atrial fibrillation, and less likely to have ischemic etiology compared with those with reduced EF (EF <40%; n=985). Unadjusted risk of in-hospital mortality (6.5% vs 3.9%; P=0.03) and post-discharge mortality (22.7% vs 17.8%; P=0.058) was slightly higher in patients with preserved EF, which, however, were not different after multivariable adjustment. Patients with preserved EF had similar rehospitalization rates (36.2% vs 33.4%; P=0.515) compared with patients with reduced EF. CONCLUSIONS: HF patients with preserved EF had a similar mortality risk and equally high rates of rehospitalization as those with reduced EF. Effective management strategies are critically needed to be established for this type of HF.","author":[{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kato","given":"Norihiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-3","issue":"10","issued":{"date-parts":[["2009"]]},"page":"1893-1900","title":"Characteristics and outcomes of hospitalized patients with heart failure and reduced vs preserved ejection fraction. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).","type":"article-journal","volume":"73"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1253/circj.CJ-09-0184","ISBN":"1347-4820 (Electronic)\\r1346-9843 (Linking)","ISSN":"1347-4820","PMID":"19652398","abstract":"BACKGROUND: Anemia is common in patients with heart failure (HF) and is associated with worse outcomes. However, the effects of anemia are unknown in an unselected group of HF patients encountered in routine clinical practice in Japan. The impact of anemia on long-term outcomes including mortality and rehospitalization among patients hospitalized with HF was thus assessed. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatments in a broad sample of patients hospitalized with worsening HF and the outcomes were followed. Study cohorts (n=1,960) were classified into 4 groups by discharge hemoglobin quartiles: <10.1 g/dl (n=482), 10.1-11.9 g/dl (n=479), 12.0-13.6 g/dl (n=487), and >or=13.7 g/dl (n=512). Of the total cohort of HF patients, 57% had anemia, defined by using the World Health Organization definition. Patients with lower hemoglobin quartiles had higher rates of all-cause death, cardiac death, and rehospitalization due to worsening HF. After multivariable adjustment, the risk for all-cause death, cardiac death, and rehospitalization significantly increased with low hemoglobin concentrations. CONCLUSIONS: Anemia was quite common especially in patients with HF encountered in routine clinical practice in Japan, and lower hemoglobin was independently associated with long-term adverse outcomes in these patients.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-4","issue":"10","issued":{"date-parts":[["2009"]]},"page":"1901-1908","title":"Anemia is an independent predictor of long-term adverse outcomes in patients hospitalized with heart failure in Japan. A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).","type":"article-journal","volume":"73"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1253/circj.CJ-09-0062","ISBN":"1347-4820 (Electronic)\\r1346-9843 (Linking)","ISSN":"1347-4820","PMID":"19521016","abstract":"BACKGROUND: Previous studies have demonstrated that renal dysfunction is common in patients with heart failure (HF), but it is not known whether chronic kidney disease (CKD) is associated with increased risks of long-term adverse outcomes in unselected HF patients encountered in current routine clinical practice in Japan. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied a broad sample of patients hospitalized with worsening HF and their outcomes with an average of 2.4 years of follow-up. The study cohort (n=2,013) were classified into 3 groups by estimated glomerular filtration rate (eGFR): > or =60 (n=579), 30-59 (n=1,025), and <30 ml x min(-1) x 1.73 m(-2) or patients with dialysis (n=409); 1,372 patients (70.3%) had an eGFR <60 ml x min(-1) x 1.73 m(-2) and 62 patients were treated with dialysis. The multivariable adjusted risk for all-cause death or rehospitalization increased with reduced eGFR; an adjusted hazard ratio (HR) 1.520 (95% confidence interval (CI) 1.186-1.949) for eGFR 30-59 ml x min(-1) x 1.73 m(-2) (P=0.001) and HR 2.566 (95%CI 1.885-3.492) for eGFR <30 ml x min(-1) x 1.73 m(-2) or patients with dialysis (P<0.001). CONCLUSIONS: CKD is common in HF and was independently associated with long-term adverse outcomes in a broad cohort of Japanese patients.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ide","given":"Tomomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-5","issue":"8","issued":{"date-parts":[["2009"]]},"page":"1442-1447","title":"Chronic kidney disease as an independent risk for long-term adverse outcomes in patients hospitalized with heart failure in Japan. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).","type":"article-journal","volume":"73"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"","ISBN":"1346-9843; 1347-4820","ISSN":"1347-4820","PMID":"19755750","abstract":"BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia in patients with heart failure (HF), but its prognostic importance is controversial. The effect of AF on long-term outcomes, including mortality and rehospitalization, among unselected HF patients hospitalized with HF in routine clinical practice in Japan was assessed in the present study. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatment strategies of a broad sample of patients hospitalized with worsening HF and the outcomes were followed with an average of 2.4 years of follow-up. The study cohort (n=2,659) was grouped according to the presence (n=937; 35.2%) or absence (n=1,722; 64.8%) of AF at baseline. After multivariable adjustment, patients with and without AF had a comparable risk for all-cause death (adjusted hazard ratio (HR) 0.931, 95% confidence interval (CI) 0.690-1.258, P=0.643), cardiac death (adjusted HR 0.949, 95%CI 0.655-1.377, P=0.784), rehospitalization because of the worsening HF (adjusted HR 1.028, 95%CI 0.816-1.295, P=0.816), and all-cause death or rehospitalization (adjusted HR 1.039, 95%CI 0.842-1.281, P=0.722). CONCLUSIONS: Among patients hospitalized for HF in Japan, AF was common, but was not an independent risk for long-term adverse outcomes, including death or rehospitalization, in routine clinical practice.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-6","issue":"11","issued":{"date-parts":[["2009"]]},"page":"2084-2090","title":"Effects of atrial fibrillation on long-term outcomes in patients hospitalized for heart failure in Japan: a report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).","type":"article-journal","volume":"73"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1038/hr.2009.199","ISBN":"1348-4214 (Electronic)\r0916-9636 (Linking)","ISSN":"0916-9636","PMID":"19960016","abstract":"Large-scale, placebo-controlled, randomized clinical trials have shown that angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) reduce mortality and hospitalization in patients with heart failure (HF) caused by left ventricular systolic dysfunction (LVSD). However, it is unknown whether ACE inhibitors and ARBs have similar effects on the long-term outcomes in HF patients encountered in routine clinical practice. The Japanese Cardiac Registry of Heart Failure in Cardiology enrolled HF patients hospitalized with worsening symptoms and they were followed during an average of 2.2 years. The outcome data were compared in patients with LVSD by echocardiography (ejection fraction, EF <40%) according to the predischarge use of ACE inhibitors (n=356) or ARBs (n=372). The clinical characteristics were similar between patients with ACE inhibitor and ARB use, except for higher prevalence of hypertensive etiology and diabetes mellitus. There was no significant difference between ACE inhibitor and ARB use in all-cause death (adjusted hazard ratio 0.958, 95% confidence interval 0.601-1.527, P=0.858) and rehospitalization (adjusted hazard ratio 0.964, 95% confidence interval 0.683-1.362, P=0.836). The effects of ACE inhibitor and ARB use on the outcomes were generally consistent across all clinically relevant subgroups examined, including age, sex, etiology, EF, hypertension, diabetes mellitus, and beta-blocker use. Discharge use of ARBs provided comparable effects with ACE inhibitors on outcomes in patients hospitalized for HF. These findings provide further support for guideline recommendations that ARBs can be used in patients with HF and LVSD as an alternative of ACE inhibitors.","author":[{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Furumoto","given":"Tomoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Kazutomo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Hypertension research : official journal of the Japanese Society of Hypertension","id":"ITEM-7","issue":"3","issued":{"date-parts":[["2010"]]},"page":"197-202","publisher":"Nature Publishing Group","title":"Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure.","type":"article-journal","volume":"33"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1253/circj.CJ-10-0599","ISBN":"1347-4820","ISSN":"1347-4820","PMID":"21060207","abstract":"Obesity is a risk factor for cardiovascular disease (CVD) and is also associated with an increased risk of death in subjects without CVD. However, in heart failure (HF), elevated body mass index (BMI) has been shown to be associated with better prognosis, but it is unknown whether this is the case in unselected HF patients encountered in routine clinical practice in Japan.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Kazutomo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-8","issue":"12","issued":{"date-parts":[["2010"]]},"page":"2605-2611","title":"Body mass index is an independent predictor of long-term outcomes in patients hospitalized with heart failure in Japan.","type":"article-journal","volume":"74"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1253/circj.CJ-09-0993","ISSN":"1347-4820","PMID":"20501958","abstract":"Previous studies demonstrated that beta-blocker use at the time of hospital discharge significantly increased postdischarge treatment rates, associated with an early (60- to 90-day) survival benefit in patients with heart failure (HF). However, it is unknown whether this therapeutic approach can also improve the long-term survival. We thus examined the long-term effects of beta-blocker use at discharge on outcomes in patients hospitalized for HF and left ventricular systolic dysfunction (LVSD) (ejection fraction <40%).","author":[{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Kazutomo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-9","issue":"7","issued":{"date-parts":[["2010"]]},"page":"1364-1371","title":"Beta-blocker use at discharge in patients hospitalized for heart failure is associated with improved survival.","type":"article-journal","volume":"74"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1253/circj.CJ-11-0267","ISSN":"1347-4820","PMID":"21778592","abstract":"BACKGROUND: Aging is associated with adverse outcomes in patients with cardiac diseases. Whether elderly patients hospitalized with heart failure (HF) had increased risks for mortality and rehospitalization compared with younger patients during the long-term follow-up was examined. The predictors of these adverse outcomes were also identified. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF and the outcomes were followed up. The majority of elderly patients were female, had lower body mass index (BMI), a higher rate of ischemic, valvular, and hypertensive heart disease as etiologies of HF, a lower estimated glomerular filtration rate (eGFR), lower hemoglobin, and higher left ventricular ejection fraction values. Even after adjustment for covariates, the elderly patients were associated with higher risks of adverse outcomes. The predictors for all-cause death were: lower eGFR, lower BMI, male sex, sustained ventricular tachycardia or fibrillation (VT/VF), and the use of diuretics at discharge. CONCLUSIONS: Among patients hospitalized with HF, elderly patients had a worse prognosis than younger patients. Lower eGFR, lower BMI, male sex, sustained VT/VF, and diuretic use were independent predictors for all-cause death in these patients with higher risk.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-10","issue":"10","issued":{"date-parts":[["2011"]]},"page":"2403-10","title":"Predictors of long-term adverse outcomes in elderly patients over 80 years hospitalized with heart failure. - A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)-.","type":"article-journal","volume":"75"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1016/j.ijcard.2010.05.002","ISBN":"0167-5273","ISSN":"01675273","PMID":"20542341","abstract":"Background: Hyperuricemia is associated with worse outcomes of patients with chronic heart failure (HF). However, it is unknown in an unselected HF patients encountered in routine clinical practice. We thus assessed the impact of hyperuricemia on long-term outcomes including mortality and rehospitalization among patients hospitalized with worsening HF. Methods: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of hospitalized HF patients and the outcomes were followed for 2.1 years after discharge. Study cohorts (n = 1869) were divided into 2 groups according to serum uric acid (UA) at discharge; ??? 7.4 mg/dL (n = 908) and < 7.4 mg/dL (n = 961). Results: Of the total cohort of HF patients, 56% had hyperuricemia defined as UA ??? 7.0 mg/dl. Patients with UA ??? 7.4 mg/dL had higher rates of all-cause death, cardiac death, rehospitalization, and all-cause death or rehospitalization due to worsening HF. After multivariable adjustment, higher UA levels were a significant and independent predictor for all-cause death (adjusted hazard ratio [HR] 1.413, 95% confidence interval [CI] 1.094-1.824, P = 0.008) and cardiac death (adjusted HR 1.399, 95% CI 1.020-1.920, P = 0.037). Conclusions: Hyperuricemia was common in patients with HF encountered in clinical practice and higher UA was independently associated with long-term adverse outcomes in these patients. ?? 2010 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Furumoto","given":"Tomoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Kazutomo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-11","issue":"2","issued":{"date-parts":[["2011"]]},"page":"143-147","publisher":"Elsevier Ireland Ltd","title":"Hyperuricemia predicts adverse outcomes in patients with heart failure","type":"article-journal","volume":"151"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1253/circj.CJ-11-1196","ISSN":"1347-4820","PMID":"22665070","abstract":"BACKGROUND: Loop diuretics are commonly used in patients with heart failure (HF) to remove retained fluid and improve symptoms. However, they may potentially worsen outcomes in HF. It remains unknown whether the use of loop diuretics is associated with adverse HF outcomes in routine clinical practice. We thus determined the effects of loop diuretic use at discharge on long-term mortality and rehospitalization among patients hospitalized with HF.\\n\\nMETHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatments of a broad sample of patients hospitalized with worsening HF and followed for 2.1 years. Among a total of 2,549 HF patients, loop diuretics were used by 2,015 patients (79%), but not 534 patients (21%). The mean age was 70.7 years and 60% were male. Etiology was ischemic in 32% and mean left ventricular ejection fraction was 42%. After adjustment for covariates, discharge use of loop diuretics was associated with significant adverse risks of cardiac death (adjusted hazard ratio [HR] 2.348, 95% confidence interval [CI] 1.246-4.423, P=0.008) and rehospitalization (adjusted HR 1.427, 95% CI 1.040-1.959, P=0.027).\\n\\nCONCLUSIONS: Among patients hospitalized with worsening HF, loop diuretic use at discharge was associated with long-term adverse outcomes, which suggests that routine chronic use of loop diuretics may be harmful for patients with HF.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-12","issue":"8","issued":{"date-parts":[["2012"]]},"page":"1920-7","title":"Loop diuretic use at discharge is associated with adverse outcomes in hospitalized patients with heart failure: a report from the Japanese cardiac registry of heart failure in cardiology (JCARE-CARD).","type":"article-journal","volume":"76"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"","ISBN":"1347-4820","ISSN":"1347-4820","PMID":"22481105","abstract":"BACKGROUND: The mode of death has not been investigated in the registry data of patients with heart failure and reduced ejection fraction (HFREF) vs. preserved ejection fraction (HFPEF). The aim of the present study was therefore to carry out this comparison. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF, and followed them for an average of 2.1 years. This study included 323 patients in whom information on both the mode of death and left ventricular EF on echocardiography could be obtained. The mode of death was cardiovascular (CV) in 63% (including 17% sudden, 36% HF, 3% myocardial infarction, and 3% stroke), non-CV in 23%, and unknown in 14%. The prevalence of CV death including sudden death was high in patients with HFREF compared to HFPEF (68% vs. 58%, P=0.020). HF death, the most common mode of death, was similar between groups (37% vs. 35%, P=0.694). In contrast, non-CV mortality was significantly higher in HFPEF than those with HFREF (28% vs. 18%, P=0.021). CONCLUSIONS: In 60-70% of deaths the mode was CV, and HF death was the most common mode of death in either HFREF or HFPEF. The prevalence of sudden death was lower, and that of non-CV death higher, in HFPEF compared with HFREF.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sobirin","given":"Mochamad Ali","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Investigators","given":"Jcare-Card","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation Journal","id":"ITEM-13","issue":"7","issued":{"date-parts":[["2012"]]},"page":"1662-1669","title":"Mode of death in patients with heart failure and reduced vs. preserved ejection fraction: report from the registry of hospitalized heart failure patients","type":"article-journal","volume":"76"},"uris":[""]},{"id":"ITEM-14","itemData":{"DOI":"10.1016/j.jjcc.2013.03.009","ISSN":"09145087","PMID":"23672787","abstract":"Background: The characteristics, in-hospital management, and outcomes of patients hospitalized with worsening heart failure (HF) have been described by large-scale registries performed mainly in the USA and Europe. However, little information is available in Japan. We thus clarified the characteristics and clinical status as well as in-hospital management and outcomes among patients hospitalized with worsening HF in Japan and compared them with those reported in previous studies. Methods: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in patients hospitalized with worsening HF. From the total cohort of JCARE-CARD, 1677 patients were randomly selected and their detailed data during acute phase were collected as another registry database in the present study. The characteristics, in-hospital management, and outcomes were analyzed. Results: The mean age was 70.7 years and 59.4% were male. Etiology was ischemic in 34.0% and mean left ventricular ejection fraction was 42.5%. Carperitide was highly used as in-hospital management in Japan (33.5%) compared to the use of nesiritide in the USA (8-11%). The use of angiotensin-converting enzyme inhibitors was lower and angiotensin II receptor blockers (ARB) were more commonly used in this study compared to other studies in the USA and Europe. In-hospital crude mortality rate was comparable among studies (4-8%), however, length of stay was longer in Japan (15-20 versus 4-9 days). Conclusions: The characteristics, clinical status, and laboratory data on admission in patients hospitalized with worsening HF were similar between the present study and previous Japanese and western studies. Management was also similar except for higher use of carperitide and ARB. The most striking difference between Japanese registries and those from the USA and Europe was the longer length of stay. ? 2013 Japanese College of Cardiology.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiology","id":"ITEM-14","issue":"2","issued":{"date-parts":[["2013"]]},"page":"95-101","publisher":"Japanese College of Cardiology","title":"Characteristics, management, and outcomes for patients during hospitalization due to worsening heart failure-A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)","type":"article-journal","volume":"62"},"uris":[""]},{"id":"ITEM-15","itemData":{"DOI":"10.1016/j.jjcc.2012.08.010","ISBN":"1876-4738","ISSN":"09145087","PMID":"23078864","abstract":"Background: A subset of patients with hypertrophic cardiomyopathy (HCM) has been reported to progress into dilated-HCM (D-HCM), characterized by left ventricular (LV) systolic dysfunction and cavity dilatation, resembling idiopathic dilated cardiomyopathy (DCM). We compared the characteristics, treatments, and outcomes in patients with heart failure (HF) due to D-HCM vs. DCM by using national registry data in Japan. Methods and results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) is a prospective observational study of patients hospitalized due to worsening HF with an average of 2.2 years of follow-up. Patients with D-HCM (n=. 41) were more likely to be male, have prior stroke, atrial fibrillation, and sustained ventricular tachycardia or ventricular fibrillation compared with DCM (n=. 486). Echocardiography demonstrated that D-HCM patients had smaller LV end-systolic diameter, higher ejection fraction, and greater wall thickness. Treatments for HF including angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, ??-blocker, and spironolactone were similar between groups except for higher use of amiodarone, warfarin, and implantable cardioverter-defibrillator for D-HCM. Mortality was significantly higher in patients with D-HCM (29.7% vs. 14.4%; p<0.05). Sudden death tended to be higher also in D-HCM (8.1% vs. 2.6%; p=. 0.06), which, however, did not reach statistical significance. Conclusions: HF patients with D-HCM had higher mortality risk than those with DCM. Effective management strategies are critically needed to be established for D-HCM. ?? 2012 Japanese College of Cardiology.","author":[{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakakibara","given":"Mamoru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiology","id":"ITEM-15","issue":"1","issued":{"date-parts":[["2013"]]},"page":"65-70","publisher":"Japanese College of Cardiology","title":"Clinical characteristics and outcomes of dilated phase of hypertrophic cardiomyopathy: Report from the registry data in Japan","type":"article-journal","volume":"61"},"uris":[""]},{"id":"ITEM-16","itemData":{"DOI":"10.1016/j.ijcard.2014.06.068","ISSN":"01675273","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsushima","given":"Shouji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fukushima","given":"Arata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakakibara","given":"Mamoru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-16","issue":"1","issued":{"date-parts":[["2014"]]},"page":"239-242","publisher":"Elsevier Ireland Ltd","title":"Clinical characteristics and CHADS2 score in patients with heart failure and atrial fibrillation: Insights from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)","type":"article-journal","volume":"176"},"uris":[""]},{"id":"ITEM-17","itemData":{"DOI":"10.1007/s00380-013-0359-5","ISBN":"0910-8327","ISSN":"16152573","PMID":"23653107","abstract":"The day of the week of admission may influence the length of stay and in-hospital death. However, the association between the admission day of the week and in-hospital outcomes has been inconsistent in heart failure (HF) patients among studies reported from Western countries. We thus analyzed this association in HF patients encountered in routine clinical practice in Japan. We studied the characteristics and in-hospital treatment in 1620 patients hospitalized with worsening HF by using the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Patients were divided into two groups according to weekday (n = 1355; 83.6%) or weekend admission (n = 265; 16.4%). The mean age was 70.7 years and 59.4% were male. Etiology was ischemic in 34.0%, and mean left ventricular ejection fraction was 42.5%. Patients admitted on the weekend were significantly older and had more comorbidities, and more severe symptoms and signs of HF on admission. Length of stay was comparable between weekend and weekday admission (35.2 ± 47.0 days vs 33.6 ± 32.0 days, P = 0.591). Crude in-hospital mortality did not differ between patients admitted on the weekend and weekdays (7.5% vs 5.2%, P = 0.136). Even after adjustment for covariates in multivariable modeling with patients admitted on weekday as the reference, in-hospital death was comparable between patients admitted on the weekend and weekdays (adjusted odds ratio 1.125, 95% confidence interval 0.631-2.004, P = 0.691). Among patients hospitalized for worsening HF, admission day of the week did not affect in-hospital death and length of stay.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart and Vessels","id":"ITEM-17","issue":"3","issued":{"date-parts":[["2014"]]},"page":"328-335","title":"Weekend versus weekday hospital admission and outcomes during hospitalization for patients due to worsening heart failure: A report from Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)","type":"article-journal","volume":"29"},"uris":[""]},{"id":"ITEM-18","itemData":{"DOI":"10.1016/j.jjcc.2013.07.012","ISBN":"0914-5087","ISSN":"09145087","PMID":"24021776","abstract":"Background and purpose: Hyponatremia is common and is associated with poor in-hospital outcomes in patients hospitalized with heart failure (HF). However, it is unknown whether hyponatremia is associated with long-term adverse outcomes. The purpose of this study was to clarify the characteristics, clinical status on admission, and management during hospitalization according to the serum sodium concentration on admission, and determine whether hyponatremia was associated with in-hospital as well as long-term outcomes in 1677 patients hospitalized with worsening HF on index hospitalization registered in the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Methods and subjects: We studied the characteristics and in-hospital treatment in 1659 patients hospitalized with worsening HF by using the JCARE-CARD database. Patients were divided into 2 groups according to serum sodium concentration on admission <135. mEq/mL (n= 176; 10.6%) or ≥135. mEq/mL (n= 1483; 89.4%). Results: The mean age was 70.7 years and 59.2% were male. Etiology was ischemic in 33.9% and mean left ventricular ejection fraction was 42.4%. After adjustment for covariates, hyponatremia was independently associated with in-hospital death [adjusted odds ratio (OR) 2.453, 95% confidence interval (CI) 1.265-4.755, p= 0.008]. It was significantly associated also with adverse long-term (mean 2.1. ±. 0.8 years) outcomes including all-cause death (OR 1.952, 95% CI 1.433-2.657), cardiac death (OR 2.053, 95% CI 1.413-2.983), and rehospitalization due to worsening HF (OR 1.488, 95% CI 1.134-1.953). Conclusions: Hyponatremia was independently associated with not only in-hospital but also long-term adverse outcomes in patients hospitalized with worsening HF. ? 2013 Japanese College of Cardiology.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsushima","given":"Shouji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakakibara","given":"Mamoru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ishimori","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiology","id":"ITEM-18","issue":"3","issued":{"date-parts":[["2014"]]},"page":"182-188","publisher":"Japanese College of Cardiology","title":"Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure","type":"article-journal","volume":"63"},"uris":[""]}],"mendeley":{"formattedCitation":"^{159,160,169–176,161–168}","plainTextFormattedCitation":"159,160,169–176,161–168","previouslyFormattedCitation":"^157–174"},"properties":{"noteIndex":0},"schema":""}159,160,169–176,161–168KorHF: Korean Heart Failure Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4070/kcj.2011.41.7.363","ISSN":"1738-5520","PMID":"21860637","abstract":"BACKGROUND AND OBJECTIVES: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea.\\n\\nSUBJECTS AND METHODS: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6±14.3 years and 50% of the patients were female.\\n\\nRESULTS: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5±15.7% and 26.1% of the patients had preserved systolic function (LVEF ≥50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death.\\n\\nCONCLUSION: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.","author":[{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shin","given":"Mi-Seung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Seong","given":"In-Whan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahn","given":"Youngkeun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Yung-Jo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Hyung Seop","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Korean Circulation Journal","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2011"]]},"page":"363","title":"Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry","type":"article","volume":"41"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.ijcard.2012.03.155","ISSN":"01675273","PMID":"22498415","author":[{"dropping-particle":"","family":"Hong","given":"Sung-Jin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Jaewon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Youn","given":"Jong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-2","issue":"3","issued":{"date-parts":[["2012"]]},"page":"416-418","publisher":"Elsevier B.V.","title":"Clinical implication of right bundle branch block in hospitalized patients with acute heart failure: Data from the Korean Heart Failure (KorHF) Registry","type":"article-journal","volume":"157"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1136/heartjnl-2012-302334","ISBN":"1468-201X","ISSN":"1468-201X","PMID":"23125248","abstract":"Hyponatraemia predicts poor prognosis in patients hospitalised for acute heart failure (AHF). Yet, the association of hyponatraemia improvement with better postdischarge outcome has not been elucidated. Here, we determined the clinical impact of hyponatraemia improvement during hospitalisation on postdischarge outcome in patients admitted for AHF.","author":[{"dropping-particle":"","family":"Lee","given":"Sang Eun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoon","given":"Chang-Hwan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Il-Young","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart (British Cardiac Society)","id":"ITEM-3","issue":"24","issued":{"date-parts":[["2012"]]},"page":"1798-804","title":"Improvement of hyponatraemia during hospitalisation for acute heart failure is not associated with improvement of prognosis: an analysis from the Korean Heart Failure (KorHF) registry.","type":"article-journal","volume":"98"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.cardfail.2011.12.006","ISSN":"10719164","PMID":"22385939","abstract":"Hypercholesterolemia is a major risk factor for incident coronary artery disease and the prevalence of heart failure (HF). The causal relationship between low total cholesterol (TC) levels and poor clinical outcome in patients with acute HF has not been investigated. This study evaluated the effect of cholesterol levels on the long-term outcome in patients hospitalized due to acute HF.","author":[{"dropping-particle":"","family":"Yoon","given":"Chang-Hwan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Youn","given":"Tae-Jin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahn","given":"Soyeon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Goo-Young","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"In-Ho","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Ji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Hyungjun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-4","issue":"3","issued":{"date-parts":[["2012"]]},"page":"194-201","publisher":"Elsevier Inc","title":"Low Serum Total Cholesterol Level is a Surrogate Marker, But Not a Risk Factor, for Poor Outcome in Patients Hospitalized With Acute Heart Failure: A Report From the Korean Heart Failure Registry","type":"article-journal","volume":"18"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1253/circj.CJ-11-1093","ISSN":"1346-9843","PMID":"22343195","author":[{"dropping-particle":"","family":"Youn","given":"Young Jin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Jun-Won","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jang-Young","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seong Woo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"on behalf of the KorHF Registry","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation Journal","id":"ITEM-5","issue":"5","issued":{"date-parts":[["2012"]]},"page":"1151-1158","title":"Treatment Performance Measures Affect Clinical Outcomes in Patients With Acute Systolic Heart Failure","type":"article","volume":"76"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1016/j.ahj.2012.10.009","ISSN":"00028703","PMID":"23237134","abstract":"Background: Prolongations of PR interval and QRS duration on 12-lead electrocardiogram are associated with atrioventricular and interventricular/ intraventricular dyssynchrony, respectively. However, their clinical significance remains unclear in real-world heart failure (HF) population. We assessed whether the presence of first-degree atrioventricular block and/or QRS prolongation (???120 ms) is associated with worse short- and long-term outcomes in patients with acute HF. Methods: The Korean Heart Failure is a nationwide registry of 3,200 consecutive patients presenting with acute HF at 24 centers in South Korea between June 2004 and April 2009. We selected 1,986 patients with sinus rhythm and divided them into 4 groups depending on the presence of first-degree atrioventricular block and/or QRS prolongation; ED-Neither (n = 1,347), ED-PR (n = 217), ED-QRS (n = 329), and ED-Both (n = 93) groups, respectively. Results: During the median follow-up of 18.2 months, overall death rate (17%, 22%, 20%, and 29%, P <.01) tended to rise with increasing number of electrical dyssynchrony markers. Patients in ED-Both group showed worst outcomes regarding the requirement of invasive managements during the index admission, in-hospital mortality, postdischarge death/rehospitalization, and cardiac device implantation. In time-dependent Cox regression analyses, presence of both PR >200 ms and QRS ???120 ms was independently associated with in-hospital death (P <.01), postdischarge death/rehospitalization (P =.03), cardiac device implantation (P <.01), and overall death (P <.01). Conclusions: A combined analysis of electrical dyssynchrony markers (PR prolongation and QRS widening) might be useful for short- and long-term risk stratifications of patients with acute HF. ?? 2013 Mosby, Inc.","author":[{"dropping-particle":"","family":"Park","given":"Seung Jung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"On","given":"Young Keun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Byeon","given":"Kyeongmin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"June Soo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Jin Oh","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu Hyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun Seok","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-6","issue":"1","issued":{"date-parts":[["2013"]]},"page":"57-64.e2","publisher":"Mosby, Inc.","title":"Short- and long-term outcomes depending on electrical dyssynchrony markers in patients presenting with acute heart failure: Clinical implication of the first-degree atrioventricular block and QRS prolongation from the Korean Heart Failure registry","type":"article-journal","volume":"165"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.ijcard.2013.07.241","ISBN":"01675273 (ISSN)","ISSN":"01675273","PMID":"23958420","abstract":"Background Hemoconcentration is a surrogate marker of effective decongestion and diuresis therapy. Recently, hemoconcentration has been associated with decreased mortality and rehospitalization in heart failure (HF) patients. However, the prognostic power of hemoconcentration in a large sample-sized HF cohort was limited until now. Methods and results We analyzed data from hospitalized patients with acute heart failure (AHF) that were enrolled in the Korean Heart Failure Registry(n = 2,357). The primary end point was a composite of all-cause mortality and HF rehospitalization during the follow-up period (median = 347, interquartile range = 78-744 days).Hemoconcentration, defined as an increased hemoglobin level between admission and discharge, was presented in 1,016 AHF patients (43.1%). In multivariable logistic regression, hemoglobin, total cholesterol, and serum glucose levels at admission, and ischemic HF, were significant determinants for hemoconcentration occurrence. The Kaplan-Meier curve showed that event-free survival was significantly higher in the hemoconcentration group compared to the non-hemoconcentration group (65.1% vs. 58.1%, log rank p < 0.001). In multiple Cox proportional hazard analysis, hemoconcentration was an independent predictor of the primary end point after adjusting for other HF risk factors (hazard ratio = 0.671, 95% confidence interval = 0.564-0.798, p < 0.001). Conclusions Hemoconcentration during hospitalization was a prognostic marker of fewer clinical events in the AHF cohort. Therefore, this novel surrogate marker will help in the risk stratification of AHF patients. ? 2013 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Oh","given":"Jaewon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hong","given":"Namki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Youn","given":"Jong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-7","issue":"5","issued":{"date-parts":[["2013"]]},"page":"4739-4743","publisher":"Elsevier Ireland Ltd","title":"Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure: Data from the Korean Heart Failure (KorHF) Registry","type":"article-journal","volume":"168"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1016/j.ijcard.2012.10.054","ISSN":"01675273","PMID":"23192012","author":[{"dropping-particle":"","family":"Oh","given":"Jaewon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hong","given":"Namki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Youn","given":"Jong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-8","issue":"3","issued":{"date-parts":[["2013"]]},"page":"1084-1087","publisher":"Elsevier B.V.","title":"The CKD-EPI is more accurate in clinical outcome prediction than MDRD equation in acute heart failure: Data from the Korean Heart Failure (KorHF) Registry","type":"article-journal","volume":"167"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1016/j.amjcard.2013.10.022","ISSN":"00029149","PMID":"24315115","abstract":"The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3%) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4%, Q2 9.5%, Q3 16.9%, Q4 19.3%, p <0.001) and NT-proBNP quartiles (Q1 7.0%, Q2 13.4%, Q3 11.6%, Q4 20.4%, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95% confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95% CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95% CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF. ? 2014 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Park","given":"Jin Joo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoon","given":"Chang Hwan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Il Young","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu Hyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung Hee","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-9","issue":"3","issued":{"date-parts":[["2014"]]},"page":"511-517","publisher":"Elsevier Inc.","title":"Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry)","type":"article-journal","volume":"113"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1016/j.ahj.2015.01.014","ISSN":"00028703","author":[{"dropping-particle":"","family":"Oh","given":"Jaewon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Song","given":"Mi Kyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hong","given":"Namki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Youn","given":"Jong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-10","issue":"5","issued":{"date-parts":[["2015"]]},"page":"713-720.e3","publisher":"Elsevier Inc.","title":"Clinical benefit of spironolactone in patients with acute decompensated heart failure and severe renal dysfunction: Data from the Korean Heart Failure (KorHF) Registry","type":"article-journal","volume":"169"},"uris":[""]}],"mendeley":{"formattedCitation":"^177–186","plainTextFormattedCitation":"177–186","previouslyFormattedCitation":"^175–184"},"properties":{"noteIndex":0},"schema":""}177–186NICOR: National Institute for Cardiovascular Outcomes Research - National Heart Failure Audit ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","container-title":"National Institute for Cardiovascular Outcomes Research","id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"National Heart Failure Audit","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁸⁷","plainTextFormattedCitation":"187","previouslyFormattedCitation":"¹⁸⁵"},"properties":{"noteIndex":0},"schema":""}187OPTIMIZE-HF: Organized Program to Initiate Life-Saving Treatment in Hospitalized Patients with Heart Failure ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2004.03.004","ISBN":"0002-8703","ISSN":"00028703","PMID":"15215791","abstract":"Heart failure (HF) affects >5 million patients in the United States, and its prevalence is increasing every year. Despite the compelling scientific evidence that angiotensin-converting enzyme inhibitors and β-blockers reduce hospitalizations and mortality rates in patients with HF, these lifesaving therapies continue to be underused. Several studies in a variety of clinical settings have documented that a significant proportion of eligible patients with HF are not receiving treatment with these guideline-recommended, evidence-based therapies. In patients hospitalized with HF, who are at particularly high risk for re-hospitalization and death, the initiation of β-blockers is often delayed because of concern that early initiation of these agents may exacerbate HF. Recent studies suggest that β-blockers can be safely and effectively initiated in patients with HF before hospital discharge and that clinical outcomes are improved. The Initiation Management Predischarge Process for Assessment of Carvedilol Therapy for Heart Failure (IMPACT-HF) trial demonstrated that pre-discharge initiation of carvedilol was associated with a higher rate of β-blocker use after hospital discharge, with no increase in hospital length of stay. In addition, there was no increase in the risk of worsening of HF. Studies of hospital-based management systems that rely on early (pre-discharge) initiation of evidence-based therapies for patients with cardiovascular disease have also found increases in post-discharge use of therapy and a reduction in the rates of mortality and hospitalization. On the basis of these pivotal studies, the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) program is designed to improve medical care and education of hospitalized patients with HF and accelerate the initiation of evidence-based HF guideline recommended therapies by administering them before hospital discharge. A registry component, planned as the most comprehensive database of the hospitalized HF population focusing on admission to discharge and 60- to 90-day follow-up, is designed to evaluate the demographic, pathophysiologic, clinical, treatment, and outcome characteristics of patients hospitalized with HF. The ultimate aim of this program is to improve the standard of HF care in the hospital and outpatient settings and increase the use of evidence-based therapeutic strategies to save lives.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis","given":"Wendy a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Chris M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2004"]]},"page":"43-51","title":"Organized program to initiate lifesaving treatment in hospitalized patients with heart failure (OPTIMIZE-HF): Rationale and design","type":"article-journal","volume":"148"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1001/jama.296.18.2217","ISSN":"1538-3598","PMID":"17090768","abstract":"CONTEXT: The association between systolic blood pressure (SBP) at admission, clinical characteristics, and outcomes in patients hospitalized for heart failure who have reduced or relatively preserved systolic function has not been well studied. OBJECTIVE: To evaluate the relationship between SBP at admission, clinical profile, and outcomes in patients hospitalized for acute heart failure. DESIGN, SETTING, AND PATIENTS: Cohort study using data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry and performance-improvement program for patients hospitalized with heart failure at 259 US hospitals between March 2003 and December 2004. Patients were divided into quartiles by SBP at hospital admission (<120, 120-139, 140-161, and >161 mm Hg). In-hospital outcomes were based on 48,612 patients aged 18 years or older with heart failure. Of the 41,267 patients with left ventricular function assessed, 21,149 (51%) had preserved left ventricular function. Postdischarge outcomes were based on a prespecified subgroup (n = 5791, 10% of patients) with follow-up data assessed between 60 and 90 days. MAIN OUTCOME MEASURES: In-hospital and postdischarge mortality. RESULTS: Patients with higher SBP were more likely to be female and black and to have preserved systolic function. Fifty percent of the patients had SBP higher than 140 mm Hg at admission. Patients with lower SBP at admission had higher in-hospital and postdischarge mortality rates. Higher SBP at admission was associated with lower in-hospital mortality rates: 7.2% (<120 mm Hg), 3.6% (120-139 mm Hg), 2.5% (140-161 mm Hg), and 1.7% (>161 mm Hg) (P<.001 for overall difference). Postdischarge mortality rates in the follow-up cohort by SBP at admission were 14.0%, 8.4%, 6.0%, and 5.4%, respectively (P<.001 for overall difference). CONCLUSIONS: Systolic hypertension is common in patients hospitalized for heart failure. Systolic blood pressure is an independent predictor of morbidity and mortality in patients with heart failure with either reduced or relatively preserved systolic function. Low SBP (<120 mm Hg) at hospital admission identifies patients who have a poor prognosis despite medical therapy. These findings may have important therapeutic implications because characteristics and outcomes differ greatly among patients with heart failure with varying SBP.","author":[{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"She","given":"Lilin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-2","issue":"18","issued":{"date-parts":[["2006"]]},"page":"2217-2226","title":"Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure.","type":"article-journal","volume":"296"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1016/j.cardfail.2006.11.008","ISBN":"1071-9164","ISSN":"10719164","PMID":"17448416","abstract":"Background: Although recent heart failure (HF) management guidelines recommend delivery of patient education and discharge instructions, little is known about predictors of delivery of these materials or how such materials relate to outpatient disposition postdischarge. This report assesses the degree to which the full set of HF discharge instructions and education comprising the Joint Commission on Accreditation of Healthcare Organizations process-of-care measure (HF-1) was provided, identifies factors predictive of use of HF-1, and determines if HF-1 predicts postdischarge outcome disposition in a registry and performance improvement (PI) program for patients hospitalized for HF. Methods and Results: In the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (ie, OPTIMIZE-HF), of 33,681 patients from 259 US hospitals, 54% received HF-1. Some patient and site characteristics, such as symptoms on admission and performance of coronary angiography, were positively associated with delivery of the full set of HF-1 components, and others, such as African-American or Hispanic race and Midwest site location, were negatively associated with HF-1 delivery. However, delivery of the full set of HF-1 components was significantly more likely in the 46% of patients receiving PI tools (OR 2.23, 95% CI 2.12-2.35; P < .0001). Delivery of the full set of HF-1 components was significantly associated with use of specialty referral programs after discharge (P < .0001). Conclusions: Despite recommendations that complete instructions be given to patients with HF before hospital discharge, both PI tools to facilitate HF-1 and HF-1 itself are underused. Efforts should focus on strengthening processes and structures that will improve consistent delivery of HF-1 to all patients. ? 2007 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chiswell","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-3","issue":"3","issued":{"date-parts":[["2007"]]},"page":"189-198","title":"Predictors of Delivery of Hospital-Based Heart Failure Patient Education: A Report from OPTIMIZE-HF","type":"article-journal","volume":"13"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1001/archinte.167.14.1493","ISBN":"0003-9926 1538-3679","ISSN":"0003-9926","PMID":"17646603","abstract":"BACKGROUND: Despite evidence-based national guidelines for optimal treatment of heart failure (HF), the quality of care remains inadequate. We sought to evaluate the effect of a national hospital-based initiative on quality of care in patients hospitalized with HF. METHODS: Two hundred fifty-nine US hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) submitted data on 48 612 patients with HF from March 1, 2003, through December 31, 2004. Admission, hospital, discharge care, and outcomes data were collected using a Web-based registry that provided real-time feedback on performance measures benchmarked to other hospitals. Process-of-care improvement tools, including evidence-based best-practice algorithms and customizable admission and discharge sets, were provided. RESULTS: Provision of complete discharge instructions and smoking-cessation counseling increased significantly (from 46.8%-66.5% and 48.2%-75.6%, respectively; P < .001 for both). Left ventricular function assessment started at a high rate (89.3%) and improved to 92.1% (P < .001). Angiotensin-converting enzyme inhibitors were prescribed at discharge to 75.8% of eligible patients, which did not improve during the 2-year study. There were trends for reduction of in-hospital mortality, postdischarge death, and combined postdischarge death and rehospitalization and a significant reduction in mean length of stay. Use of preprinted admission order sets and/or discharge checklists increased from 35.6% to 54.1% and was associated with an increase in the use of evidence-based therapies and lower risk-adjusted in-hospital mortality. CONCLUSIONS: Participation in OPTIMIZE-HF was associated with an increase in use of evidence-based therapy, adherence to performance measures, and shorter lengths of stay in patients hospitalized with HF. Increased use of process-of-care improvement tools was associated with further improvements in quality of care. TRIAL REGISTRATION: Identifier NCT00344513.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pieper","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Archives of internal medicine","id":"ITEM-4","issue":"14","issued":{"date-parts":[["2007"]]},"page":"1493-1502","title":"Influence of a performance-improvement initiative on quality of care for patients hospitalized with heart failure: results of the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF).","type":"article-journal","volume":"167"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1016/j.ahj.2006.10.008","ISBN":"1097-6744 (Electronic)","ISSN":"00028703","PMID":"17174643","abstract":"Background: The IMPACT-HF trial demonstrated that carvedilol use at the time of heart failure (HF) hospital discharge significantly increased 90-day postdischarge treatment rates. Whether there is an early survival benefit associated with this therapeutic approach in patients hospitalized for HF is unknown. We examined the early effects on mortality and rehospitalization of carvedilol use at discharge in patients hospitalized for HF and left ventricular systolic dysfunction (LVSD) compared with outcomes in patients who are eligible for, but do not receive, β blockers before discharge. Methods: The OPTIMIZE-HF program enrolled 5791 patients admitted with HF in a web-based registry at 91 hospitals participating with prespecified 60- to 90-day follow-up from March 2003 to December 2004. Outcomes data were prospectively collected on patients eligible for β-blocker therapy and analyzed according to predischarge β-blocker use. Results: The mean age was 69.7 years; 63% were male, etiology was ischemic in 52%, and mean left ventricular ejection fraction was 24.3%. A total of 2720 patients had LVSD, among whom 2373 (87.2%) were eligible to receive a β blocker at discharge and carvedilol was prescribed in 1162 (49.0%). Discharge use of carvedilol was associated with a significant reduction in mortality risk at 60 to 90 days (hazard ratio 0.46, P = .0006) and mortality or rehospitalization (odds ratio 0.71, P = .0175) compared to no predischarge β blocker. Predischarge use of carvedilol was well tolerated with high rates of continued therapy at 60 to 90 days follow-up. Similar findings were observed for other evidence-based β blockers. Conclusions: Carvedilol use at the time of HF hospital discharge is well tolerated, improves treatment rates, and is associated with an early survival benefit. These findings provide further support for guideline recommendations that carvedilol or other evidence-based β blocker should be initiated before hospital discharge in stable patients with HF and LVSD. ? 2007.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-5","issue":"1","issued":{"date-parts":[["2007"]]},"page":"1-11","title":"Carvedilol use at discharge in patients hospitalized for heart failure is associated with improved survival: An analysis from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"153"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1016/j.cardfail.2007.06.727","ISBN":"1532-8414 (Electronic)\r1071-9164 (Linking)","ISSN":"10719164","PMID":"17996820","abstract":"Background: The objective of this study was to prospectively evaluate beta-blocker use at hospital discharge as an indicator of quality of care and outcomes in patients with heart failure (HF). Methods and Results: Data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry for patients hospitalized with HF from 259 hospitals were prospectively collected and analyzed. HF medication contraindications, intolerance, and use at hospital discharge were assessed, along with 60- to 90-day follow-up data in a prespecified cohort. There were 20,118 patients with left ventricular systolic dysfunction. At discharge, 90.6% of patients were eligible to receive beta-blockers, and 83.7% were eligible to receive an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. Eligible patients discharged with beta-blockers were significantly more likely to be treated at follow-up than those not discharged with beta-blockers (93.1% vs 30.5%; P < .0001). Discharge use of beta-blockers in eligible patients was associated with a significant reduction in the adjusted risk of death (hazard ratio: 0.48; 95% confidence interval: 0.32-0.74; P < .001) and death/rehospitalization (odds ratio: 0.74; 95% confidence interval: 0.55-0.99; P = .04), although we cannot completely exclude the possibility of residual confounding. Conclusions: Discharge beta-blocker use in HF appeared to be well tolerated, improved treatment rates, and was associated with substantially lower postdischarge mortality risk. These data provide additional evidence that supports beta-blocker use at hospital discharge in eligible patients as an HF performance measure. ? 2007 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-6","issue":"9","issued":{"date-parts":[["2007"]]},"page":"722-731","title":"Prospective Evaluation of Beta-Blocker Use at the Time of Hospital Discharge as a Heart Failure Performance Measure: Results From OPTIMIZE-HF","type":"article-journal","volume":"13"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1001/jama.297.1.61","ISSN":"1538-3598","PMID":"17200476","abstract":"CONTEXT: Assessment of quality of care in heart failure has focused on the development and use of process-based performance measures, with the presumption that these processes are associated with improved clinical outcomes. However, this link remains largely untested. OBJECTIVE: To examine the relationship between current American College of Cardiology/American Heart Association (ACC/AHA) performance measures for patients hospitalized with heart failure and relevant clinical outcomes. DESIGN, SETTING, AND PATIENTS: The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure, a registry and performance improvement program for patients hospitalized with heart failure. Sixty- to ninety-day postdischarge follow-up data were prospectively collected from 5791 patients at 91 US hospitals in a prespecified 10% sample between March 2003 and December 2004. Mean patient age was 72.0 years, 51% were male, 78% were white, and 42% had ischemic etiology. Multivariable and propensity-adjusted analyses were performed to assess the process-outcome relationship for each performance measure in eligible patients. Additionally, we evaluated the process-outcome link of a potential performance measure for beta-blockade at discharge among eligible patients hospitalized with heart failure. MAIN OUTCOME MEASURES: Sixty- to ninety-day mortality and combined mortality/rehospitalization rates. RESULTS: Mortality during follow-up was 8.6% and mortality/rehospitalization was 36.2%. None of the 5 ACC/AHA heart failure performance measures was significantly associated with reduced early mortality risk, and only angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use at discharge was associated with 60- to 90-day postdischarge mortality or rehospitalization. Beta-blockade at the time of hospital discharge, currently not a heart failure performance measure, was strongly associated with reduced risk of mortality (hazard ratio, 0.48; 95% confidence interval, 0.30-0.79; P = .004) and mortality/rehospitalization during follow-up. CONCLUSIONS: Current heart failure performance measures, aside from prescription of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker at discharge, have little relationship to patient mortality and combined mortality/rehospitalization in the first 60 to 90 days after discharge. Additional measures and better methods for identifying and validating heart failure performance measures may…","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pieper","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-7","issue":"1","issued":{"date-parts":[["2007"]]},"page":"61-70","title":"Association between performance measures and clinical outcomes for patients hospitalized with heart failure.","type":"article-journal","volume":"297"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1016/j.jacc.2007.04.064","ISSN":"07351097","PMID":"17707182","abstract":"Objectives: We sought to evaluate the characteristics, treatments, and outcomes of patients with preserved and reduced systolic function heart failure (HF). Background: Heart failure with preserved systolic function (PSF) is common but not well understood. Methods: This analysis of the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry compared 20,118 patients with left ventricular systolic dysfunction (LVSD) and 21,149 patients with PSF (left ventricular ejection fraction [EF] ≥40%). Sixty- to 90-day follow-up was obtained in a pre-specified 10% sample of patients. Analyses of patients with PSF defined as EF >50% were also performed for comparison. Results: Patients with PSF (EF ≥40%) were more likely to be older, female, and Caucasian and to have a nonischemic etiology. Although length of hospital stay was the same in both groups, risk of in-hospital mortality was lower in patients with PSF (EF ≥40%) (2.9% vs. 3.9%; p < 0.0001). During 60- to 90-day post-discharge follow-up, patients with PSF (EF ≥40%) had a similar mortality risk (9.5% vs. 9.8%; p = 0.459) and rehospitalization rates (29.2% vs. 29.9%; p = 0.591) compared with patients with LVSD. Findings were comparable with those with PSF defined as EF >50%. In a risk- and propensity-adjusted model, there were no significant relationships between discharge use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or beta-blocker and 60- to 90-day mortality and rehospitalization rates in patients with PSF. Conclusions: Data from the OPTIMIZE-HF registry reveal a high prevalence of HF with PSF, and these patients have a similar post-discharge mortality risk and equally high rates of rehospitalization as patients with HF and LVSD. Despite the burden to patients and health care systems, data are lacking on effective management strategies for patients with HF and PSF. (Organized Program To Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]); ; NCT00344513). ? 2007 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-8","issue":"8","issued":{"date-parts":[["2007"]]},"page":"768-777","title":"Characteristics, Treatments, and Outcomes of Patients With Preserved Systolic Function Hospitalized for Heart Failure. A Report From the OPTIMIZE-HF Registry","type":"article-journal","volume":"50"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1016/j.amjcard.2007.07.067","ISBN":"0002-9149 (Print)\\r0002-9149 (Linking)","ISSN":"00029149","PMID":"18178411","abstract":"Anemia in heart failure (HF) is increasingly recognized and treated, but little is known about the prevalence and its relation to outcomes in patients hospitalized for decompensated HF in a situation of both reduced and preserved systolic function. We hypothesized that lower hemoglobin is correlated with death during hospitalization and 60 to 90 days postdischarge in patients with HF. The Organized Program to Initiate Lifesaving Treatment in Patients with Heart Failure is a registry and performance improvement program for hospitalized patients with HF. Study cohorts were defined by admission hemoglobin quartile. Data from 48,612 patients at 259 hospitals showed that half of the total cohort had low hemoglobin (<12.1 g/dl) and that 25% were moderately to severely anemic (lowest hemoglobin quartile, 5 to 10.7 g/dl). Patients with low hemoglobin were older, were more often women and Caucasian, and had preserved systolic function and elevated creatinine. They were also less likely to receive angiotensin-converting enzyme inhibitors and β blockers at discharge. Anemic patients had higher in-hospital mortality (4.8% vs 3.0%, lowest vs highest quartile), longer hospital length of stay (6.5 vs 5.3 days), and more readmissions by 90 days (33.1% vs 24.2%) (all p <0.0001). In conclusion, these data reveal a higher prevalence of low hemoglobin in hospitalized patients than noted in randomized HF trials and outpatient registries. Lower hemoglobin is associated with higher morbidity and mortality in hospitalized patients with HF. ? 2008 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"She","given":"Lilin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-9","issue":"2","issued":{"date-parts":[["2008"]]},"page":"223-230","title":"Relation of Low Hemoglobin and Anemia to Morbidity and Mortality in Patients Hospitalized With Heart Failure (Insight from the OPTIMIZE-HF Registry)","type":"article-journal","volume":"101"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.107.748376","ISBN":"1941-3297 (Electronic)\\r1941-3289 (Linking)","ISSN":"1941-3289","PMID":"19808270","abstract":"BACKGROUND: Differences in hospital staffing may influence outcomes for patients with acute conditions, including heart failure (HF), depending on which day of the week the patients are admitted. This study examined the relationship between the day of the week patients are hospitalized for HF and death rate, length of stay (LOS), and rehospitalization rate. METHODS AND RESULTS: A total of 259 US hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) submitted data on 48 612 patients with HF. Sixty- to 90-day postdischarge follow-up data were collected prospectively in a prespecified 10% sample. We analyzed day of admission and discharge, demographic, medical history, medication use, laboratory, and in-hospital procedure data for their association with hospital LOS and death rate. Patient characteristics were similar for weekday and weekend presentation. LOS was a median of 4.0 days and a mean of 5.7+/-5.7 days; in-hospital death rate was 3.8%. In-hospital and postdischarge risk of death were similar for each day of the week in the hospital and follow-up cohorts, respectively. LOS, however, was significantly influenced by day of admission, even after adjustment for other LOS risk factors. The shortest LOS by admission day of the week was Tuesday (5.39 days), and the longest was Friday (5.88 days; P<0.001). CONCLUSIONS: No differences in death rate by day of admission or discharge for HF hospitalizations were evident. Hospitalizations for HF on Thursday and Friday were associated with prolonged LOS. Understanding the factors responsible for the increased LOS and potential adjustments in staffing to facilitate weekend discharges may improve the efficiency of HF hospital care.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nunez","given":"Eduardo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation. Heart failure","id":"ITEM-10","issue":"1","issued":{"date-parts":[["2008"]]},"page":"50-57","title":"Day of admission and clinical outcomes for patients hospitalized for heart failure: findings from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF).","type":"article-journal","volume":"1"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1093/eurheartj/ehn210","ISBN":"1522-9645 (Electronic)\\r0195-668X (Linking)","ISSN":"0195668X","PMID":"18487210","abstract":"AIMS: Cigarette smoking is a well-established risk factor for cardiovascular disease yet several studies have shown lower mortality after acute coronary syndromes in smokers compared with non-smokers, the so called 'smoker's paradox'. This study aimed to ascertain the relationship between smoking and clinical outcomes in patients hospitalized with heart failure (HF). METHODS AND RESULTS: OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) collected data on 48 612 patients from 259 hospitals. Characteristics, treatments, and outcomes were compared for current/recent smokers vs. those without current/recent smoking, and multivariable regression analyses with adjustment for hospital clustering were performed. There were 7743 (15.9%) smokers, 39 126 (80.5%) non-smokers, and 1743 (3.6%) missing. Smokers were younger, had similar renal function, but lower ejection fraction. The risk of in-hospital mortality was less in smokers (2.3 vs. 3.9%, P < 0.001). After extensive covariate adjustment, smokers still had lower in-hospital mortality risk OR (odds ratio) 0.70, 95% CI (confidence interval) 0.56-0.88, P = 0.002. Post-discharge, smokers (n = 998) had similar mortality risk (6.7 vs. 8.4%, P = 0.29) compared with those without current/recent smoking. CONCLUSION: Smokers hospitalized with HF had lower risk adjusted in-hospital mortality and similar early post-discharge mortality compared with non-smokers. The residual association of smoking and better prognosis, the 'smoker's paradox', was not fully explained by measured covariates.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nunez","given":"Eduardo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-11","issue":"16","issued":{"date-parts":[["2008"]]},"page":"1983-1991","title":"A smoker's paradox in patients hospitalized for heart failure: Findings from OPTIMIZE-HF","type":"article-journal","volume":"29"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1016/j.amjcard.2008.07.045","ISBN":"1879-1913 (Electronic)\\r0002-9149 (Linking)","ISSN":"00029149","PMID":"19026308","abstract":"Heart failure (HF) guidelines recommend that β blockers be titrated to achieve the target doses shown to be effective in major clinical trials, if tolerated. Little is known, however, regarding the doses of β blockers used in patients with HF in routine clinical practice before, during, and after hospitalization for HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) enrolled 5,791 patients admitted with HF in a registry with prespecified 60- to 90-day follow-up at 91 academic and community hospitals throughout the United States. Among 2,373 patients with systolic HF eligible for β blockers at discharge, 1,350 (56.9%) were receiving β-blocker therapy before admission and continued on therapy, and 632 (26.6%) were newly started. The mean total daily dose for β blockers before hospital admission was <1/2 the recommended target dose (carvedilol 21.5 ± 17.8 mg and metoprolol succinate 69.2 ± 51.9 mg), with infrequent up- or down-titration during the HF hospitalization. More than 2/3 of patients had no change in their β-blocker doses in the first 60 to 90 days after hospital discharge. At 60- to 90-day postdischarge follow-up, only 17.5% and 7.9% of patients were being treated with recommended target doses of carvedilol and metoprolol succinate, respectively. In conclusion, these data reveal that the doses of β blockers applied in clinical practice are substantially less that the doses achieved in randomized clinical trials in HF and recommended in national guidelines. In the first 60 to 90 days after hospital discharge, little up-titration in β-blocker dosing occurs. Further efforts are needed to help understand and overcome this β-blocker titration gap. ? 2008 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-12","issue":"11","issued":{"date-parts":[["2008"]]},"page":"1524-1529","publisher":"Elsevier Inc.","title":"Dosing of Beta-Blocker Therapy Before, During, and After Hospitalization for Heart Failure (from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure)","type":"article-journal","volume":"102"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"10.1016/j.ahj.2008.04.030","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"18926148","abstract":"Background: Patients with heart failure (HF) are at high risk for mortality and rehospitalization in the early period after hospital discharge. We developed clinical models predictive of short-term clinical outcomes in a broad patient population discharged after hospitalization for HF. Methods: The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry is a comprehensive hospital-based registry and performance-improvement program for patients hospitalized with HF. Follow-up data were scheduled to be prospectively collected at 60 to 90 days postdischarge in a prespecified 10% sample. For the 4,402 patients included in this analysis, 19 prespecified potential predictor variables were used in a stepwise Cox proportional hazards model for all-cause mortality. Logistic regression including 45 potential variables was used to model mortality or rehospitalization. Results: The 60- to 90-day postdischarge mortality rate was 8.6% (n = 481), and 29.6% (n = 1,715) were rehospitalized. Factors predicting early postdischarge mortality include age, serum creatinine, reactive airway disease, liver disease, lower systolic blood pressure, lower serum sodium, lower admission weight, and depression. Use of statins and β-blockers at discharge was associated with significantly decreased mortality. The C-index of the model was 0.74. The most important predictors for the combined end point of death or rehospitalization were admission serum creatinine, systolic blood pressure, admission hemoglobin, discharge use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and pulmonary disease. From this analysis, 8 factors identified to carry significant risk were selected for use in a point scoring system to predict the risk of mortality within 60 days after discharge, with a C-index of 0.72. Conclusions: A substantial risk of mortality and mortality or rehospitalization is present in the first 60 to 90 days after discharge from a hospitalization for HF. Several factors were identified that signal high-risk patients. Application of these findings with a simple algorithm can distinguish patients who are low risk from those at high risk who may benefit from closer monitoring and aggressive evidence-based treatment. ? 2008 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-13","issue":"4","issued":{"date-parts":[["2008"]]},"page":"662-673","title":"Predictors of mortality after discharge in patients hospitalized with heart failure: An analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"156"},"uris":[""]},{"id":"ITEM-14","itemData":{"DOI":"10.1016/j.jacc.2008.03.048","ISBN":"1558-3597 (Electronic)\\r0735-1097 (Linking)","ISSN":"07351097","PMID":"18617067","abstract":"Objectives: This study ascertains the relationship between continuation or withdrawal of beta-blocker therapy and clinical outcomes in patients hospitalized with systolic heart failure (HF). Background: Whether beta-blocker therapy should be continued or withdrawn during hospitalization for decompensated HF has not been well studied in a broad cohort of patients. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) program enrolled 5,791 patients admitted with HF in a registry with pre-specified 60- to 90-day follow-up at 91 academic and community hospitals throughout the U.S. Outcomes data were prospectively collected and analyzed according to whether beta-blocker therapy was continued, withdrawn, or not started. Results: Among 2,373 patients eligible for beta-blockers at discharge, there were 1,350 (56.9%) who were receiving beta-blockers before admission and continued on therapy, 632 (26.6%) newly started, 79 (3.3%) in which therapy was withdrawn, and 303 (12.8%) eligible but not treated. Continuation of beta-blockers was associated with a significantly lower risk and propensity adjusted post-discharge death (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.37 to 0.99, p = 0.044) and death/rehospitalization (odds ratio: 0.69; 95% CI: 0.52 to 0.92, p = 0.012) compared with no beta-blocker. In contrast, withdrawal of beta-blocker was associated with a substantially higher adjusted risk for mortality compared with those continued on beta-blockers (HR: 2.3; 95% CI: 1.2 to 4.6, p = 0.013), but with similar risk as HF patients eligible but not treated with beta-blockers. Conclusions: The continuation of beta-blocker therapy in patients hospitalized with decompensated HF is associated with lower post-discharge mortality risk and improved treatment rates. In contrast, withdrawal of beta-blocker therapy is associated with worse risk and propensity-adjusted mortality. (Organized Program To Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-14","issue":"3","issued":{"date-parts":[["2008"]]},"page":"190-199","title":"Influence of Beta-Blocker Continuation or Withdrawal on Outcomes in Patients Hospitalized With Heart Failure. Findings From the OPTIMIZE-HF Program","type":"article-journal","volume":"52"},"uris":[""]},{"id":"ITEM-15","itemData":{"DOI":"10.1016/j.ejheart.2008.09.009","ISBN":"1388-9842 (Print)\\r1388-9842 (Linking)","ISSN":"13889842","PMID":"19006680","abstract":"Background: Coronary artery disease (CAD) is frequent among patients hospitalized with acute heart failure syndromes (AHFS). Aims: To describe the influence of coronary revascularization status on survival in patients with AHFS. Methods and results: OPTIMIZE-HF enrolled 48,612 patients with AHFS from 259 U.S. hospitals. In-hospital data were obtained for all patients and post-discharge 60-90?day follow-up in a pre-specified 10% sample. CAD was associated with higher in-hospital (3.7% vs. 2.9%, OR 1.14, 95% CI 1.00-1.31) and post-discharge mortality (9.2% vs. 6.9%, HR 1.37, 95% CI 1.03-1.81) compared to no CAD. Post-discharge, patients with CAD who were not revascularized had higher mortality compared to patients without CAD (10.6% vs. 6.9%, HR 1.56, 95% CI 1.15-2.11). This association was similar in patients with left ventricular systolic dysfunction (EF < 40%, adjusted HR 1.52, 95% CI 0.98-2.35) and preserved systolic function (EF ≥ 40%, adjusted HR1.58, 95% CI 1.05-2.39). Patients with CAD who were revascularized had similar mortality to patients without CAD (HR 1.06, 95% CI 0.62-1.80 for PSF, HR 1.13, 95% CI 0.71-1.80 for LVSD). Conclusions: In AHFS, patients with CAD have a higher 60-90?day post-discharge mortality compared to no-CAD patients. However, patients with CAD who are revascularized appear to have similar post-discharge mortality when compared to the no-CAD group. This suggests that revascularization status may confer a survival advantage in this high risk population. ? 2008.","author":[{"dropping-particle":"","family":"Rossi","given":"Joseph S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Flaherty","given":"James D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nunez","given":"Eduardo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davidson","given":"Charles J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-15","issue":"12","issued":{"date-parts":[["2008"]]},"page":"1215-1223","publisher":"Elsevier B.V.","title":"Influence of coronary artery disease and coronary revascularization status on outcomes in patients with acute heart failure syndromes: A report from OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failur","type":"article-journal","volume":"10"},"uris":[""]},{"id":"ITEM-16","itemData":{"DOI":"10.1016/j.jacc.2008.01.028","ISBN":"1558-3597 (Electronic)\\r0735-1097 (Linking)","ISSN":"07351097","PMID":"18436120","abstract":"Objectives: We sought to examine the characteristics, quality of care, and clinical outcomes for a large cohort of African-American patients hospitalized with heart failure (HF) in centers participating in a quality improvement initiative. Background: Heart failure in African Americans is characterized by variations in natural history, lesser response to evidence-based therapies, and disparate health care. We hypothesized that a performance improvement program will achieve similar adherence to quality measures in African Americans admitted with HF compared with non-African Americans. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry-based performance-improvement program includes a pre-specified 10% subgroup with 60- to 90-day follow-up. Data on quality of care measures and outcomes were analyzed for 8,608 African-American patients compared with 38,501 non-African-American patients. Results: African Americans were significantly younger and more likely to receive evidence-based medications but less likely to receive discharge instructions and smoking cessation counseling. In multivariable analyses, African-American race was an independent predictor of lower in-hospital mortality (odds ratio 0.71; 95% confidence interval 0.57 to 0.87; p < 0.001) but similar hospital length of stay. After multivariable adjustment, post-discharge outcomes were similar for American-American and non-African-American patients, but African-American race was associated with higher angiotensin-converting enzyme inhibitor prescription and left ventricular function assessment; no other HF quality indicators were influenced by race. Conclusions: In the context of a performance-improvement program, African Americans with HF received similar or better treatment with evidence-based medications, less discharge counseling, had better in-hospital survival, and similar adjusted risk of follow-up death/repeat hospital stay. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"She","given":"Lilin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-16","issue":"17","issued":{"date-parts":[["2008"]]},"page":"1675-1684","title":"Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure. Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry","type":"article-journal","volume":"51"},"uris":[""]},{"id":"ITEM-17","itemData":{"DOI":"10.1016/j.jacc.2008.04.028","ISBN":"1558-3597 (Electronic) 0735-1097 (Linking)","ISSN":"07351097","PMID":"18652942","abstract":"Objectives: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. Background: Heart failure patients experience high rates of hospital stays and poor outcomes. Although predictors of mortality have been identified in HF clinical trials, hospitalized patients might differ greatly from trial populations, and such predictors might underestimate mortality in a real-world population. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) is a registry/performance improvement program for patients hospitalized with HF in 259 U.S. hospitals. Forty-five potential predictor variables were used in a stepwise logistic regression model for in-hospital mortality. Continuous variables that did not meet linearity assumptions were transformed. All significant variables (p < 0.05) were entered into multivariate analysis. Generalized estimating equations were used to account for the correlation of data within the same hospital in the adjusted models. Results: Of 48,612 patients enrolled, mean age was 73.1 years, 52% were women, 74% were Caucasian, and 46% had ischemic etiology. Mean left ventricular ejection fraction was 0.39 ± 0.18. In-hospital mortality occurred in 1,834 (3.8%). Multivariable predictors of mortality included age, heart rate, systolic blood pressure (SBP), sodium, creatinine, HF as primary cause of hospitalization, and presence/absence of left ventricular systolic dysfunction. A scoring system was developed to predict mortality. Conclusions: Risk of in-hospital mortality for patients hospitalized with HF remains high and is increased in patients who are older and have low SBP or sodium levels and elevated heart rate or creatinine at admission. Application of this risk-prediction algorithm might help identify patients at high risk for in-hospital mortality who might benefit from aggressive monitoring and intervention. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-17","issue":"5","issued":{"date-parts":[["2008"]]},"page":"347-356","title":"Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure. Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"52"},"uris":[""]},{"id":"ITEM-18","itemData":{"DOI":"10.1016/j.amjcard.2009.02.057","ISSN":"00029149","PMID":"19576329","abstract":"Previous studies have suggested that female and elderly patients with heart failure (HF) are less likely to receive guideline-recommended therapies, but these studies have involved select patient populations. We evaluated the differences in medical care and patient outcomes by age and gender among a broad cohort of hospitalized patients with HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) is a registry and performance-improvement program involving 48,612 patients with HF from 259 hospitals. The data were analyzed by gender, age <75 years, and age > or =75 years. Appropriate angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker use were similar between women and men (p = 0.244 and p = 0.237, respectively). However, compared with men, fewer women received hospital discharge instructions (p <0.001) and the length of stay was longer (p <0.001). Risk-adjusted in-hospital and postdischarge mortality were similar. All guideline-recommended cardiac medications were prescribed less frequently at discharge to eligible patients > or =75 than to those <75 years (all p <0.001). Older age was independently associated with in-hospital and postdischarge mortality risk increases (76% and 62%, respectively; p <0.001 for both). In conclusion, among the OPTIMIZE-HF hospitals, female patients with HF generally received similar medical care and had similar risks of adverse clinical outcomes compared with male patients. Older patients with HF were less likely to receive guideline-recommended therapies and remained at greater risk of adverse outcomes.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-18","issue":"1","issued":{"date-parts":[["2009"]]},"page":"107-115","publisher":"Elsevier Inc.","title":"Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF).","type":"article-journal","volume":"104"},"uris":[""]},{"id":"ITEM-19","itemData":{"DOI":"10.1016/j.jacc.2008.09.031","ISBN":"1558-3597 (Electronic)\\r0735-1097 (Linking)","ISSN":"07351097","PMID":"19130987","abstract":"Objectives: We sought to examine associations between initiation of beta-blocker therapy and outcomes among elderly patients hospitalized for heart failure. Background: Beta-blockers are guideline-recommended therapy for heart failure, but their clinical effectiveness is not well understood, especially in elderly patients. Methods: We merged Medicare claims data with OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) records to examine long-term outcomes of eligible patients newly initiated on beta-blocker therapy. We used inverse probability-weighted Cox proportional hazards models to determine the relationships among treatment and mortality, rehospitalization, and a combined mortality-rehospitalization end point. Results: Observed 1-year mortality was 33%, and all-cause rehospitalization was 64%. Among 7,154 patients hospitalized with heart failure and eligible for beta-blockers, 3,421 (49%) were newly initiated on beta-blocker therapy. Among patients with left ventricular systolic dysfunction (LVSD) (n = 3,001), beta-blockers were associated with adjusted hazard ratios of 0.77 (95% confidence interval [CI]: 0.68 to 0.87) for mortality, 0.89 (95% CI: 0.80 to 0.99) for rehospitalization, and 0.87 (95% CI: 0.79 to 0.96) for mortality-rehospitalization. Among patients with preserved systolic function (n = 4,153), beta-blockers were associated with adjusted hazard ratios of 0.94 (95% CI: 0.84 to 1.07) for mortality, 0.98 (95% CI: 0.90 to 1.06) for rehospitalization, and 0.98 (95% CI: 0.91 to 1.06) for mortality-rehospitalization. Conclusions: In elderly patients hospitalized with heart failure and LVSD, incident beta-blocker use was clinically effective and independently associated with lower risks of death and rehospitalization. Patients with preserved systolic function had poor outcomes, and beta-blockers did not significantly influence the mortality and rehospitalization risks for these patients. ? 2009 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schulman","given":"Kevin a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-19","issue":"2","issued":{"date-parts":[["2009"]]},"page":"184-192","title":"Clinical Effectiveness of Beta-Blockers in Heart Failure. Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry","type":"article-journal","volume":"53"},"uris":[""]},{"id":"ITEM-20","itemData":{"DOI":"10.1016/j.amjmed.2008.09.046","ISBN":"0002-9343","ISSN":"00029343","PMID":"19332232","abstract":"Background: Depression is a risk factor of excessive morbidity and mortality in heart failure. We examined in-hospital treatment and postdischarge outcomes in hospitalized heart failure patients with a documented history of depression from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure. Methods: We identified patient factors associated with depression history and evaluated the association of depression with hospital treatments and mortality, and early postdischarge mortality, emergency care, and rehospitalization. Results: In 48,612 patients from 259 hospitals, depression history was present in 10.6% and occurred more often in females, whites, and those with common heart failure comorbidities, including chronic pulmonary obstructive disease (36% vs 27%), anemia (27% vs 16.5%), insulin-dependent diabetes mellitus (20% vs 16%), and hyperlipidemia (38% vs 31%), all P <.001. Patients with depression history were less likely to receive coronary interventions and cardiac devices, all P <.01; or be referred to outpatient disease management programs, P <.001. Length of hospital stay was longer with depression history (7.0 vs 6.4 days, P <.001). In 5791 patients followed-up at 60-90 days postdischarge, those with depression history had higher mortality (8.8% vs 6.4%; P = .025). After multivariable modeling, depression history remained a predictor of length of hospital stay, P <.001 and postdischarge mortality, P = .02. Conclusions: Depression history at heart failure hospitalization may be a predictor of prolonged length of hospital stay, less use of cardiac procedures and postdischarge disease management, and increased 60-90 day mortality. Patients with depression might represent a vulnerable group in which improved use of evidence-based treatment should be considered. ? 2009 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nunez","given":"Eduardo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Medicine","id":"ITEM-20","issue":"4","issued":{"date-parts":[["2009"]]},"page":"366-373","publisher":"Elsevier Inc.","title":"Depression and Clinical Outcomes in Heart Failure: An OPTIMIZE-HF Analysis","type":"article-journal","volume":"122"},"uris":[""]},{"id":"ITEM-21","itemData":{"DOI":"10.1161/CIRCOUTCOMES.108.822692","ISBN":"19417713 (ISSN)","ISSN":"19417713","abstract":"Background-Participation in clinical registries is nonrandom, so participants may differ in important ways from nonparticipants. The extent to which findings from clinical registries can be generalized to broader populations is unclear. Methods and Results-We linked data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) registry with 100% inpatient Medicare fee-for-service claims to identify matched and unmatched patients with heart failure. We evaluated differences in baseline characteristics and mortality, all-cause readmission, and cardiovascular readmission rates. We used Cox proportional hazards models to examine relationships between registry enrollment and outcomes, controlling for baseline characteristics. There were 25 245 OPTIMIZE-HF patients in the Medicare claims data and 929 161 Medicare beneficiaries with heart failure who were not enrolled in OPTIMIZE-HF. Although hospital characteristics differed, patient demographic characteristics and comorbid conditions were similar. In-hospital mortality for OPTIMIZE-HF and non-OPTIMIZE-HF patients was not significantly different (4.7% versus 4.5%; P<0.37); however, OPTIMIZE-HF patients had slightly higher 30-day (11.9% versus 11.2%; P<0.001) and 1-year unadjusted mortality (37.2% versus 35.7%; P<0.001). Controlling for other variables, OPTIMIZE-HF patients were similar to non-OPTIMIZE-HF patients for the hazard of mortality (hazard ratio, 1.02; 95% confidence interval, 0.98 to 1.06). There were small but significant decreases in all-cause (hazard ratio, 0.94; 95% CI, 0.92 to 0.97) and cardiovascular readmission (hazard ratio, 0.94; 95% CI, 0.91 to 0.98). Conclusions- Characteristics and outcomes of Medicare beneficiaries enrolled in OPTIMIZE-HF are similar to the broader Medicare population with heart failure, suggesting that findings from this clinical registry may be generalized. (Circ Cardiovasc Qual Outcomes. 2009;2:377-384.) ? 2009 American Heart Association, Inc.","author":[{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"DiMartino","given":"Lisa D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shea","given":"Alisa M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Cardiovascular Quality and Outcomes","id":"ITEM-21","issue":"4","issued":{"date-parts":[["2009"]]},"page":"377-384","title":"Representativeness of a national heart failure quality-of-care registry:Comparison of OPTIMIZE-HF and Non-OPTIMIZE-HF medicare patients","type":"article-journal","volume":"2"},"uris":[""]},{"id":"ITEM-22","itemData":{"DOI":"10.1016/j.ahj.2009.03.011","ISBN":"0002-8703","ISSN":"00028703","PMID":"19464412","abstract":"Background Most patients hospitalized for acute heart failure syndromes (AHFS) carry a diagnosis of coronary artery disease (CAD), but coronary angiography is infrequently performed. This purpose of this study was to determine the influence of coronary angiography on use of therapeutics and early postdischarge outcomes in patients with AHFS. Methods The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure program enrolled 48,612 patients admitted with AHFS at 259 academic and community hospitals throughout the United States Inhospital treatments and outcomes were tracked in all patients and postdischarge outcomes in a prespecified 10% sample. Outcome data were prospectively collected and analyzed according to whether coronary angiography was performed during the index hospitalization and whether a patient had CAD. Results Overall, 8.7% of all patients underwent inhospital angiography. Among patients with CAD who underwent angiography, 27.5% underwent inhospital myocardial revascularization. At the time of discharge, patients with CAD who underwent angiography were significantly more likely to be receiving aspirin (68.9% vs 50.3%, P < .0001), statins (56.6% vs 40.6%, P < .0001), β-blockers (78.6% vs 67.5%, P b .0001), and angiotensin-converting enzyme inhibitors (64.9% vs 51.5%, P b .0001). In patients with AHFS and CAD, the use of inhospital angiography was associated with significantly lower mortality and rehospitalization risk in the first 60 to 90 days post hospital discharge after adjustment for multiple comorbidities and patient factors: mortality (HR 0.31 [95% CI 0.14-0.70], P = .004) and death or rehospitalization (OR 0.65 [95% CI 0.50- 0.86], P = .003). There were no significant differences in any of these outcomes in patients with AHFS and a nonischemic etiology based the performance of inhospital angiography. Conclusions The performance of inhospital angiography on patients with AHFS and CAD is associated with an increased use of aspirin, statins, β-blockers, angiotensin-converting enzyme (ACE) inhibitors and myocardial revascularization. This corresponded with significantly lower rates of death, rehospitalization, and death or rehospitalization at 60 to 90 days post discharge. ? 2009, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Flaherty","given":"James D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rossi","given":"Joseph S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nunez","given":"Eduardo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davidson","given":"Charles J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-22","issue":"6","issued":{"date-parts":[["2009"]]},"page":"1018-1025","publisher":"Mosby, Inc.","title":"Influence of coronary angiography on the utilization of therapies in patients with acute heart failure syndromes: Findings from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"157"},"uris":[""]},{"id":"ITEM-23","itemData":{"DOI":"10.1097/MLR.0b013e3181ca3eb4","ISBN":"9196687061","ISSN":"0025-7079","PMID":"20125043","abstract":"BACKGROUND: Recent efforts to improve care for patients hospitalized with heart failure have focused on process-based performance measures. Data supporting the link between current process measures and patient outcomes are sparse. OBJECTIVE: To examine the relationship between adherence to hospital-level process measures and long-term patient-level mortality and readmission. RESEARCH DESIGN: Analysis of data from a national clinical registry linked to outcome data from the Centers for Medicare and Medicaid Services (CMS). SUBJECTS: A total of 22,750 Medicare fee-for-service beneficiaries enrolled in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure between March 2003 and December 2004. MEASURES: Mortality at 1 year; cardiovascular readmission at 1 year; and adherence to hospital-level process measures, including discharge instructions, assessment of left ventricular function, prescription of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker at discharge, prescription of beta-blockers at discharge, and smoking cessation counseling for eligible patients. RESULTS: Hospital conformity rates ranged from 52% to 86% across the 5 process measures. Unadjusted overall 1-year mortality and cardiovascular readmission rates were 33% and 40%, respectively. In covariate-adjusted analyses, the CMS composite score was not associated with 1-year mortality (hazard ratio, 1.00; 95% confidence interval, 0.98-1.03; P = 0.91) or readmission (hazard ratio, 1.01; 95% confidence interval, 0.99-1.04; P = 0.37). Current CMS process measures were not independently associated with mortality, though prescription of beta-blockers at discharge was independently associated with lower mortality (hazard ratio, 0.94; 95% confidence interval, 0.90-098; P = 0.004). CONCLUSION: Hospital process performance for heart failure as judged by current CMS measures is not associated with patient outcomes within 1 year of discharge, calling into question whether existing CMS metrics can accurately discriminate hospital quality of care for heart failure.","author":[{"dropping-particle":"","family":"Patterson","given":"Mark E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schulman","given":"Kevin A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Medical care","id":"ITEM-23","issue":"3","issued":{"date-parts":[["2010"]]},"page":"210-216","title":"Process of care performance measures and long-term outcomes in patients hospitalized with heart failure.","type":"article-journal","volume":"48"},"uris":[""]},{"id":"ITEM-24","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.109.884395","ISSN":"19413289","PMID":"20009044","abstract":"BACKGROUND: The clinical effectiveness of implantable cardioverter-defibrillators (ICDs) in older patients with heart failure has not been established, and older patients have been underrepresented in previous studies. METHODS AND RESULTS: We identified patients with heart failure who were aged 65 years or older and were eligible for an ICD, had left ventricular ejection fraction of 35% or less, and were discharged alive from hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure and the Get With the Guidelines-Heart Failure quality-improvement programs during the period January 1, 2003, through December 31, 2006. We matched the patients to Medicare claims to examine long-term outcomes. The main outcome measure was all-cause mortality over 3 years. The study population included 4685 patients who were discharged alive and were eligible for an ICD. Mean age was 75.2 years, 60% of the patients were women, mean ejection fraction was 25%, and 376 (8.0%) patients received an ICD before discharge. Mortality was significantly lower among patients who received an ICD compared with those who did not (19.8% versus 27.6% at 1 year, 30.9% versus 41.9% at 2 years, and 38.1% versus 52.3% at 3 years; P<0.001 for all comparisons). The inverse probability-weighted adjusted hazard of mortality at 3 years for patients receiving an ICD was 0.71 (95% CI, 0.56 to 0.91). CONCLUSIONS: Medicare beneficiaries hospitalized with heart failure and left ventricular ejection fraction of 35% or less who were selected for ICD therapy had lower risk-adjusted long-term mortality compared with those who did not receive an ICD. Clinical Trial Registration- . Identifier: NCT00344513.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schulman","given":"Kevin a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-24","issue":"1","issued":{"date-parts":[["2010"]]},"page":"7-13","title":"Clinical effectiveness of implantable cardioverter-defibrillators among Medicare beneficiaries with heart failure","type":"article-journal","volume":"3"},"uris":[""]},{"id":"ITEM-25","itemData":{"DOI":"10.1016/S0735-1097(10)61205-3","ISBN":"1538-3598 (Electronic) 0098-7484 (Linking)","ISSN":"07351097","PMID":"20442387","abstract":"CONTEXT: Readmission after hospitalization for heart failure is common. Early outpatient follow-up after hospitalization has been proposed as a means of reducing readmission rates. However, there are limited data describing patterns of follow-up after heart failure hospitalization and its association with readmission rates. OBJECTIVE: To examine associations between outpatient follow-up within 7 days after discharge from a heart failure hospitalization and readmission within 30 days. DESIGN, SETTING, AND PATIENTS: Observational analysis of patients 65 years or older with heart failure and discharged to home from hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure and the Get With the Guidelines-Heart Failure quality improvement program from January 1, 2003, through December 31, 2006. MAIN OUTCOME MEASURE: All-cause readmission within 30 days after discharge. RESULTS: The study population included 30,136 patients from 225 hospitals. Median length of stay was 4 days (interquartile range, 2-6) and 21.3% of patients were readmitted within 30 days. At the hospital level, the median percentage of patients who had early follow-up after discharge from the index hospitalization was 38.3% (interquartile range, 32.4%-44.5%). Compared with patients whose index admission was in a hospital in the lowest quartile of early follow-up (30-day readmission rate, 23.3%), the rates of 30-day readmission were 20.5% among patients in the second quartile (risk-adjusted hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.78-0.93), 20.5% among patients in the third quartile (risk-adjusted HR, 0.87; 95% CI, 0.78-0.96), and 20.9% among patients in the fourth quartile (risk-adjusted HR, 0.91; 95% CI, 0.83-1.00). CONCLUSIONS: Among patients who are hospitalized for heart failure, substantial variation exists in hospital-level rates of early outpatient follow-up after discharge. Patients who are discharged from hospitals that have higher early follow-up rates have a lower risk of 30-day readmission. TRIAL REGISTRATION: Identifier: NCT00344513.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-25","issue":"17","issued":{"date-parts":[["2010"]]},"page":"1716-1722","title":"Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure.","type":"article-journal","volume":"303"},"uris":[""]},{"id":"ITEM-26","itemData":{"DOI":"10.1016/j.amjcard.2011.05.032","ISBN":"1879-1913 (Electronic)\\n0002-9149 (Linking)","ISSN":"00029149","PMID":"21791327","abstract":"Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF <65 years at 225 hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE) registry or the Get With The Guidelines-Heart Failure (GWTG-HF) registry from January 1, 2003 through December 31, 2006. We linked these clinical data to Medicare claims data for longitudinal follow-up. Using logistic regression models with site-level random effects, we identified predictors of physician follow-up within 7 days of hospital discharge. Overall 11,420 patients (37.9%) had early physician follow-up. Patients residing in hospital referral regions with higher physician concentration were significantly more likely to have early follow-up (odds ratio 1.29, 95% confidence interval 1.12 to 1.48, for highest vs lowest quartile). Patients in rural areas (0.84, 0.78 to 0.91) and patients with lower socioeconomic status (0.79, 0.74 to 0.85) were less likely to have early follow-up. Women (0.87, 0.83 to 0.91) and black patients (0.84, 0.77 to 0.92) were less likely to receive early follow-up. Patients with greater co-morbidity were less likely to receive early follow-up. In conclusion, physician follow-up within 7 days after discharge from a HF hospitalization varied according to regional physician density, rural location, socioeconomic status, gender, race, and co-morbid conditions. Strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-26","issue":"7","issued":{"date-parts":[["2011"]]},"page":"985-991","publisher":"Elsevier Inc.","title":"Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure","type":"article-journal","volume":"108"},"uris":[""]},{"id":"ITEM-27","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.111.962290","ISBN":"1941-3297 (Electronic)\\n1941-3289 (Linking)","ISSN":"19413289","PMID":"21743005","abstract":"BACKGROUND: B-type natriuretic peptide (BNP) has been associated with short- and long-term postdischarge prognosis among hospitalized patients with heart failure. It is unknown if admission, discharge, or change from admission to discharge BNP measure is the most important predictor of long-term outcomes. METHODS AND RESULTS: We linked patients ≥65 years of age from hospitals in Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) to Medicare claims. Among patients with recorded admission and discharge BNP, we compared Cox models predicting 1-year mortality and/or rehospitalization, including clinical variables and clinical variables plus BNP. We calculated the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) for the best-fit model for each outcome versus the model with clinical variables alone. Among 7039 patients in 220 hospitals, median (25th, 75th) admission and discharge BNP were 832 pg/mL (451, 1660) and 534 pg/mL (281, 1111). Observed 1-year mortality and 1-year mortality or rehospitalization rates were 35.2% and 79.4%. The discharge BNP model had the best performance and was the most important characteristic for predicting 1-year mortality (hazard ratio for log transformation, 1.34; 95% confidence interval, 1.28 to 1.40) and 1-year death or rehospitalization (hazard ratio, 1.15; 95% confidence interval, 1.12 to 1.18). Compared with a clinical variables only model, the discharge BNP model improved risk reclassification and discrimination in predicting each outcome (1-year mortality: NRI, 5.5%, P<0.0001; IDI, 0.023, P<0.0001; 1-year mortality or rehospitalization: NRI, 4.2%, P<0.0001; IDI, 0.010, P<0.0001). CONCLUSIONS: Discharge BNP best predicts 1-year mortality and/or rehospitalization among older patients hospitalized with heart failure. Discharge BNP plus clinical variables modestly improves risk classification and model discrimination for long-term outcomes.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horton","given":"John R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reyes","given":"Eric M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaw","given":"Linda K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felker","given":"G. Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-27","issue":"5","issued":{"date-parts":[["2011"]]},"page":"628-636","title":"Admission, discharge, or change in B-type natriuretic peptide and long-term outcomes: Data from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) linked to Medicare claims","type":"article-journal","volume":"4"},"uris":[""]},{"id":"ITEM-28","itemData":{"DOI":"10.1093/eurjhf/hfs009","ISBN":"1879-0844","ISSN":"13889842","PMID":"22302663","abstract":"AIMS: Chronic obstructive pulmonary disease (COPD) is common in heart failure (HF) patients, yet the population is poorly characterized and associated with conflicting outcomes data. We aimed to evaluate the clinical characteristics and outcomes of HF patients with systolic dysfunction and COPD in a large acute HF registry.\\n\\nMETHODS AND RESULTS: OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) was a performance-improvement registry of patients hospitalized with HF (n =48 612), which included a pre-specified subgroup of patients (n =5,701) with 60- to 90-day follow-up. We performed a retrospective analysis of the clinical characteristics and outcomes (length of stay, and in-hospital and 60-day mortality) of patients with systolic dysfunction according to baseline COPD status. COPD was present in 25% of the patients. These patients had more co-morbidities compared with patients without COPD. They were less likely to receive a beta-blocker or angiotensin-converting enzyme inhibitor during hospitalization and at discharge (P < 0.001). COPD was associated with an increased median length of stay [5 days (interquartile range 3-8) vs. 4 days (interquartile range 3-7), P < 0.0001] and increased in-hospital all-cause and non-cardiovascular (CV) mortality, with rates of 4.5% vs. 3.7% (P =0.01) and 1.0% vs. 0.6% (P =0.01), respectively, for the two endpoints, but similar 60-day mortality (6.2% vs. 6.0%, P =0.28). After risk adjustment, the in-hospital non-CV mortality remained increased (odds ratio 1.65, 95% confidence interval 1.12-2.41; P =0.01).\\n\\nCONCLUSION: The presence of COPD in HF patients with systolic dysfunction is associated with an increased burden of co-morbidities, lower use of evidence-based HF medications, longer hospitalizations, and increased in-hospital non-CV mortality, but similar post-discharge mortality.","author":[{"dropping-particle":"","family":"Mentz","given":"Robert J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fiuzat","given":"Mona","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wojdyla","given":"Daniel M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chiswell","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oconnor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-28","issue":"4","issued":{"date-parts":[["2012"]]},"page":"395-403","title":"Clinical characteristics and outcomes of hospitalized heart failure patients with systolic dysfunction and chronic obstructive pulmonary disease: Findings from OPTIMIZE-HF","type":"article-journal","volume":"14"},"uris":[""]},{"id":"ITEM-29","itemData":{"DOI":"10.1016/j.jchf.2012.08.001","ISBN":"1879-0844 (Electronic) 1388-9842 (Linking)","ISSN":"22131779","PMID":"23814702","abstract":"Objectives: The purpose of this study was to examine the clinical effectiveness of aldosterone antagonists in older patients with heart failure and preserved ejection fraction (HF-PEF). Background: Aldosterone antagonists improve outcomes in HF and reduced EF. However, their role in HF-PEF remains unclear. Methods: Of the 10,570 hospitalized older (≥65 years of age) HF-PEF (EF ≥40%) patients in the Medicare-linked OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) trial, 8,013 patients had no prior aldosterone antagonist use and no current contraindications; 492 (6% of these 8,013) patients received new prescriptions for aldosterone antagonists. We assembled a matched cohort of 487 pairs of patients receiving and not receiving aldosterone antagonists, who had a similar propensity to receive these drugs and were balanced on 116 baseline characteristics. Results: Patients had a mean age of 80 years old, a mean EF of 54%, 59% were women, and 8% were African American. During 2.4 year of mean follow-up (through December 2008), the primary composite endpoint of all-cause mortality or HF hospitalization occurred in 392 (81%) and 393 (81%) patients receiving and not receiving aldosterone antagonists, respectively (hazard ratio [HR]: 0.97; 95% confidence interval [CI]: 0.84 to 1.11; p = 0.628). Aldosterone antagonists had no association with all-cause mortality (HR: 1.03; 95% CI: 0.89 to 1.20; p = 0.693) or HF hospitalization (HR: 0.88; 95% CI: 0.73 to 1.07; p = 0.188). Among 8013 prematched patients, multivariable-adjusted HR for the primary composite endpoint associated with aldosterone antagonist use was 0.93 (95% CI: 0.83 to 1.03; p = 0.144). Conclusions: In older HF-PEF patients, aldosterone antagonists had no association with clinical outcomes. Findings from the ongoing randomized controlled TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial will provide further insights into their effect in HF-PEF. ? 2013 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Patel","given":"Kanan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kitzman","given":"Dalane W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aban","given":"Inmaculada B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Love","given":"Thomas E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Allman","given":"Richard M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahmed","given":"Ali","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JACC: Heart Failure","id":"ITEM-29","issue":"1","issued":{"date-parts":[["2013"]]},"page":"40-47","title":"Aldosterone antagonists and outcomes in real-world older patients with heart failure and preserved ejection fraction","type":"article-journal","volume":"1"},"uris":[""]},{"id":"ITEM-30","itemData":{"DOI":"10.1016/j.amjcard.2012.10.041","ISBN":"9196817755","ISSN":"1879-1913","PMID":"23200803","abstract":"In patients with heart failure (HF) with chronic obstructive pulmonary disease (COPD), concerns exist regarding β blockers, particularly noncardioselective β blockers, precipitating bronchospasm or attenuating the benefit of inhaled β(2) agonists. The aim of this study was to test the hypothesis that noncardioselective β blockers would not be associated with worse outcomes compared with cardioselective β blockers in patients with concomitant COPD in a large HF registry. A retrospective analysis of patients from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) who had systolic dysfunction, documentation of β-blocker status, and follow-up information available after index hospitalization (n?= 2,670) was performed. The associations between cardioselective and noncardioselective β blockers and the end points of 60- to 90-day mortality and mortality or rehospitalization in patients with (n?= 722) and without (n?=?1,948) COPD were analyzed using regression modeling. The models were adjusted for covariate predictors of β-blocker use at discharge and clinical predictors of outcomes. Noncardioselective and cardioselective β blockers were associated with lower risk-adjusted mortality in patients with and without COPD. There was no evidence that β-blocker selectivity was associated with a difference in outcomes between patients with and those without COPD (p for interaction >0.10 for both outcomes). In conclusion, despite concerns regarding β blockers in patients with HF with COPD, there was no evidence that β-blocker selectivity was associated with differences in outcomes for patients with HF with COPD versus those without.","author":[{"dropping-particle":"","family":"Mentz","given":"Robert J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wojdyla","given":"Daniel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fiuzat","given":"Mona","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chiswell","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-30","issue":"4","issued":{"date-parts":[["2013"]]},"page":"582-7","publisher":"Elsevier Inc.","title":"Association of beta-blocker use and selectivity with outcomes in patients with heart failure and chronic obstructive pulmonary disease (from OPTIMIZE-HF).","type":"article-journal","volume":"111"},"uris":[""]},{"id":"ITEM-31","itemData":{"DOI":"10.1016/j.amjmed.2013.01.004","ISBN":"0002-9343","ISSN":"1555-7162","PMID":"23510948","abstract":"BACKGROUND: The role of angiotensin-converting enzyme (ACE) inhibitors in patients with heart failure and preserved ejection fraction remains unclear.\\n\\nMETHODS: Of the 10,570 patients aged ≥65 years with heart failure and preserved ejection fraction (≥40%) in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (2003-2004) linked to Medicare (through December 2008), 7304 were not receiving angiotensin receptor blockers and had no contraindications to ACE inhibitors. After excluding 3115 patients with pre-admission ACE inhibitor use, the remaining 4189 were eligible for new discharge prescriptions for ACE inhibitors, and 1706 received them. Propensity scores for the receipt of ACE inhibitors, calculated for each of the 4189 patients, were used to assemble a cohort of 1337 pairs of patients, balanced on 114 baseline characteristics.\\n\\nRESULTS: Matched patients had a mean age of 81 years and mean ejection fraction of 55%, 64% were women, and 9% were African American. Initiation of ACE inhibitor therapy was associated with a lower risk of the primary composite end point of all-cause mortality or heart failure hospitalization during 2.4 years of median follow-up (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.84-0.99; P = .028), but not with individual end points of all-cause mortality (HR, 0.96; 95% CI, 0.88-1.05; P = .373) or heart failure hospitalization (HR, 0.93; 95% CI, 0.83-1.05; P = .257).\\n\\nCONCLUSION: In hospitalized older patients with heart failure and preserved ejection fraction not receiving angiotensin receptor blockers, discharge initiation of ACE inhibitor therapy was associated with a modest improvement in the composite end point of total mortality or heart failure hospitalization but had no association with individual end point components.","author":[{"dropping-particle":"","family":"Mujib","given":"Marjan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Patel","given":"Kanan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kitzman","given":"Dalane W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhang","given":"Yan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aban","given":"Inmaculada B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ekundayo","given":"O James","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Love","given":"Thomas E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kilgore","given":"Meredith L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Allman","given":"Richard M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahmed","given":"Ali","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of medicine","id":"ITEM-31","issue":"5","issued":{"date-parts":[["2013"]]},"page":"401-10","title":"Angiotensin-converting enzyme inhibitors and outcomes in heart failure and preserved ejection fraction.","type":"article-journal","volume":"126"},"uris":[""]},{"id":"ITEM-32","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.114.001301","ISSN":"1941-3289","author":[{"dropping-particle":"","family":"Patel","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"G. C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahmed","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Morgan","given":"C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kilgore","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Love","given":"T. E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Deedwania","given":"P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aronow","given":"W. S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anker","given":"S. D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahmed","given":"a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-32","issue":"6","issued":{"date-parts":[["2014"]]},"page":"945-952","title":"Calcium Channel Blockers and Outcomes in Older Patients With Heart Failure and Preserved Ejection Fraction","type":"article-journal","volume":"7"},"uris":[""]}],"mendeley":{"formattedCitation":"^{93,94,195–204,96,205–214,188,215,216,189–194}","plainTextFormattedCitation":"93,94,195–204,96,205–214,188,215,216,189–194","previouslyFormattedCitation":"^{91,92,94,186–214}"},"properties":{"noteIndex":0},"schema":""}93,94,195–204,96,205–214,188,215,216,189–194RO-AHFS: Romanian Acute Heart Failure Syndromes Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.03.033","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"21742101","abstract":"Aims: The objective of the RO-AHFS registry was to evaluate the epidemiology, clinical presentation, inpatient management, and hospital course in a population hospitalized for acute heart failure syndromes. Methods: During a 12-month period, 13 Romanian medical centers enrolled all consecutive patients hospitalized with a primary diagnosis of AHFS. Patients were classified into the following 5 clinical profiles at admission: acute decompensated heart failure, cardiogenic shock, pulmonary edema, right heart failure, and hypertensive heart failure. Statistical significance was assessed using Fisher exact test or the χ2 test for categorical variables and a 1-way analysis of variance for continuous variables. Independent predictors of in-hospital all-cause mortality (ACM) were identified using a multivariate logistic regression model. Results: A total of 3,224 consecutive patients hospitalized with AHFS were enrolled. The cohort had a mean age of 69.2 ± 11.8 years and 56% were men. The mean left ventricular ejection fraction was 37.7% ± 12.5%. The percentage of patients treated with evidence-based heart failure therapies increased from admission to discharge, but even at discharge, only 56%, 66%, and 54% of patients were on a β-blocker, an angiotensin-converting enzyme inhibitors or an angiotensin receptor blocker, and a mineralocorticoid receptor antagonist, respectively. In-hospital ACM was 7.7% with substantial variation between sites (4.1%-11.0%). Increasing age, inotrope therapy, the presence of life-threatening ventricular arrhythmias, and elevated baseline blood urea nitrogen were all found to be independent risk factors for in-hospital ACM, whereas elevated systolic blood pressure and baseline treatment with a β-blocker had a protective effect. Conclusions: The RO-AHFS study found substantial variation both among sites and between Romania and other European countries. National and regional registries have important clinical implications for patient care and the design and conduct of global clinical trials. ? 2011 Mosby, Inc.","author":[{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vinereanu","given":"Dragos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Datcu","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ionescu","given":"Dan Dominic","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Capalneanu","given":"Radu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brukner","given":"Ioan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dorobantu","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ambrosy","given":"Andrew","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"MacArie","given":"Cezar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2011"]]},"page":"142-153.e1","publisher":"Mosby, Inc.","title":"The Romanian Acute Heart Failure Syndromes (RO-AHFS) registry","type":"article-journal","volume":"162"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1177/2048872612474906","ISBN":"2048-8734 (Electronic)\r2048-8726 (Linking)","ISSN":"2048-8734","PMID":"24222818","abstract":"BACKGROUND: Transaminases are commonly elevated in both the inpatient and ambulatory settings in heart failure (HF).\\n\\nAIMS: To determine the prevalence and degree of elevated transaminase levels at admission and to evaluate the association between transaminase levels and in-hospital morbidity and mortality.\\n\\nMETHODS: Over a 12-month period, the Romanian Acute Heart Failure Syndromes (RO-AHFS) registry enrolled consecutive patients hospitalized for HF at 13 medical centres. A post-hoc analysis of the 489 patients (15.2%) with alanine transaminase (ALT) and aspartate transaminase (AST) (upper limits of normal 31 IU/l and 32 IU/l, respectively) measured at baseline was performed. In-hospital mortality was compared across quartiles using multivariable Cox regression models.\\n\\nRESULTS: The prevalences of elevated ALT and AST were 28% and 24% and the medians (interquartile range) were 22 (16-47) and 23 (16-37 IU/L). Patients with elevated transaminases more commonly had right HF, cardiogenic shock, or an ejection fraction <45%. Patients with an ALT in the highest quartile were more likely to present with hypotension and a low pulse pressure, to have electrocardiographic evidence of left ventricular dyssynchrony and echocardiographic findings including increased left ventricular dimensions, reduced left ventricular ejection fraction, and valvular heart disease, to require inotropic or vasopressor support during hospitalization, and to report lower β-blocker and angiotensin-converting enzyme inhibitor utilization. After adjusting for potential confounders, ALT was directly associated with BUN increases ≥10 mg/dl, necessity for intensive care unit admission, and longer length of stay. Patients in the highest quartile of ALT experienced significantly higher rates of all-cause mortality.\\n\\nCONCLUSIONS: In patients hospitalized for HF, there is a graded relationship between admission transaminase levels and surrogates for in-hospital morbidity, while more pronounced elevations of ALT predict in-hospital mortality independent of known prognostic indicators.","author":[{"dropping-particle":"","family":"Ambrosy","given":"Andrew P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bubenek","given":"Serban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vinereanu","given":"Dragos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaduganathan","given":"Muthiah","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Macarie","given":"Cezar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European heart journal. Acute cardiovascular care","id":"ITEM-2","issue":"2","issued":{"date-parts":[["2013"]]},"page":"99-108","title":"The predictive value of transaminases at admission in patients hospitalized for heart failure: findings from the RO-AHFS registry.","type":"article-journal","volume":"2"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.2459/JCM.0000000000000192","ISBN":"0000000000000","ISSN":"1558-2027","PMID":"25252041","author":[{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ambrosy","given":"Andrew P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bubenek","given":"Serban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filipescu","given":"Daniela","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vinereanu","given":"Dragos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Petris","given":"Antoniu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Christodorescu","given":"Ruxandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Macarie","given":"Cezar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Collins","given":"Sean P.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Medicine","id":"ITEM-3","issued":{"date-parts":[["2014"]]},"page":"1","title":"Epidemiology, pathophysiology, and in-hospital management of pulmonary edema","type":"article-journal"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.2459/JCM.0000000000000030","ISBN":"0000000000000","ISSN":"1558-2027","author":[{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ambrosy","given":"Andrew P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filipescu","given":"Daniela","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bubenek","given":"Serban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vinereanu","given":"Dragos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Petris","given":"Antoniu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Collins","given":"Sean P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Macarie","given":"Cezar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Medicine","id":"ITEM-4","issue":"5","issued":{"date-parts":[["2015"]]},"page":"331-340","title":"Patterns of intensive care unit admissions in patients hospitalized for heart failure","type":"article-journal","volume":"16"},"uris":[""]}],"mendeley":{"formattedCitation":"^217–220","plainTextFormattedCitation":"217–220","previouslyFormattedCitation":"^215–218"},"properties":{"noteIndex":0},"schema":""}217–220S-HFR: Swedish Heart Failure Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfp175","ISSN":"13889842","PMID":"20023041","abstract":"Guidelines on how to diagnose and treat patients with heart failure (HF) are published regularly. However, many patients do not fulfil the diagnostic criteria and are not treated with recommended drugs. The Swedish Heart Failure Registry (S-HFR) is an instrument which may help to optimize the handling of HF patients.","author":[{"dropping-particle":"","family":"Jonsson","given":"Asa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alehagen","given":"Urban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2010"]]},"page":"25-31","title":"Heart failure registry: a valuable tool for improving the management of patients with heart failure.","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1001/jama.2010.1949","ISSN":"0098-7484","PMID":"21224459","abstract":"Angiotensin II receptor blockers (ARBs) reduce combined mortality and hospitalization in patients with heart failure (HF) with reduced left ventricular ejection fraction. Different agents have different affinity for the AT(1) receptor and may have different clinical effects, but have not been tested against each other in HF.","author":[{"dropping-particle":"","family":"Eklind-Cervenka","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rosenqvist","given":"M?rten","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-2","issue":"2","issued":{"date-parts":[["2011"]]},"page":"175-182","title":"Association of candesartan vs losartan with all-cause mortality in patients with heart failure.","type":"article-journal","volume":"305"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1001/jama.2012.14785","ISSN":"1538-3598","PMID":"23188027","abstract":"CONTEXT: Heart failure with preserved ejection fraction (HFPEF) may be as common and as lethal as heart failure with reduced ejection fraction (HFREF). Three randomized trials of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ie, renin-angiotensin system [RAS] antagonists) did not reach primary end points but may have had selection bias or been underpowered.\\n\\nOBJECTIVE: To test the hypothesis that use of RAS antagonists is associated with reduced all-cause mortality in an unselected population with HFPEF.\\n\\nDESIGN, SETTING, AND PATIENTS: Prospective study using the Swedish Heart Failure Registry of 41,791 unique patients registered from 64 hospitals and 84 outpatient clinics between 2000 and 2011. Of these, 16,216 patients with HFPEF (ejection fraction ≥40%; mean [SD] age, 75 [11] years; 46% women) were either treated (n = 12,543) or not treated (n = 3673) with RAS antagonists. Propensity scores for RAS antagonist use were derived from 43 variables. The association between use of RAS antagonists and all-cause mortality was assessed in a cohort matched 1:1 based on age and propensity score and in the overall cohort with adjustment for propensity score as a continuous covariate. To assess consistency, separate age and propensity score-matched analyses were performed according to RAS antagonist dose in patients with HFPEF and in 20,111 patients with HFREF (ejection fraction <40%) in the same registry.\\n\\nMAIN OUTCOME MEASURE: All-cause mortality.\\n\\nRESULTS: In the matched HFPEF cohort, 1-year survival was 77% (95% CI, 75%-78%) for treated patients vs 72% (95% CI, 70%-73%) for untreated patients, with a hazard ratio (HR) of 0.91 (95% CI, 0.85-0.98; P = .008). In the overall HFPEF cohort, crude 1-year survival was 86% (95% CI, 86%-87%) for treated patients vs 69% (95% CI, 68%-71%) for untreated patients, with a propensity score-adjusted HR of 0.90 (95% CI, 0.85-0.96; P = .001). In the HFPEF dose analysis, the HR was 0.85 (95% CI, 0.78-0.83) for 50% or greater of target dose vs no treatment (P < .001) and 0.94 (95% CI, 0.87-1.02) for less than 50% of target dose vs no treatment (P = .14). In the age and propensity score-matched HFREF analysis, the HR was 0.80 (95% CI, 0.74-0.86; P < .001).\\n\\nCONCLUSION: Among patients with heart failure and preserved ejection fraction, the use of RAS antagonists was associated with lower all-cause mortality.","author":[{"dropping-particle":"","family":"Lund","given":"Lars H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-3","issue":"20","issued":{"date-parts":[["2012"]]},"page":"2108-17","title":"Association between use of renin-angiotensin system antagonists and mortality in patients with heart failure and preserved ejection fraction.","type":"article-journal","volume":"308"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.ijcard.2012.06.095","ISSN":"01675273","PMID":"22805544","abstract":"Objectives: Epidemiological studies of elderly heart failure (HF) patients (≥ 85 years) are limited with inconsistent findings. Our objective is to confirm and extend epidemiological study in elderly (≥ 85 years) patients using the Swedish Heart Failure Registry database. Methods: This retrospective study included 8,347 HF patients aged ≤ 65 years and 15,889 HF patients aged ≥ 85 years. Elderly population was further divided into two subgroups: 11,412 patients were 85-90 years and 4,477 patients were > 90 years. Results: The ≥ 85 year group was characterized by more women, higher systolic blood pressure (SBP), lower body-mass index (BMI), more than twice as many HF with normal left ventricular ejection fraction (HFNEF), higher incidence of cardiovascular and non-cardiovascular comorbidities and less use of proven therapeutics compared with the ≤ 65 year group. Compared with the 85-90 year subgroup, the > 90 year subgroup had a decline in cardiovascular and non-cardiovascular comorbidities except renal insufficiency and anaemia which continued to increase with ageing (p < 0.01). Tendency was the same regardless of gender but slightly different between systolic HF (SHF) and HFNEF. In the group with HFNEF, there were more women, higher SBP, lower N-terminal pro-B-type natriuretic peptide levels, less ischaemic heart disease, more hypertension and left bundle branch block regardless of age. Atrial fibrillation was more frequent in patients with HFNEF than with SHF in the elderly group (p < 0.01). Patients with HFNEF in the > 90 year subgroup had increasing incidence of ischaemic heart disease compared to 85-90 year group (p < 0.01). Conclusions: HF patients ≥ 85 years had increased cardiovascular and non-cardiovascular comorbidities but with a decline from > 90 years. ? 2012 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Holmstr?m","given":"Alexandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sigurjonsdottir","given":"Runa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jonsson","given":"?sa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fu","given":"Michael L X","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-4","issue":"6","issued":{"date-parts":[["2013"]]},"page":"2747-2752","publisher":"Elsevier B.V.","title":"Increased comorbidities in heart failure patients ≥ 85 years but declined from > 90 years: Data from the Swedish Heart Failure Registry","type":"article-journal","volume":"167"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.112.000115","ISSN":"19413289","PMID":"23386667","abstract":"BACKGROUND: In 3 randomized controlled trials in heart failure (HF), mineralocorticoid receptor antagonists reduced mortality. The net benefit from randomized controlled trials may not be generalizable, and eplerenone was, but spironolactone was not, studied in mild HF. We tested the hypothesis that spironolactone is associated with reduced mortality also in a broad unselected contemporary population with HF and reduced ejection fraction, in particular New York Heart Association (NYHA) I-II. METHODS AND RESULTS: We prospectively studied 18 852 patients (age 71±12 years; 28% women) with NYHA I-IV and ejection fraction <40% who were registered in the Swedish Heart Failure Registry between 2000 and 2012 and who were (n=6551) or were not (n=12 301) treated with spironolactone. We derived propensity scores for spironolactone treatment based on 41 covariates. We assessed survival by Cox regression with adjustment for propensity scores and with matching based on propensity score. We performed sensitivity and residual confounding analyses and analyzed the NYHA I-II and III-IV subgroups separately. One-year survival was 83% versus 84% in treated versus untreated patients (log rank P<0.001). After adjustment for propensity scores, the hazard ratio for spironolactone was 1.05 (95% confidence interval, 1.00-1.11; P=0.054). Spironolactone interacted with NYHA (P<0.001). In the NYHA I-II subgroup, after adjustment for propensity scores, the hazard ratio for spironolactone was 1.11 (95% confidence interval, 1.02-1.21; P=0.019). CONCLUSIONS: In an unselected contemporary population of HF with reduced ejection fraction, spironolactone was not associated with reduced mortality. The net benefits of spironolactone may be lower outside the clinical trial setting and in milder HF.","author":[{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Svennblad","given":"Bodil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Melhus","given":"H?kan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hallberg","given":"P?r","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-5","issue":"2","issued":{"date-parts":[["2013"]]},"page":"174-183","title":"Association of spironolactone use with all-cause mortality in heart failure a propensity scored cohort study","type":"article-journal","volume":"6"},"uris":[""]},{"id":"ITEM-6","itemData":{"DOI":"10.1093/eurheartj/ehs305","ISBN":"0195-668x","ISSN":"0195668X","PMID":"23041499","abstract":"AIMS: The independent clinical correlates and prognostic impact of QRS prolongation in heart failure (HF) with reduced and preserved ejection fraction (EF) are poorly understood. The rationale for cardiac resynchronization therapy (CRT) in preserved EF is unknown. The aim was to determine the prevalence of, correlates with, and prognostic impact of QRS prolongation in HF with reduced and preserved EF.\\n\\nMETHODS AND RESULTS: We studied 25,171 patients (age 74.6 ± 12.0 years, 39.9% women) in the Swedish Heart Failure Registry. We assessed QRS width and 40 other clinically relevant variables. Correlates with QRS width were assessed with multivariable logistic regression, and the association between QRS width and all-cause mortality with multivariable Cox regression. Pre-specified subgroup analyses by EF were performed. Thirty-one per cent had QRS ≥120 ms. Strong predictors of QRS ≥120 ms were higher age, male gender, dilated cardiomyopathy, longer duration of HF, and lower EF. One-year survival was 77% in QRS ≥120 vs. 82% in QRS <120 ms, and 5-year survival was 42 vs. 51%, respectively (P < 0.001). The adjusted hazard ratio for all-cause mortality was 1.11 (95% confidence interval 1.04-1.18, P = 0.001) for QRS ≥120 vs. <120 ms. There was no interaction between QRS width and EF.\\n\\nCONCLUSION: QRS prolongation is associated with other markers of severity in HF but is also an independent risk factor for all-cause mortality. The risk associated with QRS prolongation may be similar regardless of EF. This provides a rationale for trials of CRT in HF with preserved EF.","author":[{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jurga","given":"Juliane","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linde","given":"Cecilia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alehagen","given":"Urban","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-6","issue":"7","issued":{"date-parts":[["2013"]]},"page":"529-539","title":"Prevalence, correlates, and prognostic significance of QRS prolongation in heart failure with reduced and preserved ejection fraction","type":"article-journal","volume":"34"},"uris":[""]},{"id":"ITEM-7","itemData":{"DOI":"10.1016/j.ijcard.2014.04.243","ISSN":"18741754","PMID":"24820737","abstract":"Background/objectives Levosimendan is used in acute heart failure (HF) and increasingly as planned repetitive infusions in stable chronic HF, but the extent of this practice is unknown. The aim was to assess the use of levosimendan vs. conventional inotropes and the use as planned repetitive vs. acute treatment, in Sweden. Methods We performed a descriptive study with individual patient validation assessing the use of levosimendan and conventional intravenous inotropes, indications for levosimendan, clinical characteristics and survival in the Swedish Heart Failure Registry between 2000 and 2011. For repetitive levosimendan, we assessed potential indications for alternative interventions. Results Of 53,548 total registrations, there were 655 confirmed with inotrope use (597 levosimendan, 37 conventional, 21 both) from 22 hospitals responding to validation, and 6069 in-patient controls with New York Heart Association III-IV and ejection fraction < 40%. The indications for levosimendan were acute HF in 384 registrations (306 patients), and planned repetitive in 234 registrations (87 patients). Planned repetitive as a proportion of total levosimendan registrations ranged 0-65% and of total levosimendan patients ranged 0-54% in different hospitals. Of planned repetitive patients without existing cardiac resynchronization therapy, implantable cardioverter defibrillator, transplant and/or assist device, 46-98% were potential candidates for such interventions. Conclusion In HF in cardiology and internal medicine in Sweden, levosimendan was the overwhelming inotrope of choice, and the use of planned repetitive levosimendan was extensive, highly variable between hospitals and may have pre-empted other interventions. Potential effects of and indications for planned repetitive levosimendan need to be evaluated in prospective studies. ? 2014 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Thorvaldsen","given":"Tonje","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagerman","given":"Inger","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-7","issue":"1","issued":{"date-parts":[["2014"]]},"page":"55-61","publisher":"Elsevier Ireland Ltd","title":"Planned repetitive use of levosimendan for heart failure in cardiology and internal medicine in Sweden","type":"article-journal","volume":"175"},"uris":[""]},{"id":"ITEM-8","itemData":{"DOI":"10.1002/ejhf.44","ISBN":"1879-0844 (Electronic) 1388-9842 (Linking)","PMID":"24464683","abstract":"AIMS: To analyse the long-term outcome, risk factor panorama, and treatment pattern in patients with heart failure (HF) with and without type 2 diabetes (T2DM) from a daily healthcare perspective. METHODS AND RESULTS: Patients with (n=8809) and without (n=27,465) T2DM included in the Swedish Heart Failure Registry (S-HFR) 2003-2011 due to a physician-based HF diagnosis were prospectively followed for long-term mortality (median follow-up time: 1.9 years, range 0-8.7 years). Left ventricular function expressed as EF did not differ between patients with and without T2DM. Survival was significantly shorter in patients with T2DM, who had a median survival time of 3.5 years compared with 4.6 years (P<0.0001). In subjects with T2DM. unadjusted and adjusted odds ratios (ORs) for mortality were 1.37 [95% confidence interval (CI) 1.30-1.44) and 1.60 (95% CI 1.50-1.71), and T2DM predicted mortality in all age groups. Ischaemic heart disease was an important predictor for mortality (OR 1.68, 95% CI 1.47-1.94), more abundant in patients with T2DM (59% vs. 45%) among whom only 35% had been subjected to coronary angiography and 32% to revascularization. Evidence-based pharmacological HF treatment was somewhat more extensive in patients with T2DM. CONCLUSION: The combination of T2DM and HF seriously compromises long-term prognosis. Ischaemic heart disease was identified as one major contributor; however, underutilization of available diagnostic and therapeutic facilities for ischaemic heart disease was obvious and may be an important area for future improvement in patients with T2DM and HF.","author":[{"dropping-particle":"","family":"Johansson","given":"Isabelle","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstrom","given":"U","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nasman","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryden","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Norhammar","given":"Anna","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Eur J Heart Fail","id":"ITEM-8","issue":"4","issued":{"date-parts":[["2014"]]},"page":"409-418","title":"Is the prognosis in patients with diabetes and heart failure a matter of unsatisfactory management? An observational study from the Swedish Heart Failure Registry","type":"article-journal","volume":"16"},"uris":[""]},{"id":"ITEM-9","itemData":{"DOI":"10.1093/europace/euu205","ISSN":"1532-2092","PMID":"25164429","abstract":"AIMS: It has been suggested that cardiac resynchronization therapy (CRT) is less utilized, dyssynchrony occurs at narrower QRS, and CRT is more beneficial in women compared with men. We tested the hypotheses that (i) CRT is more underutilized and (ii) QRS prolongation and left bundle branch block (LBBB) are more harmful in women. METHODS AND RESULTS: We studied 14 713 patients (28% women) with left ventricular ejection fraction (LVEF) <40% in the Swedish Heart Failure Registry. In women vs. men, CRT was present in 4 vs. 7% (P < 0.001) and was absent but with indication in 30 vs. 31% (P = 0.826). Next, among 13 782 patients (28% women) without CRT, 9% of women and 17% of men had non-specific intraventricular conduction delay (IVCD) and 27% of women and 24% of men had LBBB. One-year survival with narrow QRS was 85% in women and 88% in men, with IVCD 74 and 78%, and with LBBB 84 and 82%, respectively. Compared with narrow QRS, IVCD had a multivariable hazard ratio of 1.24 (95% CI 1.05-1.46, P = 0.011) in women and 1.30 (95% CI 1.19-1.42, P < 0.001) in men, and LBBB 1.03 (95% CI 0.91-1.16, P = 0.651) in women and 1.16 (95% CI 1.07-1.26, P < 0.001) in men, P for interaction between gender and QRS morphology, 0.241. CONCLUSIONS: While the proportion with CRT was lower in women, CRT was equally underutilized in both genders. QRS prolongation with or without LBBB was not more harmful in women than in men. Efforts to improve CRT implementation should be directed equally towards women and men.","author":[{"dropping-particle":"","family":"Linde","given":"Cecilia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"St?hlberg","given":"Marcus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Braunschweig","given":"Frieder","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alehagen","given":"Urban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","id":"ITEM-9","issue":"3","issued":{"date-parts":[["2014"]]},"page":"424-431","title":"Gender, underutilization of cardiac resynchronization therapy, and prognostic impact of QRS prolongation and left bundle branch block in heart failure.","type":"article-journal","volume":"17"},"uris":[""]},{"id":"ITEM-10","itemData":{"DOI":"10.1016/j.jacc.2013.10.017","ISSN":"07351097","PMID":"24161453","abstract":"Objectives The purpose of this study was to evaluate simple criteria for referral of patients from the general practitioner to a heart failure (HF) center. Background In advanced HF, the criteria for heart transplantation, left ventricular assist device, and palliative care are well known among HF specialists, but criteria for referral to an advanced HF center have not been developed for generalists. Methods We assessed observed and expected all-cause mortality in 10,062 patients with New York Heart Association (NYHA) functional class III to IV HF and ejection fraction <40% registered in the Swedish Heart Failure Registry between 2000 and 2013. Next, 5 pre-specified universally available risk factors were assessed as potential triggers for referral, using multivariable Cox regression: systolic blood pressure ≤90 mm Hg; creatinine ≥160 μmol/l; hemoglobin ≤120 g/l; no renin-angiotensin system antagonist; and no beta-blocker. Results In NYHA functional class III to IV and age groups ≤65 years, 66 to 80 years, and >80 years, there were 2,247, 4,632, and 3,183 patients, with 1-year observed versus expected survivals of 90% versus 99%, 79% versus 97%, and 61% versus 89%, respectively. In the age ≤80 years group, the presence of 1, 2, or 3 to 5 of these risk factors conferred an independent hazard ratio for all-cause mortality of 1.40, 2.30, and 4.07, and a 1-year survival of 79%, 60%, and 39%, respectively (p < 0.001). Conclusions In patients ≤80 years of age with NYHA functional class III to IV HF and ejection fraction <40%, mortality is predominantly related to HF or its comorbidities. Potential heart transplantation/left ventricular assist device candidacy is suggested by ≥1 risk factor and potential palliative care by multiple universally available risk factors. These patients may benefit from referral to an advanced HF center.","author":[{"dropping-particle":"","family":"Thorvaldsen","given":"Tonje","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"St?hlberg","given":"Marcus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-10","issue":"7","issued":{"date-parts":[["2014"]]},"page":"661-671","title":"Triage of patients with moderate to severe heart failure: Who should be referred to a heart failure center?","type":"article-journal","volume":"63"},"uris":[""]},{"id":"ITEM-11","itemData":{"DOI":"10.1002/ejhf.162","ISSN":"1879-0844","PMID":"25201219","abstract":"AIMS: Age is not a contraindication to cardiac resynchronization therapy (CRT), but the prevalence and prognostic impact of QRS prolongation with intraventricular conduction delay (IVCD) and left bundle branch block (LBBB), as well as CRT utilization, may differ with age. We tested the hypotheses that in the elderly: (i) IVCD and LBBB are more prevalent, (ii) IVCD and LBBB are more harmful, and (iii) CRT is underutilized. METHODS AND RESULTS: We studied 14 713 patients with ejection fraction ≤39% in the Swedish Heart Failure Registry and divided into age groups ≤65 years, 66-80 years and >80 years. Among 13 782 patients without CRT, IVCD was present in the three age groups in 11% vs. 15% vs. 19% and LBBB was present in 20% vs. 27% vs. 28%, respectively, (P < 0.001). The multivariable hazard ratio (HR) for all-cause mortality over a median (interquartile range) follow-up of 29 (12-53) months for IVCD vs. narrow QRS was 1.31 (1.06-1.63, P = 0.013) in the ≤65 year group, 1.32 (1.17-1.47, P < 0.001) in the 66-80 year group, and 1.26 (1.21-1.41, p < 0.001) in the >80 year group. For LBBB vs. narrow QRS it was 1.29 (1.07-1.56, P = 0.009), 1.17 (1.06-1.30, P = 0.002), and 1.10 (0.99-1.22, P = 0.091), respectively. The adjusted P for interaction between age and QRS morphology was 0.664. In the three age groups, CRT was present in 6% vs. 8% vs. 4% and absent but with indication in 23% vs. 32% vs. 37%, respectively (P < 0.001). CONCLUSIONS: Both IVCD and LBBB were more common with increasing age and were similarly strong independent predictors of mortality and in all ages. The underutilization of CRT was worse with increasing age.","author":[{"dropping-particle":"","family":"Lund","given":"Lars H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"St?hlberg","given":"Marcus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Braunschweig","given":"Frieder","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linde","given":"Cecilia","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure","id":"ITEM-11","issue":"10","issued":{"date-parts":[["2014"]]},"page":"1073-81","title":"Age, prognostic impact of QRS prolongation and left bundle branch block, and utilization of cardiac resynchronization therapy: findings from 14,713 patients in the Swedish Heart Failure Registry.","type":"article-journal","volume":"16"},"uris":[""]},{"id":"ITEM-12","itemData":{"DOI":"10.1001/jama.2014.15241","ISSN":"0098-7484","PMID":"25399276","author":[{"dropping-particle":"","family":"Lund","given":"Lars H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Friberg","given":"Leif","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-12","issue":"19","issued":{"date-parts":[["2014"]]},"page":"2008-2018","title":"Association Between Use of β-Blockers and Outcomes in Patients With Heart Failure and Preserved Ejection Fraction","type":"article-journal","volume":"312"},"uris":[""]},{"id":"ITEM-13","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.114.001730","ISSN":"1941-3297","PMID":"25575580","abstract":"BACKGROUND: -In heart failure with reduced ejection fraction (HFREF), randomized trials of statins did not demonstrate improved outcomes. However, randomized trials may not always be generalizable. The aim was to determine whether statins are associated with improved outcomes in an un-selected nationwide population of patients with HFREF overall and in relation to ischemic heart disease (IHD). METHODS AND RESULTS: -In the Swedish Heart Failure Registry, 21,864 patients with HFREF (age±SD 72±12 years, 29% women), of whom 10,345 (47%) were treated with statins, were studied. Propensity scores for statin use were derived from 42 baseline variables. The associations between statin use and outcomes were assessed with Cox regressions in a population matched 1:1 based on propensity score and age and in the overall population with adjustment for propensity score and age. The primary outcome was all-cause mortality; secondary outcomes were: cardiovascular mortality; HF hospitalization; and combined all-cause mortality or cardiovascular hospitalization. Survival at 1 year in the matched population was 83% for statin-treated vs. 79% for untreated patients, hazard ratio (HR), 0.81 (95% CI, 0.76-0.86, p<0.001). In the un-matched population, 1-year survival was 85% for statin-treated vs. 79% for untreated patients, HR after adjustment for propensity score and age, 0.84 (95% CI, 0.80-0.89, p<0.001). No examined baseline variables interacted with statin use except for IHD (p=0.001), with a HR of 0.76 (95% CI, 0.70-0.82, p<0.001) with and 0.95 (95% CI, 0.85-1.07, p=0.430 without IHD. Statin use was also associated with reduced risk for all 3 secondary outcomes. CONCLUSIONS: -In an un-selected nationwide population of patients with HFREF, statins were associated with improved outcomes, specifically in the presence of IHD. This contrasts with previous randomized controlled trials (RCTs). Additional RCTs with more generalized inclusion or focused on IHD may be warranted.","author":[{"dropping-particle":"","family":"Alehagen","given":"Urban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation. Heart failure","id":"ITEM-13","issued":{"date-parts":[["2015"]]},"title":"Association Between Use of Statins and Outcomes in Heart Failure With Reduced Ejection Fraction: A Prospective Propensity Score Matched Cohort Study of 21,864 Patients in the Swedish Heart Failure Registry.","type":"article-journal"},"uris":[""]},{"id":"ITEM-14","itemData":{"DOI":"10.1002/ejhf.222","ISSN":"1879-0844","PMID":"25581033","abstract":"AIMS: Heart failure (HF) and dementia frequently coexist, but little is known about their types, relationships to each other and prognosis. The aims were to (i) describe patients with HF and dementia, assess (ii) the proportion of specific dementia disorders in types of HF based on ejection fraction and (iii) the prognostic role of types of HF and dementia disorders. METHODS AND RESULTS: The Swedish Heart Failure Registry (RiksSvikt) and The Swedish Dementia Registry (SveDem) were record-linked. Associations between dementia disorders and HF types were assessed with multinomial logistic regression and survival was investigated with Kaplan-Meier analysis and multivariable Cox regression. We studied 775 patients found in both registries (55% men, mean age 82 years). Ejection fraction was preserved in 38% of patients, reduced in 34%, and missing in 28%. The proportions of dementia disorders were similar across HF types. Vascular dementia was the most common dementia disorder (36%), followed by other dementias (28%), mixed dementia (20%), and Alzheimer disease (16%). Over a mean follow-up of 1.5 years, 76% of patients survived 1 year. We observed no significant differences in survival with regard to HF type (P = 0.2) or dementia disorder (P = 0.5). After adjustment for baseline covariates, neither HF types nor dementia disorders were independently associated with survival. CONCLUSIONS: Heart failure with preserved ejection fraction was the most common HF type and vascular dementia was the most common dementia disorder. The proportions of dementia disorders were similar across HF types. Neither HF types nor specific dementia disorders were associated with survival.","author":[{"dropping-particle":"","family":"Cermakova","given":"Pavla","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fereshtehnejad","given":"Seyed-Mohammad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Johnell","given":"Kristina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Winblad","given":"Bengt","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eriksdotter","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Religa","given":"Dorota","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure","id":"ITEM-14","issued":{"date-parts":[["2015"]]},"page":"1-8","title":"Heart failure and dementia: survival in relation to types of heart failure and different dementia disorders.","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"^{221,222,231–234,223–230}","plainTextFormattedCitation":"221,222,231–234,223–230","previouslyFormattedCitation":"^219–232"},"properties":{"noteIndex":0},"schema":""}221,222,231–234,223–230Thai-ADHERE: Thai Acute Decompensated Heart Failure Registry ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cvdpc.2010.06.001","ISBN":"1875-4570","ISSN":"18754570","PMID":"2010590736","abstract":"Background: Heart Failure (HF) is the one of the malignant cardiac syndromes which has a high morbidity and mortality rate. In Thailand, HF is one of the major cardiovascular health problems and economic burdens disease. Thai ADHERE is the first HF registry in Thailand. Objective: To assess patient with HF in Thailand in terms of patients' characteristics, clinical presentation, causes of heart failure, and precipitating causes of heart failure, hospital course, management, and in-hospital outcomes. Material and methods: Thai Acute Decompensated Heart Failure Registry or Thai ADHERE registry is a Phase IV, multicenter, observational, and open-label registry in 18 cardiac centers in Thailand using the US ADHERE protocol. Medical records of hospitalized patients with the principal discharge diagnosis of HF from March 2006 to November 2007 were validated and registered via an electronic web based system. Results: There were 2041 HF admissions in 1612 patients with a median age of 67 years (mean 64 ?? 14 years). Age >75 years was found in 24%, 49.6% were male patients, and 67% of these admissions had prior heart failure. Underlying diseases were hypertension [(HT) = 65%], coronary artery disease [(CAD) = 47%], dyslipidemia (50%), diabetes mellitus (47%), atrial fibrillation (24%) and chronic kidney disease (19%). Clinical features at presentation were dyspnea (97%), edema (60%), pulmonary rales (85%) and pulmonary congestion by chest X-ray (93%). Sixty-nine percent (69%) were in NYHA functional class IV and 44% had a left ventricular ejection fraction (LVEF) less than 40%. Common causes of heart failure were CAD (45%), valvular heart diseases (19%), cardiomyopathy (14%) and HT (12%). Precipitating causes of heart failure were heart disease itself 54% and 20% were related to inadequate diuretics and poor patient compliance with medications. Neurohormonal blockers (NHB) [angiotensin converting enzyme inhibitors (ACEI), angiotensinoge receptor blocker (ARB), aldosterone blocker (AA) and beta blockers (BB)], were given prior to hospitalization in comparison to at discharge in 26% vs. 35%, 12% vs. 12%, 13% vs. 17% and 26% vs. 24% respectively. In-hospital mortality rate was 5.5% and the median length of hospitalization was 7.5 days. Major causes of death were sepsis, worsening of heart failure, arrhythmic arrest and acute coronary syndrome. There was a higher mortality rate in those with poor LV systolic function compared to those with preserved LV systolic func…","author":[{"dropping-particle":"","family":"Laothavorn","given":"Prasart","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hengrussamee","given":"Kriengkrai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kanjanavanit","given":"Rungsrit","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moleerergpoom","given":"Worachat","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Laorakpongse","given":"Donpichit","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pachirat","given":"Orathai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Boonyaratavej","given":"Smonporn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sritara","given":"Piyamitr","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"CVD Prevention and Control","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2010"]]},"page":"89-95","publisher":"World Heart Federation","title":"Thai acute decompensated heart failure registry (Thai ADHERE)","type":"article-journal","volume":"5"},"uris":[""]},{"id":"ITEM-2","itemData":{"ISSN":"0125-2208","PMID":"23936980","abstract":"BACKGROUND Heart failure had emerged as a major public health problem and became the leading cause of hospitalization. The Acute Decompensated Heart Failure National Registry (ADHERE) of US patients hospitalized with a primary diagnosis of acute decompensated heart Failure (ADHF) had been reported worldwide for the risk stratification and predicting In-hospital mortality. OBJECTIVE Identify clinical risk factors or treatment procedures that could predict In-hospital mortality in Thai patients with ADHF. MATERIAL AND METHOD Thai ADHERE is a multicenter, observational, prospective study. The data were collected via web-based electronic data capture and analyzed. Two thousand forty one hospitalization episodes involving 1,671 patients in the 18 participating hospitals between March 2006 and September 2007 were analyzed. All clinical factors associated with In-hospital mortality identified by univariated analysis were further analyzed by Logistic regression model. RESULTS One hundred thirteen patients died during the hospitalization period with overall mortality rate of 5.5%. Systolic blood pressure < 90 mmHg, creatinine > 2.0 mg/dL, history of stroke/TIA, and NYHA class IV were independent risk factors for In-hospital mortality with adjusted OR (95% CI) = 3.45 (1.77-6.79), 1.99 (1.30-3.05), 1.85 (1.11-3.08) and 1.69 (1.08-2.64) respectively. Hypertensive cause of CHF, prior use of lipid lowering drug, and hemoglobin level were associated with lower risk, adjusted OR (95% CI) = 0.35 (0.15-0.81), 0.51 (0.34-0.78) and 0.90 (0.82-0.98) respectively. CONCLUSION The clinical predictors for In-hospital mortality of Thai ADHERE that associated with worse outcome were systolic blood pressure < 90 mmHg, creatinine > 2.0 mg/dL, history of stroke/TIA, and NYHA class IV. Hypertensive cause of CHF, prior use of lipid lowering drug, and hemoglobin were associated favorable outcome.","author":[{"dropping-particle":"","family":"Moleerergpoom","given":"Worachat","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hengrussamee","given":"Kriengrai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piyayotai","given":"Dilok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jintapakorn","given":"Woravut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sukhum","given":"Pradub","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kunjara-Na-Ayudhya","given":"Rapeephon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suwanjutah","given":"Thouantosaporn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Laothavorn","given":"Prasart","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","id":"ITEM-2","issue":"2","issued":{"date-parts":[["2013","2"]]},"page":"157-64","title":"Predictors of in-hospital mortality in acute decompensated heart failure (Thai ADHERE).","type":"article-journal","volume":"96"},"uris":[""]}],"mendeley":{"formattedCitation":"^235,236","plainTextFormattedCitation":"235,236","previouslyFormattedCitation":"^233,234"},"properties":{"noteIndex":0},"schema":""}235,236THESUS-HF: The Sub-Saharan Africa Survey of Heart Failure ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/archinternmed.2012.3310","ISBN":"1538-3679","ISSN":"1538-3679","PMID":"22945249","abstract":"BACKGROUND: Acute heart failure (AHF) in sub-Saharan Africa has not been well characterized. Therefore, we sought to describe the characteristics, treatment, and outcomes of patients admitted with AHF in sub-Saharan Africa.\\n\\nMETHODS: The Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) was a prospective, multicenter, observational survey of patients with AHF admitted to 12 university hospitals in 9 countries. Among patients presenting with AHF, we determined the causes, treatment, and outcomes during 6 months of follow-up.\\n\\nRESULTS: From July 1, 2007, to June 30, 2010, we enrolled 1006 patients presenting with AHF. Mean (SD) age was 52.3 (18.3) years, 511 (50.8%) were women, and the predominant race was black African (984 of 999 [98.5%]). Mean (SD) left ventricular ejection fraction was 39.5% (16.5%). Heart failure was most commonly due to hypertension (n = 453 [45.4%]) and rheumatic heart disease (n = 143 [14.3%]). Ischemic heart disease (n = 77 [7.7%]) was not a common cause of AHF. Concurrent renal dysfunction (estimated glomerular filtration rate, <30 mL/min/173 m(2)), diabetes mellitus, anemia (hemoglobin level, <10 g/dL), and atrial fibrillation were found in 73 (7.7%), 114 (11.4%), 147 (15.2%), and 184 cases (18.3%), respectively; 65 of 500 patients undergoing testing (13.0%) were seropositive for the human immunodeficiency virus. The median hospital stay was 7 days (interquartile range, 5-10), with an in-hospital mortality of 4.2%. Estimated 180-day mortality was 17.8% (95% CI, 15.4%-20.6%). Most patients were treated with renin-angiotensin system blockers but not β-blockers at discharge. Hydralazine hydrochloride and nitrates were rarely used.\\n\\nCONCLUSIONS: In African patients, AHF has a predominantly nonischemic cause, most commonly hypertension. The condition occurs in middle-aged adults, equally in men and women, and is associated with high mortality. The outcome is similar to that observed in non-African AHF registries, suggesting that AHF has a dire prognosis globally, regardless of the cause.","author":[{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okechukwu S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Serigne Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Archives of internal medicine","id":"ITEM-1","issue":"18","issued":{"date-parts":[["2012"]]},"page":"1386-94","title":"The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries.","type":"article-journal","volume":"172"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1093/eurheartj/eht393","ISSN":"0195668X","PMID":"24048728","abstract":"AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population.\\n\\nMETHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown.\\n\\nCONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.","author":[{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okekuchwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-2","issue":"40","issued":{"date-parts":[["2013"]]},"page":"3151-3159","title":"Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry","type":"article-journal","volume":"34"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1002/ejhf.103","ISSN":"18790844","PMID":"24962957","abstract":"AIMS: In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive acute heart failure patients from Africa, have not been described.\\n\\nMETHODS AND RESULTS: From 1006 patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF), renal function was determined by the estimated glomerular filtration rate using the Modification of Diet in Renal Disease (MDRD) formula. Worsening renal function was defined as an increase in creatinine ≤0.3 mg/dL (26.5 ?mol/L) from baseline to day 7/discharge. The mean (SD) age of the patients was 52.4 (18.2) years, 481 (50.8%) were women and the predominant race was black African [932 of 946 (98.5%)]. Heart failure was most commonly a result of hypertension (n = 363, 39.5%) and only 7.8% had ischaemic heart failure. At hospital admission, 289 patients (30.6%) had an estimated glomerular filtration rate ≤60 ml/min.1.73m(2) . Worsening renal function during hospitalization was detected in 53 (9.8 %) of 543 patients with a follow-up creatinine value, and was independently associated with the Western sub-Saharan region, body mass index, and the presence of rales. Worsening renal function was an independent predictor of death or readmission over 60 days [multivariable hazard ratio = 2.06 (1.10, 3.38); P = 0.023] and all-cause death over 180 days [multivariable hazard ratio =1.92 (1.08, 3.38); P = 0.025].\\n\\nCONCLUSIONS: Renal dysfunction is also prevalent in younger non-ischaemic acute heart failure patients in Africa, but worsening renal function is less prevalent and has different predictors compared with Western cohorts. Nevertheless, worsening renal function is strongly and independently related with clinical outcome.","author":[{"dropping-particle":"","family":"Sani","given":"Mahmoud U.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liu","given":"Licette","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okechukwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adrian A.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-3","issue":"7","issued":{"date-parts":[["2014"]]},"page":"718-728","title":"Renal dysfunction in African patients with acute heart failure","type":"article-journal","volume":"16"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1016/j.cardfail.2013.11.005","ISSN":"10719164","PMID":"24269854","abstract":"Objective The aim of this study was to assess the predictive utility of 12-lead electrocardiogram (ECG) abnormalities among Africans with acute heart failure (HF). Methods and Results We used the Sub-Saharan Africa Survey of Heart Failure, a multicenter prospective cohort study of 1,006 acute HF patients, and regression models to relate baseline ECG findings to all-cause mortality and readmission during a 6-month follow-up period. Of 814 ECGs available, 523 (49.0% male) were obtained within 15 days of admission, among which 97.7% showed abnormalities. Mean age was 52.0 years and median follow-up was 180 days, with 77 deaths (Kaplan-Meier 17.5%) through day 180 and 63 patients with death or readmission to day 60. QRS width, QT duration, bundle branch block, and ischemic changes were not associated with outcomes. Increasing ventricular rate was associated with increasing risk of both outcomes (hazard ratio [HR] 1.07 per 5 beats/min increase for 60-day death or readmission, 95% confidence interval [CI] 1.02-1.12; P =.0047), and the presence of sinus rhythm was associated with lower risk (HR 0.58, 95% CI 0.34-0.97; P =.0385). There was a strong association between survival and heart rate in patients in sinus rhythm, with heart rate >119 beats/min conveying the worst mortality risk. Conclusions ECG abnormalities are almost universal among Africans with acute HF, which may add to the immediate diagnosis of patients presenting with dyspnea. Although some ECG findings have prognostic value for risk of adverse outcomes, most of them are nonspecific and add little to the risk stratification of these patients. ? 2014 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Milo","given":"Olga","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okechukwu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud U.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-4","issue":"1","issued":{"date-parts":[["2014"]]},"page":"45-52","publisher":"Elsevier Inc","title":"Prognostic significance of ECG abnormalities for mortality risk in acute heart failure: Insight from the Sub-Saharan Africa survey of heart failure (THESUS-HF)","type":"article-journal","volume":"20"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1007/s00392-015-0810-y","ISSN":"1861-0684","author":[{"dropping-particle":"","family":"Ogah","given":"Okechukwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud U.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical Research in Cardiology","id":"ITEM-5","issued":{"date-parts":[["2015"]]},"title":"Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"^237–241","plainTextFormattedCitation":"237–241","previouslyFormattedCitation":"^235–239"},"properties":{"noteIndex":0},"schema":""}237–241S3: Documented heart failure registry outcomes PATIENT REPORTED OUTCOMESRegistries MeasuringSelf-reported symptoms at discharge12Self reported symptoms at clinic follow-up4Global quality of life 2CLINICIAN REPORTED OUTCOMESDischarge medications19Treatment response14Device placement10Performance measures8Surgery required6NYHA status6New dialysis5Major adverse cardiac or cerebrovascular event4Scheduled outpatient follow-up4Progress to transplant3Progress to mechanical assistance2Discharge creatinine2HOSPITAL REPORTED OUTCOMESAll cause or specific mortality (In hospital & long-term)24Admission for heart failure22Hospital length of stay18All cause or specific readmission16ICU / CCU admission11ICU / CCU length of stay10Discharge disposition6Unscheduled ambulatory visit (ED or clinic) for heart failure3NYHA: New York Heart Association; ICU: Intensive care unit; CCU: Cardiac care unit; ED: Emergency departmentS4: Patient-reported outcome questionnaire informationMLHFQKCCQCHQTypeHeart failure-specificHeart failure-specificCHF-specificCost$500 per physical location$5000 per site per year for >5000 patientsNot allowed to incorporate into outcome setsTime to complete<10 minutes<10 minutes10-20 minutesTranslations>3052<10Technical qualityValidityConsiderable evidence for construct and content validity. Significant correlation with other measures (e.g. NYHA, San Diego Heart Failure Questionnaire). Significant correlation with sub-measures (e.g. fatigue, shortness of breath). Able to discriminate sub-populations (e.g. younger vs older; severe vs less severe illness, etc). Good evidence for construct validity. Significant correlation with other measures (e.g. NYHA). Able to discriminate sub-populations. Construct validity, reliability. Strong correlation with NYHA. Able to discriminate between ages groups and genders. ReliabilityInternal consistency: Cronbach’s alpha 0.86-0.95Test-retest: ICC 0.88 Internal consistency: Cronbach’s alpha 0.93Test-retest: ICC 0.88 Internal consistency: Cronbach’s alpha 0.78-0.95 Test-retest: ICC 0.93Responsive-nessHigh. Demonstrated in numerous, large-scale trials. Consistent with other measures (e.g SF-12). Scores consistent with drug initiation, device therapy, and improved outpatient treatmentHigh. Reported to be at least as sensitive to change as clinical measures (e.g. NYHA, 6MWT). Lower scores correlate with mortality, hospitalization, and poorer event-free survivalHigh, across different subpopulations. Significant improvements in each of the CHQ subscales observed.MLHFQ: Minnesota Living with Heart Failure Questionnaire; KCCQ: Kansas City Cardiomyopathy Questionnaire; CHQ: Chronic Heart Failure Questionnaire; NYHA: New York Heart Association; 6MWT: 6 minute walk test; ICC: Intraclass correlation coefficientS5: PROMs: KCCQ, PROMIS and PHQ-2KCCQ ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/S0735-1097(00)00531-3","ISBN":"0735-1097","ISSN":"07351097","PMID":"10758967","abstract":"Objectives. To create a valid, sensitive, disease-specific health status measure for patients with congestive heart failure (CHF). Background. Quantifying health status is becoming increasingly important for CHF. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a new, self- administered, 23-item questionnaire that quantifies physical limitations, symptoms, self-efficacy, social interference and quality of life. Methods. To establish the performance characteristics of the KCCQ, two distinct patient cohorts were recruited: 70 stable and 59 decompensated CHF patients with ejection fractions of <40. Upon entry into the study, patients were administered the KCCQ, the Minnesota Living with Heart Failure Questionnaire and the Short Form-36 (SF-36). Questionnaires were repeated three months later. Results. Convergent validity of each KCCQ domain was documented by comparison with available criterion standards (r = 0.46 to 0.74; p < 0.001 for all). Among those with stable CHF who remained stable by predefined criteria (n = 39), minimal changes in KCCQ domains were detected over three months of observation (mean change = 0.8 to 4.0 points, p = NS for all). In contrast, large changes in score were observed among patients whose decompensated CHF improved three months later (n = 39; mean change = 15.4 to 40.4 points, p < 0.01 for all). The sensitivity of the KCCQ was substantially greater than that of the Minnesota Living with Heart Failure and the SF-36 questionnaires. Conclusions. The KCCQ is a valid, reliable and responsive health status measure for patients with CHF and may serve as a clinically meaningful outcome in cardiovascular research, patient management and quality assessment. (C) 2000 by the American College of Cardiology.","author":[{"dropping-particle":"","family":"Green","given":"C. Patrick","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Porter","given":"Charles B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bresnahan","given":"Dennis R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spertus","given":"John a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2000"]]},"page":"1245-1255","title":"Development and evaluation of the Kansas City cardiomyopathy questionnaire: A new health status measure for heart failure","type":"article-journal","volume":"35"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴²","plainTextFormattedCitation":"242","previouslyFormattedCitation":"²⁴⁰"},"properties":{"noteIndex":0},"schema":""}242:The following questions refer to your heart failure and how it may affect your life. Please read and complete the following questions. There are no right or wrong answers. Please mark the answer that best applies to you.1.?Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue. Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks.Extremely LimitedQuite a bit LimitedModerately LimitedSlightly LimitedNot at all LimitedLimited for other reasons or did not do the activitya. Showering/bathingb. Walking 1 block on level groundc. Hurrying or jogging (as if to catch a bus)2.?Over the past 2 weeks, how many times did you have swelling in your feet, ankles or legs when you woke up in the morning?Every morning3 or more times per week but not every day1-2 times per weekLess than once a weekNever over the past 2 weeks ?3.?Over the past 2 weeks, on average, how many times has fatigue limited your ability to do what you wanted?All of? the timeSeveral times per dayAt least once a day3 or more times per week but not every day1-2 times per weekLess than once a weekNever over the? past 2 weeks4.?Over the past 2 weeks, on average, how many times has shortness of breath limited your ability to do what you wanted?All of? the timeSeveral times per dayAt least once a day3 or more times per week but not every day1-2 times per weekLess than once a weekNever over the? past 2 weeks5.?Over the past 2 weeks, on average, how many times have you been forced to sleep sitting up in a chair or with at least 3 pillows to prop you up because of shortness of breath?Every night3 or more times per week but not every day1-2 times per weekLess than once a weekNever over the? past 2 weeks6.?Over the past 2 weeks, how much has your heart failure limited your enjoyment of life?It has extremely limited my enjoyment of lifeIt has limited my enjoyment of life quite a bitIt has moderately limited my enjoyment of lifeIt has slightly limited my enjoyment of lifeIt has not limited my enjoyment of life at all7. If you had to spend the rest of your life with your heart failure the way it is right now, how would you feel about this?Not at all satisfiedMostly dissatisfiedSomewhat satisfiedMostly satisfiedCompletely satisfied8.?How much does your heart failure affect your lifestyle? Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks.Severely LimitedLimited quite a bitModerately limitedSlightly limitedDid not limit at allDoes not apply or did not do for other reasonsa. Hobbies, recreational, activitiesb. Working or doing household choresc. Visiting family or friends out of your homePROMIS ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Patient-Reported Outcomes Measurement Information System (PROMIS)","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴³","plainTextFormattedCitation":"243","previouslyFormattedCitation":"²⁴¹"},"properties":{"noteIndex":0},"schema":""}243:PHQ-2 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Patient Health Questionnaire-2 (PHQ-2)","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴⁴","plainTextFormattedCitation":"244","previouslyFormattedCitation":"²⁴²"},"properties":{"noteIndex":0},"schema":""}244:S6: Complications of heart failure therapyMedicationsRationale: Heart failure has numerous evidence-based medical therapies. In fact, these are the mainstay of heart failure management, particularly systolic dysfunction (HFrEF) or concomitant atrial fibrillation. Therefore, it is important to consider adverse medication events. Through the MLHFQ we can get some insight into medication complications. Question 16: giving you side effects from treatments? However, this is non-specific in that the patient may misunderstand adverse effects, events, or complications. It is important that clinicians implementing the set specifically look into adverse medication events. A systematic search strategy was not fruitful for this topic, as the results were either far too broad, or far too narrow, limiting the utility of such as search in each case. Also, each medication has numerous potential side effects that are not practical to enumerate. Because of this, for medication complications, we propose a broad scheme arranged as follows:Major reaction / allergyExamplesBleed on warfarinAngioedema on ACEIAnaphylaxisMinor adverse reaction / intoleranceExamplesCough on ACEIFatigue on beta blockerThe suggested time point for this is within 30 days of the introduction of a new medical therapy or at routine follow-up after hospitalization. This would be easy to collect as a clinician reported measure during follow-up appointmentsHospitalizationRationale: Hospitalization has been listed as an outcome independently. However, being hospitalized can be associated with adverse events independent of the disease process. For example, a patient admitted for acute decompensated HF may suffer an MI, but this would be related to the HF presentation, not the hospitalization itself. However, if this person during the course of treatment were to pick up a nosocomial infection, that would be related to the act of being hospitalized. Therefore, we propose the following infections complications related to hospitalizationMajor nosocomial infection requiring IV antibiotic therapy and/or a prolonged hospital stayMinor infection easily treated with oral antibiotics that does not prolong hospital stay or can be treated on an outpatient basisA systematic search strategy was not fruitful for this topic, as the results were either far too broad, or far too narrow, limiting the utility of such as search in each case. Also, search strategies has trouble teasing out complications while in hospital vs. complications as a result of being in hospital, which is a very important distinction. The time point for these complications would be at 30-day follow up post hospitalization. This would be easy to collect by reviewing hospital documentation or by patient self-report validated by hospital recordsInterventional/DeviceSystematic StrategyMedical Subject Heading (MeSH):Defibrillators, Implantable Cardiac Resynchronization DevicesComplications (subheading)Heart FailureFree Text:OutcomesString: (1 OR 2) AND 3 AND 4 AND 5Result: 45 papersIrrelevant: 9Relevant to device therapy in heart failure, but do not discuss specific device related complications: 31Papers referenced: 5 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.2010.1915","ISBN":"1538-3598 (Electronic)\\n0098-7484 (Linking)","ISSN":"0098-7484","PMID":"21205965","abstract":"Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symptoms or a recent diagnosis of heart failure.","author":[{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Jeptha","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mark","given":"Daniel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sanders","given":"Gillian D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2011"]]},"page":"43-49","title":"Non-evidence-based ICD implantations in the United States.","type":"article-journal","volume":"305"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1161/CIRCEP.111.964270","ISBN":"1941-3084 (Electronic)\\r1941-3084 (Linking)","ISSN":"19413149","PMID":"22007037","abstract":"BACKGROUND: In the United States, patients aged >75 years are the most rapidly growing segment in the population, with an expected increase of 126% by 2050. These patients account for >70% of the pacemakers and up to two thirds of the implantable cardioverter-defibrillators implanted annually. Our aim was to explore the clinical outcomes of device complications in the octogenarian population.\\n\\nMETHODS AND RESULTS: We performed a retrospective chart review of 506 patients undergoing laser lead extraction from January 2004 to September 2009. This population was divided into the following 2 groups based solely on age: octogenarians and nonoctogenarians. These 2 groups were compared on the basis of several characteristics and clinical outcomes. There were 118 patients in the octogenarian group (78 men) and 388 in the nonoctogenarians group (301 men) aged 85±3.8 and 64.2±12.4 years, respectively. A total of 253 leads (atrial, 99; ventricular, 145; coronary sinus, 9) were removed from the patients in the octogenarian group, and 814 leads (atrial, 295; ventricular, 442; coronary sinus, 77) were removed from the patients in the nonoctogenarian group. The main indication for extraction for both groups was infection. The lead implant duration was 59.6±52.8 and 38.6±43.9 months for octogenarians and nonoctogenarians, respectively. There was no significant difference with respect to the proportion of minor (P=0.65), major (P=0.56), and total (P=0.50) complications.\\n\\nCONCLUSIONS: Laser lead extraction is demonstrated to be a safe and effective treatment method in octogenarian patients with multiple comorbidities.","author":[{"dropping-particle":"","family":"Rodriguez","given":"Yasser","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Garisto","given":"Juan D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Carrillo","given":"Roger G.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Arrhythmia and Electrophysiology","id":"ITEM-2","issue":"5","issued":{"date-parts":[["2011"]]},"page":"719-723","title":"Laser lead extraction in the octogenarian patient","type":"article-journal","volume":"4"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1111/j.1540-8167.2011.02066.x","ISBN":"1045-3873","ISSN":"10453873","PMID":"21489029","abstract":"INTRODUCTION: Patients with chronic kidney disease (CKD) have increased morbidity following invasive procedures. We hypothesized that patients with CKD have higher complication rates following device implantation than patients with normal renal function.\\n\\nMETHODS: We reviewed the medical records of patients undergoing ICD or pacemaker implantation from August 2004 to August 2007. The estimated glomerular filtration rate (GFR) was calculated using the Cockroft-Gault equation. Those with GFR ≥ 90 cc/min served as controls. The remainder was grouped according to American Kidney Foundation stages of CKD. Bleeding complications were defined as need for pocket exploration or blood transfusion; cardiac tamponade; or hematoma requiring pressure dressing, change in medications or prolonged hospitalization. Infection was defined as infection of the pocket or lead system, or development of bacteremia/sepsis within 60 days.\\n\\nRESULTS: There were 82 bleeding complications (5.7%) and 7 infections (0.5%) temporally related to device implantation in 1,440 patients. End-stage renal disease (ESRD), defined as GFR < 15 mL/min or need for dialysis, was identified in 32 patients. Infection rates were significantly higher in patients with ESRD versus controls (12.5% vs 0.2%; P < 0.0001). A significant increase in bleeding complications was observed in ESRD versus controls (21.9% vs 3.2%, respectively; P<0.0001). Bleeding complications were considerably greater than controls in moderate (GFR 30-59 mL/min) and severe (GFR 15-29 mL/min) CKD (7.4% and 9.8% vs 3.2%, respectively; P < 0.005).\\n\\nCONCLUSION: ESRD markedly increases bleeding and device-related infections. The risk of both complications parallels the severity of CKD. Further research is needed to reduce adverse outcomes in this high-risk population.","author":[{"dropping-particle":"","family":"Tompkins","given":"Christine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McLean","given":"Rhondalyn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cheng","given":"Alan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brinker","given":"Jeffrey a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marine","given":"Joseph E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nazarian","given":"Saman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spragg","given":"David D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sinha","given":"Sunil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Halperin","given":"Henry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tomaselli","given":"Gordon F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Berger","given":"Ronald D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Calkins","given":"Hugh","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Henrikson","given":"Charles a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Electrophysiology","id":"ITEM-3","issue":"10","issued":{"date-parts":[["2011"]]},"page":"1099-1104","title":"End-stage renal disease predicts complications in pacemaker and ICD implants","type":"article-journal","volume":"22"},"uris":[""]},{"id":"ITEM-4","itemData":{"DOI":"10.1093/eurjhf/hfr158","ISBN":"1879-0844 (Electronic)\\r1388-9842 (Linking)","ISSN":"13889842","PMID":"22179034","abstract":"AIMS: The European CRT Survey is a joint initiative of the Heart Failure Association (HFA) and the European Heart Rhythm Association (EHRA) of the European Society of Cardiology evaluating the contemporary implantation practice of cardiac resynchronization therapy (CRT) in Europe.\\n\\nMETHODS AND RESULTS: Patients who had a successful CRT implantation were enrolled from 141 centres in 13 countries between November 2008 and June 2009. Baseline demographics, clinical and implantation data were collected, with a follow-up of ～1 year (9-15 months). The current report describes clinical outcomes including symptom severity, cardiovascular (CV) hospitalization, and survival. A total of 2438 patients were enrolled, and follow-up data were acquired from 2111 patients (87%). The population included important groups of patients poorly represented in randomized controlled trials, including very elderly patients and those with prior device implantation, atrial fibrillation, and/or QRS duration <120 ms. Investigators reported substantial improvement in New York Heart Association (NYHA) functional class at follow-up. Patient self-assessment indicated that 81% of the patients felt improved, 16% reported no change, and 4% reported deterioration. During follow-up, 207 (10%) patients died, 346 (16%) had a CV hospitalization, and 501 (24%) died or had CV hospitalization. Worse NYHA functional class, atrial fibrillation, ischaemic aetiology, and device type (CRT-P, i.e. CRT alone) were associated with poorer survival. Women had a better outcome, as did patients who had a CRT-D (with an implantable cardioverter defibrillator function) device.\\n\\nCONCLUSIONS: Outcomes including death and hospitalization in this European CRT survey were consistent with results from clinical trials of CRT. At 1 year follow-up, most patients who received a CRT device considered their symptoms improved compared with their pre-implant assessment. Although prospective, this is an observational study of successful CRT implantations, and outcomes in subgroup analyses must be interpreted with appropriate conservatism.","author":[{"dropping-particle":"","family":"Bogale","given":"Nigussie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Priori","given":"Silvia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cleland","given":"John G F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brugada","given":"Josep","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linde","given":"Cecilia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Auricchio","given":"Angelo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Veldhuisen","given":"Dirk J.","non-dropping-particle":"Van","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Limbourg","given":"Tobias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gitt","given":"Anselm","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gras","given":"Daniel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stellbrink","given":"Christoph","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gasparini","given":"Maurizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Derumeaux","given":"Geneviéve","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gadler","given":"Fredrik","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Buga","given":"Laszlo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-4","issue":"1","issued":{"date-parts":[["2012"]]},"page":"61-73","title":"The European CRT Survey: 1 year (915 months) follow-up results","type":"article-journal","volume":"14"},"uris":[""]},{"id":"ITEM-5","itemData":{"DOI":"10.1001/jama.2013.8641","ISSN":"1538-3598","PMID":"23942680","abstract":"IMPORTANCE The benefits of cardiac resynchronization therapy (CRT) in clinical trials were greater among patients with left bundle-branch block (LBBB) or longer QRS duration. OBJECTIVE To measure associations between QRS duration and morphology and outcomes among patients receiving a CRT defibrillator (CRT-D) in clinical practice. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of Medicare beneficiaries in the National Cardiovascular Data Registry's ICD Registry between 2006 and 2009 who underwent CRT-D implantation. Patients were stratified according to whether they were admitted for CRT-D implantation or for another reason, then categorized as having either LBBB or no LBBB and QRS duration of either 150 ms or greater or 120 to 149 ms. MAIN OUTCOMES AND MEASURES All-cause mortality; all-cause, cardiovascular, and heart failure readmission; and complications. Patients underwent follow-up for up to 3 years, with follow-up through December 2011. RESULTS Among 24 169 patients admitted for CRT-D implantation, 1-year and 3-year mortality rates were 9.2% and 25.9%, respectively. All-cause readmission rates were 10.2% at 30 days and 43.3% at 1 year. Both the unadjusted rate and adjusted risk of 3-year mortality were lowest among patients with LBBB and QRS duration of 150 ms or greater (20.9%), compared with LBBB and QRS duration of 120 to 149 ms (26.5%; adjusted hazard ratio [HR], 1.30 [99% CI, 1.18-1.42]), no LBBB and QRS duration of 150 ms or greater (30.7%; HR, 1.34 [99% CI, 1.20-1.49]), and no LBBB and QRS duration of 120 to 149 ms (32.3%; HR, 1.52 [99% CI, 1.38-1.67]). The unadjusted rate and adjusted risk of 1-year all-cause readmission were also lowest among patients with LBBB and QRS duration of 150 ms or greater (38.6%), compared with LBBB and QRS duration of 120 to 149 ms (44.8%; adjusted HR, 1.18 [99% CI, 1.10-1.26]), no LBBB and QRS duration of 150 ms or greater (45.7%; HR, 1.16 [99% CI, 1.08-1.26]), and no LBBB and QRS duration of 120 to 149 ms (49.6%; HR, 1.31 [99% CI, 1.23-1.40]). There were no observed associations with complications. CONCLUSIONS AND RELEVANCE Among fee-for-service Medicare beneficiaries undergoing CRT-D implantation in clinical practice, LBBB and QRS duration of 150 ms or greater, compared with LBBB and QRS duration less than 150 ms or no LBBB regardless of QRS duration, was associated with lower risk of all-cause mortality and of all-cause, cardiovascular, and heart failure readmissions.","author":[{"dropping-particle":"","family":"Peterson","given":"Pamela N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"Laura G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Jeptha P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA","id":"ITEM-5","issue":"6","issued":{"date-parts":[["2013"]]},"page":"617-26","title":"QRS duration, bundle-branch block morphology, and outcomes among older patients with heart failure receiving cardiac resynchronization therapy.","type":"article-journal","volume":"310"},"uris":[""]}],"mendeley":{"formattedCitation":"^245–249","plainTextFormattedCitation":"245–249","previouslyFormattedCitation":"^243–247"},"properties":{"noteIndex":0},"schema":""}245–249Additional papers:2 records obtained by general database searching prior to developing the systematic search ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1540-8159.2005.00195.x","ISBN":"0147-8389 (Print)\\r0147-8389 (Linking)","ISSN":"01478389","PMID":"16176531","abstract":"BACKGROUND: Although more than 150,000 implantable cardioverter defibrillators (ICDs) are implanted yearly worldwide, only few studies systematically examined complications of ICD therapy in large patient cohorts. METHODS: We prospectively analyzed ICD-related complications in 440 consecutive patients who underwent first implantation of an ICD system for primary or secondary prevention of sudden cardiac death within the last 10 years at our institution. All study patients received pectoral nonthoracotomy ICD lead systems with the exception of one patient who had an artificial tricuspid valve. RESULTS: During 46 +/- 37 months follow-up, 136 of 440 patients (31%) experienced at least one complication including implant procedure-related complications in 43 patients (10%), ICD generator-related complications in 28 patients (6%), lead-related complications in 52 patients (12%), and inappropriate shocks in 54 patients (12%). The most serious complications included one perioperative death due to heart failure (0.2%), two ICD system infections necessitating device removal (0.5%) and two perioperative cerebrovascular strokes (0.5%). CONCLUSIONS: We conclude that more than one quarter of ICD patients experience complications during a mean follow-up of almost 4 years, although serious complications such as intraoperative death or ICD system infections are rare in patients with nonthoracotomy ICD systems. Recognition of these complications is the prerequisite for advances in ICD technology and management strategies to avoid their recurrence.","author":[{"dropping-particle":"","family":"Alter","given":"Peter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Waldhans","given":"Stefan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Plachta","given":"Eveline","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moosdorf","given":"Rainer","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grimm","given":"Wolfram","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PACE - Pacing and Clinical Electrophysiology","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2005"]]},"page":"926-932","title":"Complications of implantable cardioverter defibrillator therapy in 440 consecutive patients","type":"article-journal","volume":"28"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.jacc.2011.06.007","ISBN":"1558-3597 (Electronic)\\r0735-1097 (Linking)","ISSN":"1558-3597","PMID":"21867832","abstract":"The number of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy (CRT) implantations is increasing drastically worldwide, and hence, the number of implanting centers is also increasing. Despite abundant data on the beneficial effect of these devices, little is known regarding safety and complication rates. Eleven ICD and 7 CRT trials were systematically reviewed to provide data on the frequency of in-hospital mortality and complications related to the implantation. Average in-hospital mortality was 2.7% in trials using both thoracotomy and nonthoracotomy ICDs, 0.2% in trials using nonthoracotomy ICDs, and 0.3% in CRT trials. The pneumothorax rate was similar between the nonthoracotomy ICD and CRT trials (0.9%) Coronary sinus complications occurred in 2.0% of patients undergoing CRT. Lead dislodgement rates were higher in CRT trials (5.7%) than in nonthoracotomy ICD trials (1.8%).","author":[{"dropping-particle":"","family":"Rees","given":"Johannes B","non-dropping-particle":"van","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bie","given":"Mihály K","non-dropping-particle":"de","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thijssen","given":"Joep","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Borleffs","given":"C Jan Willem","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schalij","given":"Martin J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Erven","given":"Lieselot","non-dropping-particle":"van","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-2","issue":"10","issued":{"date-parts":[["2011"]]},"page":"995-1000","publisher":"Elsevier Inc.","title":"Implantation-related complications of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices a systematic review of randomized clinical trials.","type":"article-journal","volume":"58"},"uris":[""]}],"mendeley":{"formattedCitation":"^250,251","plainTextFormattedCitation":"250,251","previouslyFormattedCitation":"^248,249"},"properties":{"noteIndex":0},"schema":""}250,251Complications discussed **We should focus on complications other than mortality or rehospitalisation, as these are discussed elsewhere**Alter 2005 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1540-8159.2005.00195.x","ISBN":"0147-8389 (Print)\\r0147-8389 (Linking)","ISSN":"01478389","PMID":"16176531","abstract":"BACKGROUND: Although more than 150,000 implantable cardioverter defibrillators (ICDs) are implanted yearly worldwide, only few studies systematically examined complications of ICD therapy in large patient cohorts. METHODS: We prospectively analyzed ICD-related complications in 440 consecutive patients who underwent first implantation of an ICD system for primary or secondary prevention of sudden cardiac death within the last 10 years at our institution. All study patients received pectoral nonthoracotomy ICD lead systems with the exception of one patient who had an artificial tricuspid valve. RESULTS: During 46 +/- 37 months follow-up, 136 of 440 patients (31%) experienced at least one complication including implant procedure-related complications in 43 patients (10%), ICD generator-related complications in 28 patients (6%), lead-related complications in 52 patients (12%), and inappropriate shocks in 54 patients (12%). The most serious complications included one perioperative death due to heart failure (0.2%), two ICD system infections necessitating device removal (0.5%) and two perioperative cerebrovascular strokes (0.5%). CONCLUSIONS: We conclude that more than one quarter of ICD patients experience complications during a mean follow-up of almost 4 years, although serious complications such as intraoperative death or ICD system infections are rare in patients with nonthoracotomy ICD systems. Recognition of these complications is the prerequisite for advances in ICD technology and management strategies to avoid their recurrence.","author":[{"dropping-particle":"","family":"Alter","given":"Peter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Waldhans","given":"Stefan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Plachta","given":"Eveline","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moosdorf","given":"Rainer","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grimm","given":"Wolfram","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PACE - Pacing and Clinical Electrophysiology","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2005"]]},"page":"926-932","title":"Complications of implantable cardioverter defibrillator therapy in 440 consecutive patients","type":"article-journal","volume":"28"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵⁰","plainTextFormattedCitation":"250","previouslyFormattedCitation":"²⁴⁸"},"properties":{"noteIndex":0},"schema":""}250:Many rare but significant complications discussedSplit into 4 categoriesImplant procedure relatedGenerator relatedLead relatedInappropriate shocksFor ICHOM’s purposes, we should focus on implant procedure related, as this may have the most direct bearing on the schema we are using to classify, time points / ease of collection, and patient quality of lifeSee table below for a comprehensive complication description Al-Khatib 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.2010.1915","ISBN":"1538-3598 (Electronic)\\n0098-7484 (Linking)","ISSN":"0098-7484","PMID":"21205965","abstract":"Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symptoms or a recent diagnosis of heart failure.","author":[{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Jeptha","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mark","given":"Daniel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sanders","given":"Gillian D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2011"]]},"page":"43-49","title":"Non-evidence-based ICD implantations in the United States.","type":"article-journal","volume":"305"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴⁵","plainTextFormattedCitation":"245","previouslyFormattedCitation":"²⁴³"},"properties":{"noteIndex":0},"schema":""}245:Examined complications in evidence-based vs. non-evidence based ICD implantsComplications discussed:HematomaDeathPneumothoraxCardiac tamponadeDevice infectionRodriguez 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCEP.111.964270","ISBN":"1941-3084 (Electronic)\\r1941-3084 (Linking)","ISSN":"19413149","PMID":"22007037","abstract":"BACKGROUND: In the United States, patients aged >75 years are the most rapidly growing segment in the population, with an expected increase of 126% by 2050. These patients account for >70% of the pacemakers and up to two thirds of the implantable cardioverter-defibrillators implanted annually. Our aim was to explore the clinical outcomes of device complications in the octogenarian population.\\n\\nMETHODS AND RESULTS: We performed a retrospective chart review of 506 patients undergoing laser lead extraction from January 2004 to September 2009. This population was divided into the following 2 groups based solely on age: octogenarians and nonoctogenarians. These 2 groups were compared on the basis of several characteristics and clinical outcomes. There were 118 patients in the octogenarian group (78 men) and 388 in the nonoctogenarians group (301 men) aged 85±3.8 and 64.2±12.4 years, respectively. A total of 253 leads (atrial, 99; ventricular, 145; coronary sinus, 9) were removed from the patients in the octogenarian group, and 814 leads (atrial, 295; ventricular, 442; coronary sinus, 77) were removed from the patients in the nonoctogenarian group. The main indication for extraction for both groups was infection. The lead implant duration was 59.6±52.8 and 38.6±43.9 months for octogenarians and nonoctogenarians, respectively. There was no significant difference with respect to the proportion of minor (P=0.65), major (P=0.56), and total (P=0.50) complications.\\n\\nCONCLUSIONS: Laser lead extraction is demonstrated to be a safe and effective treatment method in octogenarian patients with multiple comorbidities.","author":[{"dropping-particle":"","family":"Rodriguez","given":"Yasser","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Garisto","given":"Juan D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Carrillo","given":"Roger G.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Arrhythmia and Electrophysiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2011"]]},"page":"719-723","title":"Laser lead extraction in the octogenarian patient","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴⁶","plainTextFormattedCitation":"246","previouslyFormattedCitation":"²⁴⁴"},"properties":{"noteIndex":0},"schema":""}246:Examined outcomes of laser lead extraction between octogenarians and non-octogenariansDiscussed:DeathBacteremiaPericardial tamponadeTompkins 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1540-8167.2011.02066.x","ISBN":"1045-3873","ISSN":"10453873","PMID":"21489029","abstract":"INTRODUCTION: Patients with chronic kidney disease (CKD) have increased morbidity following invasive procedures. We hypothesized that patients with CKD have higher complication rates following device implantation than patients with normal renal function.\\n\\nMETHODS: We reviewed the medical records of patients undergoing ICD or pacemaker implantation from August 2004 to August 2007. The estimated glomerular filtration rate (GFR) was calculated using the Cockroft-Gault equation. Those with GFR ≥ 90 cc/min served as controls. The remainder was grouped according to American Kidney Foundation stages of CKD. Bleeding complications were defined as need for pocket exploration or blood transfusion; cardiac tamponade; or hematoma requiring pressure dressing, change in medications or prolonged hospitalization. Infection was defined as infection of the pocket or lead system, or development of bacteremia/sepsis within 60 days.\\n\\nRESULTS: There were 82 bleeding complications (5.7%) and 7 infections (0.5%) temporally related to device implantation in 1,440 patients. End-stage renal disease (ESRD), defined as GFR < 15 mL/min or need for dialysis, was identified in 32 patients. Infection rates were significantly higher in patients with ESRD versus controls (12.5% vs 0.2%; P < 0.0001). A significant increase in bleeding complications was observed in ESRD versus controls (21.9% vs 3.2%, respectively; P<0.0001). Bleeding complications were considerably greater than controls in moderate (GFR 30-59 mL/min) and severe (GFR 15-29 mL/min) CKD (7.4% and 9.8% vs 3.2%, respectively; P < 0.005).\\n\\nCONCLUSION: ESRD markedly increases bleeding and device-related infections. The risk of both complications parallels the severity of CKD. Further research is needed to reduce adverse outcomes in this high-risk population.","author":[{"dropping-particle":"","family":"Tompkins","given":"Christine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McLean","given":"Rhondalyn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cheng","given":"Alan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brinker","given":"Jeffrey a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marine","given":"Joseph E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nazarian","given":"Saman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spragg","given":"David D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sinha","given":"Sunil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Halperin","given":"Henry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tomaselli","given":"Gordon F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Berger","given":"Ronald D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Calkins","given":"Hugh","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Henrikson","given":"Charles a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Electrophysiology","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2011"]]},"page":"1099-1104","title":"End-stage renal disease predicts complications in pacemaker and ICD implants","type":"article-journal","volume":"22"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴⁷","plainTextFormattedCitation":"247","previouslyFormattedCitation":"²⁴⁵"},"properties":{"noteIndex":0},"schema":""}247:This highlights that device implantation can be associated with severe complications, and that infection should be subdivided into major / moderate / minor at minimumvan Rees 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2011.06.007","ISBN":"1558-3597 (Electronic)\\r0735-1097 (Linking)","ISSN":"1558-3597","PMID":"21867832","abstract":"The number of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy (CRT) implantations is increasing drastically worldwide, and hence, the number of implanting centers is also increasing. Despite abundant data on the beneficial effect of these devices, little is known regarding safety and complication rates. Eleven ICD and 7 CRT trials were systematically reviewed to provide data on the frequency of in-hospital mortality and complications related to the implantation. Average in-hospital mortality was 2.7% in trials using both thoracotomy and nonthoracotomy ICDs, 0.2% in trials using nonthoracotomy ICDs, and 0.3% in CRT trials. The pneumothorax rate was similar between the nonthoracotomy ICD and CRT trials (0.9%) Coronary sinus complications occurred in 2.0% of patients undergoing CRT. Lead dislodgement rates were higher in CRT trials (5.7%) than in nonthoracotomy ICD trials (1.8%).","author":[{"dropping-particle":"","family":"Rees","given":"Johannes B","non-dropping-particle":"van","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bie","given":"Mihály K","non-dropping-particle":"de","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thijssen","given":"Joep","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Borleffs","given":"C Jan Willem","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schalij","given":"Martin J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Erven","given":"Lieselot","non-dropping-particle":"van","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2011"]]},"page":"995-1000","publisher":"Elsevier Inc.","title":"Implantation-related complications of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices a systematic review of randomized clinical trials.","type":"article-journal","volume":"58"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵¹","plainTextFormattedCitation":"251","previouslyFormattedCitation":"²⁴⁹"},"properties":{"noteIndex":0},"schema":""}251:A systematic review / meta-analysis of device complicationsThe incidences of the following complications were compiledPneumothorax, coronary vascular, bleeding / hematoma, and lead dislodgementThis paper did not discuss infection-related complicationsBogale 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfr158","ISBN":"1879-0844 (Electronic)\\r1388-9842 (Linking)","ISSN":"13889842","PMID":"22179034","abstract":"AIMS: The European CRT Survey is a joint initiative of the Heart Failure Association (HFA) and the European Heart Rhythm Association (EHRA) of the European Society of Cardiology evaluating the contemporary implantation practice of cardiac resynchronization therapy (CRT) in Europe.\\n\\nMETHODS AND RESULTS: Patients who had a successful CRT implantation were enrolled from 141 centres in 13 countries between November 2008 and June 2009. Baseline demographics, clinical and implantation data were collected, with a follow-up of ～1 year (9-15 months). The current report describes clinical outcomes including symptom severity, cardiovascular (CV) hospitalization, and survival. A total of 2438 patients were enrolled, and follow-up data were acquired from 2111 patients (87%). The population included important groups of patients poorly represented in randomized controlled trials, including very elderly patients and those with prior device implantation, atrial fibrillation, and/or QRS duration <120 ms. Investigators reported substantial improvement in New York Heart Association (NYHA) functional class at follow-up. Patient self-assessment indicated that 81% of the patients felt improved, 16% reported no change, and 4% reported deterioration. During follow-up, 207 (10%) patients died, 346 (16%) had a CV hospitalization, and 501 (24%) died or had CV hospitalization. Worse NYHA functional class, atrial fibrillation, ischaemic aetiology, and device type (CRT-P, i.e. CRT alone) were associated with poorer survival. Women had a better outcome, as did patients who had a CRT-D (with an implantable cardioverter defibrillator function) device.\\n\\nCONCLUSIONS: Outcomes including death and hospitalization in this European CRT survey were consistent with results from clinical trials of CRT. At 1 year follow-up, most patients who received a CRT device considered their symptoms improved compared with their pre-implant assessment. Although prospective, this is an observational study of successful CRT implantations, and outcomes in subgroup analyses must be interpreted with appropriate conservatism.","author":[{"dropping-particle":"","family":"Bogale","given":"Nigussie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Priori","given":"Silvia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cleland","given":"John G F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brugada","given":"Josep","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linde","given":"Cecilia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Auricchio","given":"Angelo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Veldhuisen","given":"Dirk J.","non-dropping-particle":"Van","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Limbourg","given":"Tobias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gitt","given":"Anselm","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gras","given":"Daniel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stellbrink","given":"Christoph","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gasparini","given":"Maurizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Derumeaux","given":"Geneviéve","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gadler","given":"Fredrik","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Buga","given":"Laszlo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2012"]]},"page":"61-73","title":"The European CRT Survey: 1 year (915 months) follow-up results","type":"article-journal","volume":"14"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴⁸","plainTextFormattedCitation":"248","previouslyFormattedCitation":"²⁴⁶"},"properties":{"noteIndex":0},"schema":""}248:Discussed the incidences of the following complications:Device-related, lead malposition / displacement, arrhythmias, device replacement, phrenic stimulation, infection.Peterson 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.2013.8641","ISSN":"1538-3598","PMID":"23942680","abstract":"IMPORTANCE The benefits of cardiac resynchronization therapy (CRT) in clinical trials were greater among patients with left bundle-branch block (LBBB) or longer QRS duration. OBJECTIVE To measure associations between QRS duration and morphology and outcomes among patients receiving a CRT defibrillator (CRT-D) in clinical practice. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of Medicare beneficiaries in the National Cardiovascular Data Registry's ICD Registry between 2006 and 2009 who underwent CRT-D implantation. Patients were stratified according to whether they were admitted for CRT-D implantation or for another reason, then categorized as having either LBBB or no LBBB and QRS duration of either 150 ms or greater or 120 to 149 ms. MAIN OUTCOMES AND MEASURES All-cause mortality; all-cause, cardiovascular, and heart failure readmission; and complications. Patients underwent follow-up for up to 3 years, with follow-up through December 2011. RESULTS Among 24 169 patients admitted for CRT-D implantation, 1-year and 3-year mortality rates were 9.2% and 25.9%, respectively. All-cause readmission rates were 10.2% at 30 days and 43.3% at 1 year. Both the unadjusted rate and adjusted risk of 3-year mortality were lowest among patients with LBBB and QRS duration of 150 ms or greater (20.9%), compared with LBBB and QRS duration of 120 to 149 ms (26.5%; adjusted hazard ratio [HR], 1.30 [99% CI, 1.18-1.42]), no LBBB and QRS duration of 150 ms or greater (30.7%; HR, 1.34 [99% CI, 1.20-1.49]), and no LBBB and QRS duration of 120 to 149 ms (32.3%; HR, 1.52 [99% CI, 1.38-1.67]). The unadjusted rate and adjusted risk of 1-year all-cause readmission were also lowest among patients with LBBB and QRS duration of 150 ms or greater (38.6%), compared with LBBB and QRS duration of 120 to 149 ms (44.8%; adjusted HR, 1.18 [99% CI, 1.10-1.26]), no LBBB and QRS duration of 150 ms or greater (45.7%; HR, 1.16 [99% CI, 1.08-1.26]), and no LBBB and QRS duration of 120 to 149 ms (49.6%; HR, 1.31 [99% CI, 1.23-1.40]). There were no observed associations with complications. CONCLUSIONS AND RELEVANCE Among fee-for-service Medicare beneficiaries undergoing CRT-D implantation in clinical practice, LBBB and QRS duration of 150 ms or greater, compared with LBBB and QRS duration less than 150 ms or no LBBB regardless of QRS duration, was associated with lower risk of all-cause mortality and of all-cause, cardiovascular, and heart failure readmissions.","author":[{"dropping-particle":"","family":"Peterson","given":"Pamela N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Qualls","given":"Laura G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Jeptha P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Stephen C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2013"]]},"page":"617-26","title":"QRS duration, bundle-branch block morphology, and outcomes among older patients with heart failure receiving cardiac resynchronization therapy.","type":"article-journal","volume":"310"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴⁹","plainTextFormattedCitation":"249","previouslyFormattedCitation":"²⁴⁷"},"properties":{"noteIndex":0},"schema":""}249:Discussed the following complications related to device implantation at 30 days, 90 days, and 3 years stratified by QRS widthDevice complication bottom line:Though many of these are rare, they are often associated with further interventions (chest drainage for pneumo/hemothorax) or major interventions (pericardial drainage or surgery for tamponade). Also, as shown above, infectious complications may range from minor only requiring oral antibiotics, to severe requiring device explant. Therefore, we propose a comprehensive but simplified scheme for considering device implantation related complications:InfectiousMajor implant infection requiring antibiotics and surgical explantModerate wound infection requiring antibiotics and local wound care measures Minor wound infection / cellulitis requiring antibiotics only Cardiac PerforationPerforation of anatomical component requiring aggressive intervention such as surgery or image-guided drain placementPneumothorax / hemothoraxRequiring chest drain placement and likely a short inpatient stayBleedingMajor bleed requiring explorationMinor bleed controlled locallyMinor bleed resulting in a hematomaDevice malfunctionMajor requiring explant or revisionSuch as lead fracture or generator failureMinor requiring follow-up appointment / reprogrammingSuch as inappropriate shocks or loss of captureDetailed complication assessmentComplication typeDefinition/questionsSourceTime pointsMedication: Adverse events and side-effectsD: Major adverse event related to heart failure medication, requiring hospitalization, or a major allergic reaction (immunologic) requiring medical treatment and discontinuation of the medication.Q: Did the patient have: a major adverse event (including major allergic reactions) requiring medical treatment, related to heart failure medication during this admission, and/or as a cause of this admission? Y/NPatient and clinician-reportedAt discharge following all hospital admissions related to heart failureHospitalization due to treatment: Nosocomial infectionD: Major nosocomial infection requiring IV antibiotic therapy and/or a prolonged hospital stay (14 days or more).Q: Did the patient have a major nosocomial infection (requiring IV antibiotics and/or prolonged hospital stay – 14 days or more) during this admission? Y/NPatient and clinician-reportedAt discharge following all hospital admissions related to heart failureDeviceD: A major device complication requiring intervention.Q: Did the patient have any of the following complications related to a device for Heart Failure during or related to this admission or appointment: active bleeding requiring exploration and/or transfusion, abscess related to the device, minor infection (localized, treated with antibiotics and surgical drainage) related to the device, major infection (systemic, requiring device explant) related to the device, minor malfunction (requiring follow-up appointment/reprogramming), inappropriate shocks, and/or major malfunction (requiring explant or revision)? Y/NPatient and clinician-reported At discharge following all hospital admissions related to heart failureD: Definition; Q: Questions to ask; Y/N: Yes/no responsesS7: Registry-based evidence for proposed case-mix variables and accompanying definitionsNotes:Arranged by variable, with supporting evidence followingA summative “bottom line” at the end of each variable section highlighting the relevant findingsStandard medical and statistical abbreviations used throughout (LV, OR, etc.)All references to odds /risk of comorbidity and/or treatment refer to patients with heart failure. In papers that report both unadjusted and adjusted results, adjusted results were favouredAGEADHEREYancy 2006ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2005.09.022","ISSN":"07351097","PMID":"16386668","abstract":"OBJECTIVES: The aims of this analysis were to describe the clinical characteristics, management, and outcomes of patients hospitalized for acute decompensated heart failure (HF) with preserved systolic function (PSF). BACKGROUND: Clinically meaningful characteristics of these patients have not been fully studied in a large database. METHODS: Data from >100,000 hospitalizations from the Acute Decompensated Heart Failure National Registry (ADHERE) database were analyzed. RESULTS: Heart failure with PSF was present in 50.4% of patients with in-hospital assessment of left ventricular function. When compared with patients with systolic dysfunction, patients with PSF were more likely to be older, women, and hypertensive and less likely to have had a prior myocardial infarction or be receiving an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. In-hospital mortality was lower in patients with PSF compared with patients with systolic dysfunction (2.8% vs. 3.9%; adjusted odds ratio [OR]: 0.86; p = 0.005), but duration of intensive care unit stay and total hospital length of stay were similar. Serum creatinine >2 mg/dl was associated with increased in-hospital mortality in both systolic function groups (PSF: 4.8%; systolic dysfunction: 8.4%; p < 0.0001), and the most powerful predictors of in-hospital mortality in both groups were blood urea nitrogen >37 mg/dl (OR: 2.53; 95% confidence interval [CI]: 2.22 to 2.87) and systolic blood pressure ≤125 mm Hg (OR: 2.58; 95% CI: 2.33 to 2.86). CONCLUSIONS: Heart failure with PSF is common and is characterized by a unique patient profile. Event rates are worrisome and reflect a need for more effective management strategies. ? 2006 by the American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stevenson","given":"Lynne Warner","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marco","given":"Teresa","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2006"]]},"page":"76-84","title":"Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) database","type":"article-journal","volume":"47"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰","plainTextFormattedCitation":"10","previouslyFormattedCitation":"¹⁰"},"properties":{"noteIndex":0},"schema":""}10:Age >73 conferred an adjusted OR for in-hospital mortality ranging from:1.76 (1.58 – 1.96) – LV function assessed2.13 (1.92 – 2.36) – No LV function assessedADHERE-IntWest 2011ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfr064","ISBN":"1879-0844","ISSN":"13889842","PMID":"21712289","abstract":"To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF).","author":[{"dropping-particle":"","family":"West","given":"Ryenn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kociol","given":"Robb","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oconnor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2011"]]},"page":"945-952","title":"Characterization of heart failure patients with preserved ejection fraction: A comparison between ADHERE-US registry and ADHERE-International registry","type":"article-journal","volume":"13"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁸","plainTextFormattedCitation":"28","previouslyFormattedCitation":"²⁸"},"properties":{"noteIndex":0},"schema":""}28:A 1 year age increase conferred an adjusted HR for in-hospital mortality of 1.02 (1.01 – 1.04)AHEADSpinar 2011ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/cc10584","ISBN":"0195-668X","ISSN":"1364-8535","PMID":"22152228","abstract":"INTRODUCTION: The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.\\n\\nMETHODS: The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.\\n\\nRESULTS: Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.\\n\\nCONCLUSIONS: The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.","author":[{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmír","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarová","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Critical Care","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2011"]]},"page":"R291","publisher":"BioMed Central Ltd","title":"Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁴","plainTextFormattedCitation":"34","previouslyFormattedCitation":"³⁴"},"properties":{"noteIndex":0},"schema":""}34: In patients in acute heart failure without cardiogenic shock, age >70 conferred an adjusted OR for in-hospital mortality of 2.7 (1.7 – 4.1) COHEREFranciosa 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1527-5299.2006.05804.x","ISSN":"1527-5299","abstract":"Women and the elderly are underrepresented in clinical trials of heart failure (HF). The authors analyzed, by sex and age groups, a registry of 4280 community patients initiating carvedilol for HF. Women (n=1485) were older than men (n=2793) and had worse functional class with higher left ventricular ejection fraction and blood pressure. Women also had more HF hospitalizations, less use of angiotensin-converting enzyme inhibitors, and lower doses of carvedilol. Nevertheless, during 1-year follow-up, both groups experienced greater than 40% reductions in HF hospitalizations (P<.001), with mortality of 7.3% in women vs 9.1% in men (P=.085). With increasing age, left ventricular ejection fraction, blood pressure, and functional class increased, whereas angiotensin-converting enzyme inhibitor use and carvedilol doses decreased. HF hospitalizations fell at least 40% in all age groups after starting carvedilol (P<.001). Characteristics of women and the elderly with HF in the community suggest increased risk, but both populations respond well after initiating carvedilol.","author":[{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2006"]]},"page":"317-323","title":"Heart Failure in Community Practice: Relationship to Age and Sex in a Beta-Blocker Registry","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁵","plainTextFormattedCitation":"65","previouslyFormattedCitation":"⁶³"},"properties":{"noteIndex":0},"schema":""}65:NYHA status was inversely proportional to ageIncreased all cause mortality at 6 months & 1 year for <65 vs. ≥65 (p<0.0001)Trend of increasing mortality with age group (<55, 55-64, 65-75, >75), p<0.0001 Greenberg 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2006.06.050","ISSN":"00029149","PMID":"17126654","abstract":"Risk factors for outcomes in heart failure (HF) were derived from populations in clinical trials, at hospital discharge, or in localized geographic or socioeconomic strata before the widespread use of beta blockers. This study observed 4,280 patients in a community-based HF registry for 1 year after completing carvedilol titration. Independent risk factors for death, hospitalization for HF, or hospitalization for cardiovascular reasons other than HF were first identified by age-, gender-, and race-adjusted analyses, then by multivariate analysis adjusted simultaneously for all factors. Over this period, 7% of patients died, 11% were hospitalized for HF, 12% were hospitalized for other cardiovascular reasons, and 27% had > or =1 of these events. The most significant outcome predictors were New York Heart Association class III or IV, history of hospitalization for HF or other cardiovascular reasons, and angina pectoris, all associated with increased odds of having an adverse outcome (all p < or =0.001). The left ventricular ejection fraction was not a significant outcome predictor by multivariate analysis. The odds ratio for an adverse outcome was significantly reduced for patients with hypertensive or idiopathic causes of HF and for those whose physicians had graduated from medical school > or =24 years earlier compared with <14 years earlier (all p <0.005). In conclusion, easily obtained historical information predicts clinical outcomes in patients with HF in the year after initiating carvedilol. In this unselected community population, these historical factors were better predictors of risk than the left ventricular ejection fraction.","author":[{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2006"]]},"page":"1480-1484","title":"Predictors of clinical outcomes in patients given carvedilol for heart failure.","type":"article-journal","volume":"98"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁴","plainTextFormattedCitation":"64","previouslyFormattedCitation":"⁶²"},"properties":{"noteIndex":0},"schema":""}64:Age (unit not specified) conferred an adjusted OR of 1.007 (1.0 – 1.014) for adverse clinical outcomes All cause mortality, heart failure hospitalization, cardiovascular non-heart failure hospitalizationEHFS IIHarjola 2010 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfq002","ISSN":"1879-0844","PMID":"20156940","abstract":"Acute heart failure (AHF) has a poor prognosis. We evaluated 3- and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II.","author":[{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2010"]]},"page":"239-248","title":"Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure.","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁵","plainTextFormattedCitation":"75","previouslyFormattedCitation":"⁷³"},"properties":{"noteIndex":0},"schema":""}75: A 10 year age increase conferred and adjusted HR for mortality of:1.32 (1.17 – 1.5) from discharge to 3 months1.31 (1.17 – 1.48) from 3 to 12 monthsESC-HFMaggioni 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hft050","ISBN":"1879-0844","ISSN":"13889842","PMID":"23537547","abstract":"AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.\\n\\nMETHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.\\n\\nCONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.","author":[{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Leiro","given":"Marisa Crespo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drozdz","given":"Jaroslaw","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fruhwald","given":"Friedrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gullestad","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Logeart","given":"Damien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fabbri","given":"Gianna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Persson","given":"Hans","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rauchhaus","given":"Mathias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nielsen","given":"Olav Wendelboe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2013"]]},"page":"808-817","title":"EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁸","plainTextFormattedCitation":"78","previouslyFormattedCitation":"⁷⁶"},"properties":{"noteIndex":0},"schema":""}78: A 1 year age increase conferred an adjusted HR for 1 year all cause mortality of:1.03 (1.02 – 1.04) for acute heart failure1.04 (1.03 – 1.05) for chronic heart failure GWTG-HFHernandez 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.298.13.1525","ISSN":"1538-3598","PMID":"17911497","abstract":"CONTEXT: Practice guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for patients with heart failure and left ventricular ejection fraction of 30% or less. The influence of sex and race on ICD use among eligible patients is unknown. OBJECTIVE: To examine sex and racial differences in the use of ICD therapy. DESIGN, SETTING, AND PATIENTS: Observational analysis of 13,034 patients admitted with heart failure and left ventricular ejection fraction of 30% or less and discharged alive from hospitals in the American Heart Association's Get With the Guidelines-Heart Failure quality-improvement program. Patients were treated between January 2005 and June 2007 at 217 participating hospitals. MAIN OUTCOME MEASURES: Use of ICD therapy or planned ICD therapy at discharge. RESULTS: Among patients eligible for ICD therapy, 4615 (35.4%) had ICD therapy at discharge (1614 with new ICDs, 527 with planned ICDs, and 2474 with prior ICDs). ICDs were used in 375 of 1329 eligible black women (28.2%), 754 of 2531 white women (29.8%), 660 of 1977 black men (33.4%), and 2356 of 5403 white men (43.6%) (P < .001). After adjustment for patient characteristics and hospital factors, the adjusted odds of ICD use were 0.73 (95% confidence interval, 0.60-0.88) for black men, 0.62 (95% confidence interval, 0.56-0.68) for white women, and 0.56 (95% confidence interval, 0.44-0.71) for black women, compared with white men. The differences were not attributable to the proportions of women and black patients at participating hospitals or to differences in the reporting of left ventricular ejection fraction. CONCLUSIONS: Less than 40% of potentially eligible patients hospitalized for heart failure received ICD therapy, and rates of use were lower among eligible women and black patients than among white men.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-1","issue":"13","issued":{"date-parts":[["2007"]]},"page":"1525-1532","title":"Sex and racial differences in the use of implantable cardioverter-defibrillators among patients hospitalized with heart failure.","type":"article-journal","volume":"298"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸¹","plainTextFormattedCitation":"81","previouslyFormattedCitation":"⁷⁹"},"properties":{"noteIndex":0},"schema":""}81:For a 10 year age increase:Adjusted OR for ICD (placed or planned) – 2 models0.83 (0.80-0.86)0.81 (0.78-0.84)Forman 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2009.03.010","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"19464411","abstract":"Background Heart failure (HF) is common among elderly adults. Although multiple studies demonstrate age-related declines in the utilization of evidence-based therapies for coronary artery disease, there are few analyses of HF patients to distinguish possible age-related management differences. Methods We analyzed 57,937 HF admissions from January 2005 through April 2007 in 257 hospitals participating in the American Heart Association's Get With The Guidelines-Heart Failure program. Patient characteristics and management were stratified by age groups =65, 66-75, 76-85, and >85 years. Multivariable regression analyses were used to assess the influence of age on use of therapies and inhospital mortality. Results The mean patient age was 73 ± 14 years; 18.7% were >85 years of age. Prescriptions of most HF therapies were relatively reduced with age but still remained high overall. Although 88.6% of patients ≤65 years of age with left ventricular systolic dysfunction were prescribed angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and 90.9% were prescribed ?-blockers, among those >85 years of age with left ventricular systolic dysfunction, 79% were prescribed angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and 82.7% were prescribed ?-blockers. Regression analysis that accounted for typical confounders demonstrated that older age was associated with diminished utilization of most evidence-based treatment measures as well as increased mortality. Conclusions Get With The Guidelines-Heart Failure data demonstrate that guidelines recommended therapies are frequently utilized for older patients with HF, including patients >85 years old. Nonetheless, age-related differences in therapy persist, suggesting that opportunities to improve care still remain. ? 2009, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Forman","given":"Daniel E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cannon","given":"Christopher P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2009"]]},"page":"1010-1017","publisher":"Mosby, Inc.","title":"Influence of age on the management of heart failure: Findings from Get with the Guidelines-Heart Failure (GWTG-HF)","type":"article-journal","volume":"157"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁰","plainTextFormattedCitation":"90","previouslyFormattedCitation":"⁸⁸"},"properties":{"noteIndex":0},"schema":""}90:More likely to meet GWTG evidence-based recommendations if youngerPiccini 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCULATIONAHA.108.773838","ISSN":"00097322","PMID":"18697821","abstract":"BACKGROUND: The frequency and characterization of patients receiving cardiac resynchronization therapy (CRT) are largely unknown since the publication of pivotal clinical trials and subsequent incorporation of CRT into the American College of Cardiology/American Heart Association guidelines for heart failure. METHODS AND RESULTS: We analyzed 33,898 patients admitted from January 2005 through September 2007 to 228 hospitals participating in the American Heart Association's Get With the Guidelines-Heart Failure program. There were 4201 patients (12.4%) discharged alive with CRT, including 811 new implants. Patients discharged with CRT were older (median age, 75 versus 72 years) and had lower median left ventricular ejection fraction (30% versus 38%), more frequent ischemic cardiomyopathy (58% versus 45%), more history of atrial fibrillation (38% versus 27%), and higher rates of beta-blocker and aldosterone antagonist use (P<0.0001 for all) than those without CRT. We found that 4.8% of patients with left ventricular ejection fraction <or=35% were discharged with a new CRT implant, which varied greatly by hospital. Ten percent of patients discharged with a new CRT implant had a left ventricular ejection fraction >35%. Major factors associated with lower rates of new CRT placement were treatment in the northeast (odds ratio, 0.40; 95% confidence interval, 0.30 to 0.53), black race (odds ratio, 0.45; 95% confidence interval, 0.36 to 0.57), increasing left ventricular ejection fraction per 10% (odds ratio, 0.56; 95% confidence interval, 0.52 to 0.60), and increasing age per 10 years in those >70 years of age (odds ratio, 0.56; 95% confidence interval, 0.48 to 0.65). CONCLUSIONS: Although CRT is a recent evidence-based therapy for heart failure, patterns of use differ significantly from clinical trials and published guidelines. Important variations also exist for CRT therapy based on race, geographic region, comorbidities, and age and need to be addressed through further study and/or quality-of-care initiatives.","author":[{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thomas","given":"Kevin L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lewis","given":"William R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2008"]]},"page":"926-933","title":"Use of cardiac resynchronization therapy in patients hospitalized with heart failure","type":"article-journal","volume":"118"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁵","plainTextFormattedCitation":"85","previouslyFormattedCitation":"⁸³"},"properties":{"noteIndex":0},"schema":""}85:For a 10 year increase in age:If <75 more likely to get CRT if indicated (adjusted OR 1.26 (1.20 – 1.31)If <75 more likely to get a new CRT placed (adjusted OR 1.44 (1.28 – 1.60)If >75 less likely to get new CRT placed (adjusted OR 0.56 (0.48 – 0.65)Ambardekar 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2009.07.034","ISSN":"00028703","PMID":"19781426","abstract":"Background: Medication and dietary nonadherence are precipitating factors for heart failure (HF) hospitalization; however, the characteristics, outcomes, and quality of care of patients with nonadherence are unknown. Recognizing features of nonadherent patients may provide a means to reduce rehospitalization for this population. Methods: GWTG-HF registry data were collected from 236 hospitals and 54,322 patients from January 1, 2005 to December 30, 2007. Demographics, clinical characteristics, in-hospital outcomes, and quality of care were stratified by precipitating factor for HF admission. Multivariate logistic regression analysis was used to determine the association of nonadherence with length of stay (LOS) and in-hospital mortality. Results: Clinicians documented dietary and/or medication nonadherence as the reason for admission in 5576 (10.3%) of HF hospitalizations. Nonadherent patients were younger and more likely to be male, minority, uninsured, and have nonischemic HF. These patients had lower ejection fractions (34.9% vs 39.6%, P < .0001), more frequent previous HF hospitalizations, higher brain natriuretic peptide levels (1813 vs 1371 pg/mL, P < .0001), and presented with greater signs of congestion. Despite this, nonadherent patients had shorter LOS (odds ratio 0.94, 95% CI 0.92-0.97) and lower in-hospital mortality (odds ratio 0.65, 95% CI 0.51-0.83) in multivariate analysis. Although nonadherent patients received high rates of Joint Commission core measures, rates of other evidence-based treatments were less optimal. Conclusions: Nonadherence is a common precipitant for HF admission. Despite a higher risk profile, nonadherent patients had lower in-hospital mortality and LOS, suggesting that it may be easier to stabilize nonadherent patients by reinstituting sodium and/or fluid restriction and resuming medical therapy. ? 2009 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pan","given":"Wenqin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2009"]]},"page":"644-652","publisher":"Mosby, Inc.","title":"Characteristics and in-hospital outcomes for nonadherent patients with heart failure: Findings from Get With The Guidelines-Heart Failure (GWTG-HF)","type":"article-journal","volume":"158"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁸","plainTextFormattedCitation":"88","previouslyFormattedCitation":"⁸⁶"},"properties":{"noteIndex":0},"schema":""}88:A 1 year decrease in age was associated with therapy non-adherence (medical and dietary)Adjusted OR 1.022 (1.019 – 1.026)Allen 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁰","plainTextFormattedCitation":"100","previouslyFormattedCitation":"⁹⁸"},"properties":{"noteIndex":0},"schema":""}100:A 10 year increase in age was associated with increased odds of discharge to a skilled nursing facilityAdjusted OR 1.98 (1.82 – 2.15)Whellan 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2011.04.005","ISBN":"1532-8414 (Electronic)\\r1071-9164 (Linking)","ISSN":"10719164","PMID":"21807326","abstract":"Background: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. Methods and Results: A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With The Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r 2 of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation. Conclusions: Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2011"]]},"page":"649-656","publisher":"Elsevier Inc","title":"Predictors of hospital length of stay in heart failure: Findings from get with the guidelines","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁵","plainTextFormattedCitation":"95","previouslyFormattedCitation":"⁹³"},"properties":{"noteIndex":0},"schema":""}95:For a 10 year age increase, the odds of a length of stay beyond 4-6 days was1.01 (1.00 – 1.02) adjusted for patient characteristicsNon-significant when further adjusted for patient / hospital characteristics and labs 1.00 (0.99 – 1.01)However, this was heavily adjusted with an exceptional amount of adjustment variables, so the results may well be spurious and due to multiple testingHeidenreich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCOUTCOMES.110.959122","ISSN":"19417713","PMID":"22235067","abstract":"BACKGROUND: Hospitals enrolled in the American Heart Association's Get With The Guidelines Program for heart failure (GWTG-HF) have improved their process of care. However, it is unclear if process of care and outcomes are better in the GWTG-HF hospitals compared with hospitals not enrolled. METHODS AND RESULTS: We compared hospitals enrolled in GWTG-HF from 2006 to 2007 with other hospitals using data on 4 process of heart failure care measures, 5 noncardiac process measures, risk-adjusted 30-day mortality, and 30-day all-cause readmission after a heart failure hospitalization, as reported by the Center for Medicare and Medicaid Services (CMS). Among the 4460 hospitals reporting data to CMS, 215 (5%) were enrolled in GWTG-HF. Of the 4 CMS heart failure performance measures, GWTG-HF hospitals had significantly higher documentation of the left ventricular ejection fraction (93.4% versus 88.8%), use of angiotensin-converting enzyme inhibitor or angiotensin receptor antagonist (88.3% versus 86.6%), and discharge instructions (74.9% versus 70.5%) (P<0.005 for all). Smoking cessation counseling rates were similar (94.1% versus 94.0%; P=0.51). There was no significant difference in compliance with noncardiac process of care. After heart failure discharge, all-cause readmission at 30 days was 24.5% and mortality at 30 days after admission was 11.1%. After adjustment for hospital characteristics, 30-day mortality rates were no different (P=0.45). However, 30-day readmission was lower for GWTG hospitals (-0.33%; 95% CI, -0.53% to -0.12%; P=0.002). CONCLUSIONS: Although there was evidence that hospitals enrolled in the GTWG-HF program demonstrated better processes of care than other hospitals, there were few clinically important differences in outcomes. Further identification of opportunities to improve outcomes, and inclusion of these metrics in GTWG-HF, may further support the value of GTWG-HF in improving care for patients with HF.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Cardiovascular Quality and Outcomes","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2012"]]},"page":"37-43","title":"Get with the guidelines program participation, process of care, and outcome for medicare patients hospitalized with heart failure","type":"article-journal","volume":"5"},"uris":[""]}],"mendeley":{"formattedCitation":"¹¹⁰","plainTextFormattedCitation":"110","previouslyFormattedCitation":"¹⁰⁸"},"properties":{"noteIndex":0},"schema":""}110:A 10 year age increase was associated with lower adjusted odds of meeting certain quality / evidence based indicators:EF documentation – 0.90 (0.87 – 0.92)ACEI/ARB at discharge if indicated – 0.92 (0.88 – 0.95)Smoking cessation counselling – 0.90 (0.84 – 0.97)Whellan 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2012.02.006","ISSN":"10719164","PMID":"22633304","abstract":"Background: Guidelines recommend hospice care as a treatment option for end-stage heart failure (HF) patients. Little is known regarding utilization of hospice care in a contemporary cohort of patients hospitalized with HF and how this may vary by estimated mortality risk. Methods: We analyzed HF patients ≥65 years (n = 58,330) from 214 hospitals participating in the Get With the Guidelines-HF program. Univariate analysis comparing patients discharged to hospice versus other patients was performed. Hospice utilization was evaluated for deciles of estimated 90-day mortality risk using a validated model. Multivariate analysis using admission patient and hospital characteristics was also performed to determine factors associated with hospice discharge. Results: There were 1,442 patients discharged to hospice, and rates of referral varied widely by hospital (interquartile range 0-3.7%) as shown in the univariate analysis. Patients discharged to hospice were significantly older and more often white, had lower left ventricular ejection fraction, higher B-type natriuretic peptide, and lower systolic blood pressure on admission. Utilization rates for each decile of 90-day estimated mortality risk ranged from 0.3% to 8.6%. Multivariable analysis found that factors associated with hospice utilization included increased age, low systolic blood pressure on admission, and increased blood urea nitrogen. Conclusions: Hospice utilization remains low among HF patients, even those with the highest predicted risk of death. ? 2012 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2012"]]},"page":"471-477","publisher":"Elsevier Inc","title":"Utilization of hospice and predicted mortality risk among older patients hospitalized with heart failure: Findings from GWTG-HF","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁸","plainTextFormattedCitation":"108","previouslyFormattedCitation":"¹⁰⁶"},"properties":{"noteIndex":0},"schema":""}108:10 year age increase associated with discharge to hospiceAdjusted OR 1.86 (1.74 – 2.00)Hess 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/jce.12100","ISSN":"10453873","PMID":"23437793","abstract":"INTRODUCTION: Practice guidelines recommend the use of ICDs in patients with heart failure (HF) and a left ventricular ejection fraction (LVEF) of ≤ 35% in the absence of contraindications. METHODS AND RESULTS: We performed an analysis of ICD use among patients admitted with HF with LVEF of ≤ 35% and discharged alive from 251 hospitals participating in the American Heart Association's Get With The Guidelines-HF Program between January 2005 and September 2011. Among 35,772 guideline-eligible patients, 17,639 received an ICD prior to hospitalization (10,886), during hospitalization (4,876), or were discharged with plans to undergo ICD placement after hospitalization (1,877). After adjustment, increasing age was associated with lower ICD use (odds ratio [OR] 0.89, 95% confidence interval [CI] 0.87-0.91 per 5-year increase in age, P < 0.0001). Compared with patient age < 55 years, older age groups ≥ 65 years were less likely to receive an ICD (P < 0.003). Compared with men in the same age group, women were significantly less likely to receive an ICD; this difference was more marked with increasing age (P value for interaction = 0.006). There was a temporal increase in ICD use (adjusted OR 1.23, 95% CI 1.15-1.31 of ICD use per year) that was similar in each age group (P value for interaction = 0.665). CONCLUSIONS: Eligible older HF patients age ≥ 65 years were significantly less likely to receive an ICD. With increasing age, women were less likely to receive an ICD than men. ICD use significantly increased over time in all age groups; however, age-related differences in ICD use persisted.","author":[{"dropping-particle":"","family":"Hess","given":"Paul L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Electrophysiology","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2013"]]},"page":"664-671","title":"Age differences in the use of implantable cardioverter-defibrillators among older patients hospitalized with heart failure","type":"article-journal","volume":"24"},"uris":[""]}],"mendeley":{"formattedCitation":"¹¹⁶","plainTextFormattedCitation":"116","previouslyFormattedCitation":"¹¹⁴"},"properties":{"noteIndex":0},"schema":""}116:≥65 years lower adjusted odds of getting ICD if indicated65-74: 0.85 (0.76 – 0.95)75-84: 0.63 (0.56 – 0.72)≥85: 0.28 (0.24 – 0.34)HIJC-HFKawashiro 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1346-9843","PMID":"18931450","abstract":"BACKGROUND: Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.","author":[{"dropping-particle":"","family":"Kawashiro","given":"Naomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogawa","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsuda","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"Nobuhisa","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2008"]]},"page":"2015-2020","title":"Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry.","type":"article-journal","volume":"72"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³⁵","plainTextFormattedCitation":"135","previouslyFormattedCitation":"¹³³"},"properties":{"noteIndex":0},"schema":""}135:Age >70 conferred and adjusted HR for All cause mortality: 1.71 (1.38 – 2.12)Cardiac mortality: 1.76 (1.30 – 2.38)IMPACT-HFO’Connor 2005 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2004.08.160","ISBN":"1071-9164","ISSN":"10719164","PMID":"15812748","abstract":"Background: Hospitalizations for decompensated heart failure are frequent. The Initiation Management Pre-discharge Assessment of Carvedilol Heart Failure (IMPACT-HF) registry collected observational data in patients hospitalized for worsening heart failure to characterize an unselected group of patients and to confirm the generalizability of the IMPACT-HF main trial population. Methods and Results: The IMPACT-HF registry was conducted concurrently with the IMPACT-HF study, a randomized trial of in-hospital initiation of carvedilol compared with the standard practice of postdischarge β-blocker initiation. Patients were eligible for registry enrollment if they were hospitalized for heart failure regardless of ejection fraction. There were no exclusions to participation. Patients were followed for 60 days. The IMPACT-HF Registry enrolled 567 patients. The mean age was 71 years, 52% of the patients were men and 82% were Caucasian. At discharge, 71% received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 41% received digoxin, and 62% received β-blockers. The 60-day rate of rehospitalization or death was 31%. Conclusion: The IMPACT-HF registry enrolled elderly patients admitted for worsening heart failure primarily resulting from progressive volume overload. The 60-day rate of death or rehospitalization was high despite the use of evidence-based therapies. New treatments for this population are needed to decrease the morbidity and mortality associated with decompensated heart failure. ? 2005 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gallup","given":"Dianne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hasselblad","given":"Vic","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2005"]]},"page":"200-205","title":"Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: Observations from the IMPACT-HF registry","type":"article-journal","volume":"11"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁴⁰","plainTextFormattedCitation":"140","previouslyFormattedCitation":"¹³⁸"},"properties":{"noteIndex":0},"schema":""}140: 10 year age increase was associated with an adjusted OR for 60 day mortality or readmission of 1.26 (1.11 – 1.44)IMPROVE-HFYancy 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2008.12.016","ISSN":"00028703","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2009"]]},"page":"754-762.e2","publisher":"Mosby, Inc.","title":"Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: Findings from IMPROVE HF","type":"article-journal","volume":"157"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁴²","plainTextFormattedCitation":"142","previouslyFormattedCitation":"¹⁴⁰"},"properties":{"noteIndex":0},"schema":""}142: Oldest tertile of age consistently less likely to receive current recommended therapy10 year age increase had consistent 10 – 15% decreases in odds of receiving evidence based therapyACEI/ARB, beta-blocker, aldosterone antagonist, ICD/CRT, and heart failure educationIN-HFOliva 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfs117","ISBN":"1388-9842\\r1879-0844","ISSN":"13889842","PMID":"22833614","abstract":"AIMS: Registries and surveys improve knowledge of the 'real world'. This paper aims to describe baseline clinical profiles, management strategies, and the in-hospital outcome of patients admitted to hospital for an acute heart failure (AHF) episode.\\n\\nMETHODS AND RESULTS: IN-HF Outcome is a nationwide, prospective, multicentre, observational study conducted in 61 Cardiology Centres in Italy. Up to December 2009, 5610 patients had been enrolled, 1855 (33%) with AHF and 3755 (67%) with chronic heart failure (CHF). Baseline and in-hospital outcome data of AHF patients are presented. Mean age was 72 ± 12 years, and 39.8% were female. Hospital admission was due to new-onset heart failure (HF) in 43% of cases. Co-morbid conditions were observed more frequently in the worsening HF group, while those with de novo HF showed a higher heart rate, blood pressure, and more preserved left ventricular ejection fraction (LVEF). Electrical devices were previously implanted in 13.3% of the entire group. Inotropes were administered in 19.4% of the patients. The median duration of hospital stay was 10 days (interquartile range 7-15). All-cause in-hospital death was 6.4%, similar in worsening and de novo HF. Older age, hypotension, cardiogenic shock, pulmonary oedema, symptoms of hypoperfusion, hyponatraemia, and elevated creatinine were independent predictors of all-cause death.\\n\\nCONCLUSION: Our registry confirms that in-hospital mortality in AHF is still high, with a long length of stay. Pharmacological treatment seems to be practically unchanged in the last decades, and the adherence to HF guidelines concerning implantable cardioverter defibrillators/cardiac resynchronization therapy is still very low. Some AHF phenotypes are characterized by worst prognosis and need specific research projects.","author":[{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cacciatore","given":"Giuseppe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chinaglia","given":"Alessandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2012"]]},"page":"1208-1217","title":"Acute heart failure patient profiles, management and in-hospital outcome: Results of the Italian Registry on Heart Failure Outcome","type":"article-journal","volume":"14"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵⁴","plainTextFormattedCitation":"154","previouslyFormattedCitation":"¹⁵²"},"properties":{"noteIndex":0},"schema":""}154: All cause in hospital mortality increased with age2.8% at 60 years to 12.7% at ≥80 years (p=0.0001 for trend)Tavazzi 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.112.000161","ISSN":"19413289","PMID":"23476054","abstract":"BACKGROUND: Clinical observational studies on heart failure (HF) deal mostly with hospitalized patients, few with chronic outpatients, all with no or limited longitudinal observation. METHODS AND RESULTS: This is a multicenter, nationwide, prospective observational trial on a population of 5610 patients, 1855 hospitalized for acute HF (AHF) and 3755 outpatients with chronic HF (CHF), followed up for 1 year. The cumulative total mortality rate at 1 year was 24% in AHF (19.2% in 797 patients with de novo HF and 27.7% in 1058 with worsening HF) and 5.9% in CHF. Cardiovascular deaths accounted for 73.1% and 65.3% and HF deaths for 42.4% and 40.5% of total deaths in AHF and CHF patients, respectively. One-year hospitalization rates were 30.7% in AHF and 22.7% in CHF patients. Among the independent predictors of 1-year all-cause death, age, low systolic blood pressure, anemia, and renal dysfunction were identified in both acute and chronic patients. A few additional variables were significant only in AHF (signs of cerebral hypoperfusion, low serum sodium, chronic obstructive pulmonary disease, and acute pulmonary edema), whereas others were observed only in CHF patients (lower body mass index, higher heart rate, New York Heart Association class, large QRS, and severe mitral regurgitation). CONCLUSIONS: In this contemporary data set, patients with CHF had a relatively low mortality rate compared with those with AHF. Rates of adverse outcomes in patients admitted for AHF remain very high either in-hospital or after discharge. Most deaths were cardiovascular in origin and ≈40% of deaths were directly related to HF.","author":[{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cacciatore","given":"Giuseppe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chinaglia","given":"Alessandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"Di","family":"Lenarda","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2013"]]},"page":"473-481","title":"Multicenter prospective observational study on acute and chronic heart failure one-year follow-up results of in-hf (italian network on heart failure) outcome registry","type":"article-journal","volume":"6"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵⁶","plainTextFormattedCitation":"156","previouslyFormattedCitation":"¹⁵⁴"},"properties":{"noteIndex":0},"schema":""}156:5 year age increase conferred an adjusted HR for 1 year all cause mortality of 1.2 (1.14 – 1.27) – Acute HF1.18 (1.09-1.28) – Chronic HFMortara 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.healun.2014.05.015","ISSN":"10532498","author":[{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Carbonieri","given":"Emanuele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Midi","given":"Paolo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Journal of Heart and Lung Transplantation","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2014"]]},"page":"1056-1065","publisher":"Elsevier","title":"Treatment with inotropes and related prognosis in acute heart failure: Contemporary data from the Italian Network on Heart Failure (IN-HF) Outcome registry","type":"article-journal","volume":"33"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵⁷","plainTextFormattedCitation":"157","previouslyFormattedCitation":"¹⁵⁵"},"properties":{"noteIndex":0},"schema":""}157:1 year age increase increased odds of all cause in hospital mortalityAdjusted OR 1.08 (1.06-1.11)KorHFChoi 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4070/kcj.2011.41.7.363","ISSN":"1738-5520","PMID":"21860637","abstract":"BACKGROUND AND OBJECTIVES: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea.\\n\\nSUBJECTS AND METHODS: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6±14.3 years and 50% of the patients were female.\\n\\nRESULTS: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5±15.7% and 26.1% of the patients had preserved systolic function (LVEF ≥50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death.\\n\\nCONCLUSION: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.","author":[{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shin","given":"Mi-Seung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Seong","given":"In-Whan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahn","given":"Youngkeun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Yung-Jo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Hyung Seop","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Korean Circulation Journal","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2011"]]},"page":"363","title":"Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry","type":"article","volume":"41"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁷⁷","plainTextFormattedCitation":"177","previouslyFormattedCitation":"¹⁷⁵"},"properties":{"noteIndex":0},"schema":""}177:Age (units not specified) conferred an increased HR for all cause mortality of 1.023 (1.004-1.042)OPTIMIZE-HFO’Connor 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2008.04.030","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"18926148","abstract":"Background: Patients with heart failure (HF) are at high risk for mortality and rehospitalization in the early period after hospital discharge. We developed clinical models predictive of short-term clinical outcomes in a broad patient population discharged after hospitalization for HF. Methods: The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry is a comprehensive hospital-based registry and performance-improvement program for patients hospitalized with HF. Follow-up data were scheduled to be prospectively collected at 60 to 90 days postdischarge in a prespecified 10% sample. For the 4,402 patients included in this analysis, 19 prespecified potential predictor variables were used in a stepwise Cox proportional hazards model for all-cause mortality. Logistic regression including 45 potential variables was used to model mortality or rehospitalization. Results: The 60- to 90-day postdischarge mortality rate was 8.6% (n = 481), and 29.6% (n = 1,715) were rehospitalized. Factors predicting early postdischarge mortality include age, serum creatinine, reactive airway disease, liver disease, lower systolic blood pressure, lower serum sodium, lower admission weight, and depression. Use of statins and β-blockers at discharge was associated with significantly decreased mortality. The C-index of the model was 0.74. The most important predictors for the combined end point of death or rehospitalization were admission serum creatinine, systolic blood pressure, admission hemoglobin, discharge use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and pulmonary disease. From this analysis, 8 factors identified to carry significant risk were selected for use in a point scoring system to predict the risk of mortality within 60 days after discharge, with a C-index of 0.72. Conclusions: A substantial risk of mortality and mortality or rehospitalization is present in the first 60 to 90 days after discharge from a hospitalization for HF. Several factors were identified that signal high-risk patients. Application of these findings with a simple algorithm can distinguish patients who are low risk from those at high risk who may benefit from closer monitoring and aggressive evidence-based treatment. ? 2008 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2008"]]},"page":"662-673","title":"Predictors of mortality after discharge in patients hospitalized with heart failure: An analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"156"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁰","plainTextFormattedCitation":"200","previouslyFormattedCitation":"¹⁹⁸"},"properties":{"noteIndex":0},"schema":""}200:10 year age increase, adjusted HR for mortality (discharge to follow-up) 1.22 (1.11-1.34)Abraham 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2008.04.028","ISBN":"1558-3597 (Electronic) 0735-1097 (Linking)","ISSN":"07351097","PMID":"18652942","abstract":"Objectives: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. Background: Heart failure patients experience high rates of hospital stays and poor outcomes. Although predictors of mortality have been identified in HF clinical trials, hospitalized patients might differ greatly from trial populations, and such predictors might underestimate mortality in a real-world population. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) is a registry/performance improvement program for patients hospitalized with HF in 259 U.S. hospitals. Forty-five potential predictor variables were used in a stepwise logistic regression model for in-hospital mortality. Continuous variables that did not meet linearity assumptions were transformed. All significant variables (p < 0.05) were entered into multivariate analysis. Generalized estimating equations were used to account for the correlation of data within the same hospital in the adjusted models. Results: Of 48,612 patients enrolled, mean age was 73.1 years, 52% were women, 74% were Caucasian, and 46% had ischemic etiology. Mean left ventricular ejection fraction was 0.39 ± 0.18. In-hospital mortality occurred in 1,834 (3.8%). Multivariable predictors of mortality included age, heart rate, systolic blood pressure (SBP), sodium, creatinine, HF as primary cause of hospitalization, and presence/absence of left ventricular systolic dysfunction. A scoring system was developed to predict mortality. Conclusions: Risk of in-hospital mortality for patients hospitalized with HF remains high and is increased in patients who are older and have low SBP or sodium levels and elevated heart rate or creatinine at admission. Application of this risk-prediction algorithm might help identify patients at high risk for in-hospital mortality who might benefit from aggressive monitoring and intervention. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2008"]]},"page":"347-356","title":"Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure. Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"52"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁴","plainTextFormattedCitation":"204","previouslyFormattedCitation":"²⁰²"},"properties":{"noteIndex":0},"schema":""}204:10 year age increase, adjusted HR for hospital mortality 1.34 (1.26-1.41)Fonaorw 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2009.02.057","ISSN":"00029149","PMID":"19576329","abstract":"Previous studies have suggested that female and elderly patients with heart failure (HF) are less likely to receive guideline-recommended therapies, but these studies have involved select patient populations. We evaluated the differences in medical care and patient outcomes by age and gender among a broad cohort of hospitalized patients with HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) is a registry and performance-improvement program involving 48,612 patients with HF from 259 hospitals. The data were analyzed by gender, age <75 years, and age > or =75 years. Appropriate angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker use were similar between women and men (p = 0.244 and p = 0.237, respectively). However, compared with men, fewer women received hospital discharge instructions (p <0.001) and the length of stay was longer (p <0.001). Risk-adjusted in-hospital and postdischarge mortality were similar. All guideline-recommended cardiac medications were prescribed less frequently at discharge to eligible patients > or =75 than to those <75 years (all p <0.001). Older age was independently associated with in-hospital and postdischarge mortality risk increases (76% and 62%, respectively; p <0.001 for both). In conclusion, among the OPTIMIZE-HF hospitals, female patients with HF generally received similar medical care and had similar risks of adverse clinical outcomes compared with male patients. Older patients with HF were less likely to receive guideline-recommended therapies and remained at greater risk of adverse outcomes.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2009"]]},"page":"107-115","publisher":"Elsevier Inc.","title":"Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF).","type":"article-journal","volume":"104"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁵","plainTextFormattedCitation":"205","previouslyFormattedCitation":"²⁰³"},"properties":{"noteIndex":0},"schema":""}205:≥75 vs. <75, significantly less likely to have the following evidence based quality of care metrics:ACEI/ARB, aldosterone antagonist, or beta-blocker at dischargeWarfarin if atrial fibrillationLVEF assessmentSmoking cessation counselling≥75 years In hospital mortality adjusted OR 1.76 (1.54-2.02)60-90 day mortality adjusted OR 1.62 (1.26-2.08)RO-AHFSChioncel 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2459/JCM.0000000000000030","ISBN":"0000000000000","ISSN":"1558-2027","author":[{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ambrosy","given":"Andrew P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filipescu","given":"Daniela","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bubenek","given":"Serban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vinereanu","given":"Dragos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Petris","given":"Antoniu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Collins","given":"Sean P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Macarie","given":"Cezar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Medicine","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2015"]]},"page":"331-340","title":"Patterns of intensive care unit admissions in patients hospitalized for heart failure","type":"article-journal","volume":"16"},"uris":[""]}],"mendeley":{"formattedCitation":"²²⁰","plainTextFormattedCitation":"220","previouslyFormattedCitation":"²¹⁸"},"properties":{"noteIndex":0},"schema":""}220:In patients requiring ICU admission, age as a continuous variable conferred an adjusted HR of 1.24 (1.04-1.457)THESUS-HFSliwa 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/eht393","ISSN":"0195668X","PMID":"24048728","abstract":"AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population.\\n\\nMETHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown.\\n\\nCONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.","author":[{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okekuchwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-1","issue":"40","issued":{"date-parts":[["2013"]]},"page":"3151-3159","title":"Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry","type":"article-journal","volume":"34"},"uris":[""]}],"mendeley":{"formattedCitation":"²³⁸","plainTextFormattedCitation":"238","previouslyFormattedCitation":"²³⁶"},"properties":{"noteIndex":0},"schema":""}238: Failed to demonstrate an effect of a 10 year increase on the risk ofAll cause death or readmission at 60 daysAll cause death at 180 daysHowever, this is a heavily adjusted model, and the results may be attributable to multiple testing. Age: bottom line:Increasing age has been shown to consistently (predictably) be associated with an increased risk of all cause mortality, largely in acute heart failure patients. It has also been shown to be a risk of not receiving evidence-based and guideline directed heart failure therapy (devices, medications, etc.). For these reasons, age should be included as a case-mix variable. SEXADHEREGalvao 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2005.09.005","ISSN":"10719164","PMID":"16520256","abstract":"Background: The impact of gender differences has not been well described in patients hospitalized with acute decompensated heart failure (ADHF). Methods and Results: Through review of medical records, data on characteristics, treatments, and outcomes were analyzed on 105,388 patient records according to gender. Women accounted for 52% of these admissions and were older than men (74.5 versus 70.1 years,) and more commonly had preserved left ventricular function (51% versus 28%). Based on history, women were less likely to have coronary artery disease (51% versus 64%) and its risk factors, but more commonly had hypertension (76% versus 70%). Both genders received similar intravenous diuretic regimens, but fewer women received vasoactive therapy (24% vs 31%). Evidence-based oral therapies were underused in both genders. Women consistently received less procedure-oriented therapy. Mean length of stay (women 5.9, men 5.8 days) and the risk-adjusted in-hospital mortality (adjusted odds ratio 0.974 [0.910-1.042], P = .4390) were similar in both genders. Conclusion: More women than men are hospitalized with ADHF. Heart failure with preserved left ventricular function predominates in women. Though women are treated less aggressively, treatment gaps exists in both sexes. Despite these differences, length of stay and in-hospital mortality rates are similar. ? 2006 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Galvao","given":"Marie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kalman","given":"Jill","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Demarco","given":"Teresa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Galvin","given":"Catherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ghali","given":"Jalal K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moskowitz","given":"Robert M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2006"]]},"page":"100-107","title":"Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: Analysis from the acute decompensated heart failure national registry (ADHERE)","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"¹²","plainTextFormattedCitation":"12","previouslyFormattedCitation":"¹²"},"properties":{"noteIndex":0},"schema":""}12:Women relative to men found less likely to receive:Discharge instructionsLV function assessmentACEI at discharge Women as a group had fewer in hospital deaths (p=0.0041)Diercks 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1553-2712.2008.00030.x","ISBN":"1553-2712 (Electronic)\\r1069-6563 (Linking)","ISSN":"10696563","PMID":"18275445","abstract":"OBJECTIVES: It has been reported that the mortality risk for heart failure differs between men and women. It has been postulated that this is due to differences in comorbid features. Variation in risk profiles by gender may limit the performance of stratification algorithms available for heart failure in women. This analysis examined the ability of a published risk stratification model to predict outcomes in women. METHODS: The Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM) database was used. Characteristics, treatments, and outcomes for men and women were compared. The ADHERE registry classification and regression tree (CART) analysis was used for the risk stratification evaluation. RESULTS: Of 10,984 ADHERE-EM patients, 5,736 (52.2%) were women. In-hospital mortality was similar between men and women (p = 0.727). Significant differences (p < 0.0002) were noted by gender in all three variables in the CART model (blood urea nitrogen [BUN] > or = 43 mg/dL, systolic blood pressure < 115 mm Hg, and serum creatinine > or = 2.75 mg/dL). However, the CART model effectively stratified both genders into distinct risk groups with no significant difference in mortality by gender within stratified groups. CONCLUSIONS: The ADHERE Registry CART tool is effective at predicting risk in ED patients, regardless of gender.","author":[{"dropping-particle":"","family":"Diercks","given":"Deborah B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kirk","given":"J. Douglas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Emerman","given":"Charles L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hollander","given":"Judd E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Weber","given":"Jim Edward","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Summers","given":"Richard L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peacock IV","given":"W. Franklin","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Academic Emergency Medicine","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2008"]]},"page":"151-158","title":"Risk stratification in women enrolled in the Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM)","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"²³","plainTextFormattedCitation":"23","previouslyFormattedCitation":"²³"},"properties":{"noteIndex":0},"schema":""}23:No difference noted between men and women in terms of in-hospital mortality within risk stratified groupsWomen were older (75.7±14.2 vs. 70.2±14.4) Women more likely to be classified low risk vs. menOR 1.3 (1.2-1.4)Men more likely to be high risk relative to womenOR 1.7 (1.2-2.4)In hospital mortality OR for high vs. low risk:Men: 8.6 (4.0-18.1)Women: 9.3 (4.2-20.3)So: women less likely to be high risk, and being high risk carries a significant risk of in hospital mortality, so women are indirectly likely to have less risk of in hospital mortality. AHEADParencia 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejim.2012.11.005","ISSN":"09536205","PMID":"23219321","abstract":"Background The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival. ? 2012 European Federation of Internal Medicine.","author":[{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horakova","given":"Katerina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Internal Medicine","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2013"]]},"page":"151-160","title":"Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)","type":"article-journal","volume":"24"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁷","plainTextFormattedCitation":"37","previouslyFormattedCitation":"³⁷"},"properties":{"noteIndex":0},"schema":""}37:Proportionally more with HFpEF (≥50% EF)Decreased EF (≤50% EF) shown on Kaplan-Meier analysis to be associated with poorer 30 day survival (P<0.001)COHEREFranciosa 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1527-5299.2006.05804.x","ISSN":"1527-5299","abstract":"Women and the elderly are underrepresented in clinical trials of heart failure (HF). The authors analyzed, by sex and age groups, a registry of 4280 community patients initiating carvedilol for HF. Women (n=1485) were older than men (n=2793) and had worse functional class with higher left ventricular ejection fraction and blood pressure. Women also had more HF hospitalizations, less use of angiotensin-converting enzyme inhibitors, and lower doses of carvedilol. Nevertheless, during 1-year follow-up, both groups experienced greater than 40% reductions in HF hospitalizations (P<.001), with mortality of 7.3% in women vs 9.1% in men (P=.085). With increasing age, left ventricular ejection fraction, blood pressure, and functional class increased, whereas angiotensin-converting enzyme inhibitor use and carvedilol doses decreased. HF hospitalizations fell at least 40% in all age groups after starting carvedilol (P<.001). Characteristics of women and the elderly with HF in the community suggest increased risk, but both populations respond well after initiating carvedilol.","author":[{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2006"]]},"page":"317-323","title":"Heart Failure in Community Practice: Relationship to Age and Sex in a Beta-Blocker Registry","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁵","plainTextFormattedCitation":"65","previouslyFormattedCitation":"⁶³"},"properties":{"noteIndex":0},"schema":""}65:No significant mortality difference between men & women in terms of 6 and 12 month mortalityp=0.069; p=0.085 respectivelyHigher proportion of women had a 12 month hospitalization for HF13 vs. 11%; p=0.016Fewer women reached target beta-blocker dose (not formally tested)Greenberg 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2006.06.050","ISSN":"00029149","PMID":"17126654","abstract":"Risk factors for outcomes in heart failure (HF) were derived from populations in clinical trials, at hospital discharge, or in localized geographic or socioeconomic strata before the widespread use of beta blockers. This study observed 4,280 patients in a community-based HF registry for 1 year after completing carvedilol titration. Independent risk factors for death, hospitalization for HF, or hospitalization for cardiovascular reasons other than HF were first identified by age-, gender-, and race-adjusted analyses, then by multivariate analysis adjusted simultaneously for all factors. Over this period, 7% of patients died, 11% were hospitalized for HF, 12% were hospitalized for other cardiovascular reasons, and 27% had > or =1 of these events. The most significant outcome predictors were New York Heart Association class III or IV, history of hospitalization for HF or other cardiovascular reasons, and angina pectoris, all associated with increased odds of having an adverse outcome (all p < or =0.001). The left ventricular ejection fraction was not a significant outcome predictor by multivariate analysis. The odds ratio for an adverse outcome was significantly reduced for patients with hypertensive or idiopathic causes of HF and for those whose physicians had graduated from medical school > or =24 years earlier compared with <14 years earlier (all p <0.005). In conclusion, easily obtained historical information predicts clinical outcomes in patients with HF in the year after initiating carvedilol. In this unselected community population, these historical factors were better predictors of risk than the left ventricular ejection fraction.","author":[{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2006"]]},"page":"1480-1484","title":"Predictors of clinical outcomes in patients given carvedilol for heart failure.","type":"article-journal","volume":"98"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁴","plainTextFormattedCitation":"64","previouslyFormattedCitation":"⁶²"},"properties":{"noteIndex":0},"schema":""}64:No difference found on multivariable analysis in for outcomes of all cause mortality, HF hospitalization, or non-HF CV hospitalizationAdjusted OR 1.013 (0.866-1.185)EHFS IINieminen 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejheart.2007.12.012","ISSN":"1388-9842","PMID":"18279769","abstract":"This analysis evaluates the gender differences in patients hospitalised for acute heart failure (AHF) in the EuroHeart Failure Survey II (EHFS).","author":[{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose Luis","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2008"]]},"page":"140-148","title":"Gender related differences in patients presenting with acute heart failure. Results from EuroHeart Failure Survey II.","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁴","plainTextFormattedCitation":"74","previouslyFormattedCitation":"⁷²"},"properties":{"noteIndex":0},"schema":""}74:No sex differences in survival to 12 monthsNo differences between sexes in terms of:Length of stayICU/CCU admissionHospital deathDeath/MI/CVA composite outcomeClinical picture different between sexes:Women – higher odds of:Atrial arrhythmia as cause of index hospitalization – 1.23 (1.06-1.42)Valvular disease as cause of index hospitalization – 1.54 (1.33-1.79)Older – 73.1(12) vs. 67.8(12.4) p<0.001HTN – 1.41 (1.23-1.63)Living alone – 1.95 (1.62-2.37)Retired – 1.67 (1.42-1.95)Living in special accommodation – 3.04 (2.15-4.30)DM – 1.18 (1.02-1.36) Anemia – 1.60 (1.35-1.93)Thyroid disease – 2.69 (2.07-3.50)Men higher odds of (OR for being female, so <1 means favours women):Ventricular arrhythmia as cause of index hospitalization – 0.63 (0.44-0.91)Therapy non-compliance – 0.69 (0.58-0.83)Chronic heart failure – 0.77 (0.67-0.88)CAD: 0.54 (0.47-0.61)DCM – 0.59 (0.49-0.70)ICD – 0.43 (0.27-0.68)PVD – 0.51 (0.41-0.64)Smoking – 0.3 (0.24-0.38)COPD – 0.62 (0.52-0.74)Renal failure – 0.70 (0.58-0.84However: these appear to be univariable associations of baseline data only, so may not be the most robust comparisonHarjola 2010 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfq002","ISSN":"1879-0844","PMID":"20156940","abstract":"Acute heart failure (AHF) has a poor prognosis. We evaluated 3- and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II.","author":[{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2010"]]},"page":"239-248","title":"Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure.","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁵","plainTextFormattedCitation":"75","previouslyFormattedCitation":"⁷³"},"properties":{"noteIndex":0},"schema":""}75:No difference between males and females in Kaplan-Meier estimates of 3 & 12 month mortality (p=0.819)No sex difference in mortality from discharge to 3 monthsHR 1.11 (0.86-1.43)No sex difference in mortality from 3-12 monthsHR 0.97 (0.76-1.23) ESC-HFMaggioni 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hft050","ISBN":"1879-0844","ISSN":"13889842","PMID":"23537547","abstract":"AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.\\n\\nMETHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.\\n\\nCONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.","author":[{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Leiro","given":"Marisa Crespo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drozdz","given":"Jaroslaw","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fruhwald","given":"Friedrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gullestad","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Logeart","given":"Damien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fabbri","given":"Gianna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Persson","given":"Hans","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rauchhaus","given":"Mathias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nielsen","given":"Olav Wendelboe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2013"]]},"page":"808-817","title":"EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁸","plainTextFormattedCitation":"78","previouslyFormattedCitation":"⁷⁶"},"properties":{"noteIndex":0},"schema":""}78:Female proportionally more in acute heart failure 37.4 vs. 29.7 respectively (p<0.0001)GWTG-HFHernandez 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.298.13.1525","ISSN":"1538-3598","PMID":"17911497","abstract":"CONTEXT: Practice guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for patients with heart failure and left ventricular ejection fraction of 30% or less. The influence of sex and race on ICD use among eligible patients is unknown. OBJECTIVE: To examine sex and racial differences in the use of ICD therapy. DESIGN, SETTING, AND PATIENTS: Observational analysis of 13,034 patients admitted with heart failure and left ventricular ejection fraction of 30% or less and discharged alive from hospitals in the American Heart Association's Get With the Guidelines-Heart Failure quality-improvement program. Patients were treated between January 2005 and June 2007 at 217 participating hospitals. MAIN OUTCOME MEASURES: Use of ICD therapy or planned ICD therapy at discharge. RESULTS: Among patients eligible for ICD therapy, 4615 (35.4%) had ICD therapy at discharge (1614 with new ICDs, 527 with planned ICDs, and 2474 with prior ICDs). ICDs were used in 375 of 1329 eligible black women (28.2%), 754 of 2531 white women (29.8%), 660 of 1977 black men (33.4%), and 2356 of 5403 white men (43.6%) (P < .001). After adjustment for patient characteristics and hospital factors, the adjusted odds of ICD use were 0.73 (95% confidence interval, 0.60-0.88) for black men, 0.62 (95% confidence interval, 0.56-0.68) for white women, and 0.56 (95% confidence interval, 0.44-0.71) for black women, compared with white men. The differences were not attributable to the proportions of women and black patients at participating hospitals or to differences in the reporting of left ventricular ejection fraction. CONCLUSIONS: Less than 40% of potentially eligible patients hospitalized for heart failure received ICD therapy, and rates of use were lower among eligible women and black patients than among white men.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-1","issue":"13","issued":{"date-parts":[["2007"]]},"page":"1525-1532","title":"Sex and racial differences in the use of implantable cardioverter-defibrillators among patients hospitalized with heart failure.","type":"article-journal","volume":"298"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸¹","plainTextFormattedCitation":"81","previouslyFormattedCitation":"⁷⁹"},"properties":{"noteIndex":0},"schema":""}81:Women less likely to have =ICD placed/planned if eligible – 2 modelsAdjusted OR:0.62 (0.56-0.68)0.58 (0.52-0.65)Piccini 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2009.04.091","ISBN":"1558-3597","ISSN":"07351097","PMID":"19778670","abstract":"Objectives: This study sought to examine quality of care and warfarin use at discharge in patients with atrial fibrillation (AF) and heart failure (HF). Background: Atrial fibrillation is common in HF, and national guidelines recommend discharge on warfarin for stroke prophylaxis. However, the frequency and factors associated with the guideline adherence are poorly described. Methods: We analyzed 72,534 HF admissions from January 2005 through March 2008 at 255 hospitals participating in the American Heart Association's Get With The Guidelines HF program. Multivariable logistic regression was used to identify independent factors associated with warfarin use at discharge. Results: In this HF population, 20.5% (n = 14,901) had AF on admission, whereas another 13.7% (n = 9,918) had a prior history of AF but were in a regular rhythm at admission. Contraindications to warfarin therapy were documented in 9.2%. Among eligible HF patients without contraindications, the median prevalence of warfarin therapy at discharge was 64.9% (interquartile range 55.5 to 73.4) and did not improve during the 3.5 years of study. After adjustment, major factors associated with no warfarin use at discharge included increasing age, nonwhite race, anemia, and treatment in the south. Warfarin use also varied inversely with CHADS2 (congestive heart failure, hypertension, age >75, diabetes, and prior stroke or transient ischemic attack) risk (70.9% to 59.5% for CHADS2 score 1 to 6, p < 0.0001). Conclusions: Guideline-recommended warfarin use in patients with AF and HF is less than optimal, has not improved over time, and varies significantly according to age, race, risk profile, region, and hospital site. ? 2009 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Patel","given":"Manesh R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lewis","given":"William R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"14","issued":{"date-parts":[["2009"]]},"page":"1280-1289","publisher":"Elsevier Inc.","title":"Quality of Care for Atrial Fibrillation Among Patients Hospitalized for Heart Failure","type":"article-journal","volume":"54"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁶","plainTextFormattedCitation":"86","previouslyFormattedCitation":"⁸⁴"},"properties":{"noteIndex":0},"schema":""}86:Women less likely to receive warfarin if in atrial fibrillation and eligibleAdjusted OR for no warfarin at discharge 1.14 (1.05-1.23)Ambardekar 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2009.07.034","ISSN":"00028703","PMID":"19781426","abstract":"Background: Medication and dietary nonadherence are precipitating factors for heart failure (HF) hospitalization; however, the characteristics, outcomes, and quality of care of patients with nonadherence are unknown. Recognizing features of nonadherent patients may provide a means to reduce rehospitalization for this population. Methods: GWTG-HF registry data were collected from 236 hospitals and 54,322 patients from January 1, 2005 to December 30, 2007. Demographics, clinical characteristics, in-hospital outcomes, and quality of care were stratified by precipitating factor for HF admission. Multivariate logistic regression analysis was used to determine the association of nonadherence with length of stay (LOS) and in-hospital mortality. Results: Clinicians documented dietary and/or medication nonadherence as the reason for admission in 5576 (10.3%) of HF hospitalizations. Nonadherent patients were younger and more likely to be male, minority, uninsured, and have nonischemic HF. These patients had lower ejection fractions (34.9% vs 39.6%, P < .0001), more frequent previous HF hospitalizations, higher brain natriuretic peptide levels (1813 vs 1371 pg/mL, P < .0001), and presented with greater signs of congestion. Despite this, nonadherent patients had shorter LOS (odds ratio 0.94, 95% CI 0.92-0.97) and lower in-hospital mortality (odds ratio 0.65, 95% CI 0.51-0.83) in multivariate analysis. Although nonadherent patients received high rates of Joint Commission core measures, rates of other evidence-based treatments were less optimal. Conclusions: Nonadherence is a common precipitant for HF admission. Despite a higher risk profile, nonadherent patients had lower in-hospital mortality and LOS, suggesting that it may be easier to stabilize nonadherent patients by reinstituting sodium and/or fluid restriction and resuming medical therapy. ? 2009 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pan","given":"Wenqin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2009"]]},"page":"644-652","publisher":"Mosby, Inc.","title":"Characteristics and in-hospital outcomes for nonadherent patients with heart failure: Findings from Get With The Guidelines-Heart Failure (GWTG-HF)","type":"article-journal","volume":"158"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁸","plainTextFormattedCitation":"88","previouslyFormattedCitation":"⁸⁶"},"properties":{"noteIndex":0},"schema":""}88:Male associated with dietary and medical noncomplianceAdjusted OR 1.274 (1.196-1.358)Whellan 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2011.04.005","ISBN":"1532-8414 (Electronic)\\r1071-9164 (Linking)","ISSN":"10719164","PMID":"21807326","abstract":"Background: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. Methods and Results: A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With The Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r 2 of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation. Conclusions: Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2011"]]},"page":"649-656","publisher":"Elsevier Inc","title":"Predictors of hospital length of stay in heart failure: Findings from get with the guidelines","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁵","plainTextFormattedCitation":"95","previouslyFormattedCitation":"⁹³"},"properties":{"noteIndex":0},"schema":""}95: Women has slightly longer lengths of stay (beyond 4-6 days) after adjustment1.06 (1.04-1.07) (patient characteristics)1.04 (1.03-1.06) (patient, hospital, labs)Krantz 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2011.02.322","ISBN":"1879-1913 (Electronic) 0002-9149 (Linking)","ISSN":"00029149","PMID":"21482418","abstract":"Hospitalized patients with heart failure and decreased ejection fraction are at substantial risk for mortality and rehospitalization, yet no acute therapies are proven to decrease this risk. Therefore, in-hospital use of medications proved to decrease long-term mortality is a critical strategy to improve outcomes. Although endorsed in guidelines, predictors of initiation and continuation of angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), β blockers, and aldosterone antagonists have not been well studied. We assessed noncontraindicated use patterns for the 3 medications using the Get With the GuidelinesHeart Failure (GWTG-HF) registry from February 2009 through March 2010. Medication continuation was defined as treatment on admission and discharge. Multivariable logistic regression using generalized estimating equations was used to determine factors associated with discharge use. In total 9,474 patients were enrolled during the study period. Of those treated before hospitalization, overall continuation rates were 88.5% for ACE inhibitors/ARBs, 91.6% for β blockers, and 71.9% for aldosterone-antagonists. Of patients untreated before admission, 87.4% had ACE inhibitors/ARBs and 90.1% had β blocker initiated during hospitalization or at discharge, whereas only 25.2% were started on an aldosterone antagonist. In multivariate analysis, admission therapy was most strongly associated with discharge use (adjusted odds ratios 7.4, 6.0, and 20.9 for ACE inhibitors/ARBs, β blockers, and aldosterone antagonists, respectively). Western region, younger age, and academic affiliation were also associated with higher discharge use. Although ACE inhibitor/ARB and β-blocker continuation rates were high, aldosterone antagonist use was lower despite potential eligibility. In conclusion, being admitted on evidence-based medications is the most powerful, independent predictor of discharge use. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kaltenbach","given":"Lisa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2011"]]},"page":"1818-1823","publisher":"Elsevier Inc.","title":"Patterns and predictors of evidence-based medication continuation among hospitalized heart failure patients (from get with the guidelines-heart failure)","type":"article-journal","volume":"107"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁷","plainTextFormattedCitation":"97","previouslyFormattedCitation":"⁹⁵"},"properties":{"noteIndex":0},"schema":""}97:No differences found in aldosterone antagonist or beta blocker use between sexesMales more likely to get ACEI/ARB at discharge if clinically indicatedAdjusted OR 1.3 (1.03-1.64)Allen 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁰","plainTextFormattedCitation":"100","previouslyFormattedCitation":"⁹⁸"},"properties":{"noteIndex":0},"schema":""}100:Women had higher odds of discharge to a skilled nursing facilityAdjusted OR 1.53(1.42-1.66)Discharge to nursing facility associated with higher adjusted risk of All cause mortality HR 1.76 (1.66-1.87)All cause rehospitalisation HR 1.08 (1.03-1.14)Klein 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.960484","ISSN":"19413289","PMID":"21862732","abstract":"Although women account for a significant proportion of heart failure (HF) hospitalizations, data on the quality of care and in-hospital outcomes in women are limited.","author":[{"dropping-particle":"","family":"Klein","given":"Liviu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bonow","given":"Robert O.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Williams","given":"Mark","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2011"]]},"page":"589-598","title":"Quality of care and outcomes in women hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰²","plainTextFormattedCitation":"102","previouslyFormattedCitation":"¹⁰⁰"},"properties":{"noteIndex":0},"schema":""}102:Women less likely (adjusted odds) to meet the following performance/quality of care measures:LV function documented – 0.81 (0.76-0.86)Warfarin if a.fib and indicated – 0.91 (0.86-0.96)ICD placed/planned if EF≤35% - 0.70 (0.65-0.75)Hsich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.12.013","ISSN":"00028703","PMID":"22424014","abstract":"Background: There are no sex-specific survival comparisons between patients with heart failure (HF) with reduced and those with preserved ejection fraction. Large registries noting women have better survival than men combined HF patients with reduced and preserved EF. Other registries that compared patients with reduced and preserved EF did not analyze their data by sex. We sought to evaluate sex/EF differences in mortality and risk factors for survival in hospitalized patients with HF. Methods: We included hospitals fully participating in Get With The Guidelines-Heart Failure that admitted HF patients with reduced (EF <40%) or preserved (EF ≥50%) EF. The primary end point was in-hospital mortality. Multivariate generalized estimating equation logistic models were used to compute odds ratios accounting for hospital clustering. Results: The study cohort consisted of 51,428 patients with EF <40% (36% women, 64% men) and 37,699 patients with EF ≥50% (65% women, 35% men). Women compared with men with reduced and preserved EF were older and more likely to have hypertension, depression, or valvular heart disease and less likely to have coronary artery disease or peripheral vascular disease. There were no sex differences in in-hospital mortality (EF <40%, 2.69% women vs 2.89% men, P =.20; EF ≥50%, 2.61% women vs 2.62% men, P =.96), and risk factors such as age, systolic blood pressure, heart rate, and history of renal failure/dialysis were highly predictive of death for each sex/EF subgroup. Conclusions: In a large, multicenter registry, we found that despite differences in baseline characteristics, women and men with reduced and preserved EF have similar in-hospital mortality and risk factors predicting death. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Hsich","given":"Eileen M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2012"]]},"page":"430-437.e3","publisher":"Mosby, Inc.","title":"Sex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"¹¹¹","plainTextFormattedCitation":"111","previouslyFormattedCitation":"¹⁰⁹"},"properties":{"noteIndex":0},"schema":""}111:No difference was noted in terms of in hospital mortality between sexesHIJC-HFKawashiro 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1346-9843","PMID":"18931450","abstract":"BACKGROUND: Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.","author":[{"dropping-particle":"","family":"Kawashiro","given":"Naomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogawa","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsuda","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"Nobuhisa","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2008"]]},"page":"2015-2020","title":"Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry.","type":"article-journal","volume":"72"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³⁵","plainTextFormattedCitation":"135","previouslyFormattedCitation":"¹³³"},"properties":{"noteIndex":0},"schema":""}135:No mortality differences between sexes in terms of total mortality and cardiac specific mortalityIMPROVE-HFYancy 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2008.12.016","ISSN":"00028703","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2009"]]},"page":"754-762.e2","publisher":"Mosby, Inc.","title":"Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: Findings from IMPROVE HF","type":"article-journal","volume":"157"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁴²","plainTextFormattedCitation":"142","previouslyFormattedCitation":"¹⁴⁰"},"properties":{"noteIndex":0},"schema":""}142:Men had increased odds of (adjusted):ACEI/ARB at discharge 1.136 (1.02-1.264)Anticoagulation if a.fib 1.439 (1.192-1.736)Heart failure education 1.156 (1.06-1.26)ICD/CRT 1.422 (1.260-1.606)Men had decreased odds of:Aldosterone antagonist use 0.793 (0.639-0.985)IN-HFCioffi 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ijcard.2013.06.020","ISBN":"0167-5273","ISSN":"01675273","PMID":"23850320","abstract":"Background Chronic renal dysfunction (RD) frequently coexists with heart failure (HF) and influences outcome. Patients with acute HF (AHF) and severe RD are frequently excluded in the trials. We characterized these subjects and assessed incidence and predictors of in-hospital and one-year mortalities. Methods We selected the 455 patients included in the \"IN-HF Outcome\" Italian registry belonging to the lowest quartile of estimated glomerular filtration rate (eGFR < 40 ml/min/1.73 m2). Results Mean eGFR at entry in severe RD patients was 28 ?? 9 ml/min/1.73 m2. Compared to 1368 patients with more preserved eGFR, they were older, with more co-morbidities and more frequently ischemic etiology of HF. In-hospital and one-year all-cause mortality rates were 14% and 44% respectively, twice higher than the entire population. Predictors of in-hospital mortality were an abnormal status of consciousness, older age, hyponatremia, lower systolic blood pressure and eGFR. The same conditions (except eGFR) predicted one-year mortality together with the absence of diabetes and no treatment with beta-blockers or diuretics. Conclusions In patients with AHF and severe RD, in-hospital and one-year all-cause mortality rates are very high. Independent predictors such as older age, and signs of hypoperfusion and hyponatremia may be identified but preventing and reversing RD remain the key targets for the clinical management of these patients. ?? 2013 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Cioffi","given":"Giovanni","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cacciatore","given":"Giuseppe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chinaglia","given":"Alessandra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tarantini","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"Pietro","family":"Maggioni","given":"Aldo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2013"]]},"page":"3691-3697","title":"Clinical features, and in-hospital and 1-year mortalities of patients with acute heart failure and severe renal dysfunction. Data from the Italian Registry IN-HF Outcome","type":"article-journal","volume":"168"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵⁵","plainTextFormattedCitation":"155","previouslyFormattedCitation":"¹⁵³"},"properties":{"noteIndex":0},"schema":""}155:Sex was not associated with increased in hospital or 1 year mortalityKorHFChoi 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4070/kcj.2011.41.7.363","ISSN":"1738-5520","PMID":"21860637","abstract":"BACKGROUND AND OBJECTIVES: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea.\\n\\nSUBJECTS AND METHODS: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6±14.3 years and 50% of the patients were female.\\n\\nRESULTS: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5±15.7% and 26.1% of the patients had preserved systolic function (LVEF ≥50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death.\\n\\nCONCLUSION: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.","author":[{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shin","given":"Mi-Seung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Seong","given":"In-Whan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahn","given":"Youngkeun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Yung-Jo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Hyung Seop","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Korean Circulation Journal","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2011"]]},"page":"363","title":"Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry","type":"article","volume":"41"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁷⁷","plainTextFormattedCitation":"177","previouslyFormattedCitation":"¹⁷⁵"},"properties":{"noteIndex":0},"schema":""}177: Sex was not associated with five year survival or risk of readmissionHR 1.026 (0.874-1.205) – univariableOPTIMIZE-HFFonarow 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2009.02.057","ISSN":"00029149","PMID":"19576329","abstract":"Previous studies have suggested that female and elderly patients with heart failure (HF) are less likely to receive guideline-recommended therapies, but these studies have involved select patient populations. We evaluated the differences in medical care and patient outcomes by age and gender among a broad cohort of hospitalized patients with HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) is a registry and performance-improvement program involving 48,612 patients with HF from 259 hospitals. The data were analyzed by gender, age <75 years, and age > or =75 years. Appropriate angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker use were similar between women and men (p = 0.244 and p = 0.237, respectively). However, compared with men, fewer women received hospital discharge instructions (p <0.001) and the length of stay was longer (p <0.001). Risk-adjusted in-hospital and postdischarge mortality were similar. All guideline-recommended cardiac medications were prescribed less frequently at discharge to eligible patients > or =75 than to those <75 years (all p <0.001). Older age was independently associated with in-hospital and postdischarge mortality risk increases (76% and 62%, respectively; p <0.001 for both). In conclusion, among the OPTIMIZE-HF hospitals, female patients with HF generally received similar medical care and had similar risks of adverse clinical outcomes compared with male patients. Older patients with HF were less likely to receive guideline-recommended therapies and remained at greater risk of adverse outcomes.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2009"]]},"page":"107-115","publisher":"Elsevier Inc.","title":"Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF).","type":"article-journal","volume":"104"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁵","plainTextFormattedCitation":"205","previouslyFormattedCitation":"²⁰³"},"properties":{"noteIndex":0},"schema":""}205:Sex was not associated with mortality or rehospitalisationFemale sex was associated with a slightly higher length of stay ratio1.06(1.03-1.08)Female sex was associated with lower adjusted odds of:Discharge instructions 0.96 (0.93-0.99)LV assessment 0.86 (0.81-0.92)Aldosterone antagonist use 0.89 (0.81-0.99)Warfarin if a.fib and indicated 0.89 (0.78-0.92)S-HFRLinde 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/europace/euu205","ISSN":"1532-2092","PMID":"25164429","abstract":"AIMS: It has been suggested that cardiac resynchronization therapy (CRT) is less utilized, dyssynchrony occurs at narrower QRS, and CRT is more beneficial in women compared with men. We tested the hypotheses that (i) CRT is more underutilized and (ii) QRS prolongation and left bundle branch block (LBBB) are more harmful in women. METHODS AND RESULTS: We studied 14 713 patients (28% women) with left ventricular ejection fraction (LVEF) <40% in the Swedish Heart Failure Registry. In women vs. men, CRT was present in 4 vs. 7% (P < 0.001) and was absent but with indication in 30 vs. 31% (P = 0.826). Next, among 13 782 patients (28% women) without CRT, 9% of women and 17% of men had non-specific intraventricular conduction delay (IVCD) and 27% of women and 24% of men had LBBB. One-year survival with narrow QRS was 85% in women and 88% in men, with IVCD 74 and 78%, and with LBBB 84 and 82%, respectively. Compared with narrow QRS, IVCD had a multivariable hazard ratio of 1.24 (95% CI 1.05-1.46, P = 0.011) in women and 1.30 (95% CI 1.19-1.42, P < 0.001) in men, and LBBB 1.03 (95% CI 0.91-1.16, P = 0.651) in women and 1.16 (95% CI 1.07-1.26, P < 0.001) in men, P for interaction between gender and QRS morphology, 0.241. CONCLUSIONS: While the proportion with CRT was lower in women, CRT was equally underutilized in both genders. QRS prolongation with or without LBBB was not more harmful in women than in men. Efforts to improve CRT implementation should be directed equally towards women and men.","author":[{"dropping-particle":"","family":"Linde","given":"Cecilia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"St?hlberg","given":"Marcus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Braunschweig","given":"Frieder","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alehagen","given":"Urban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2014"]]},"page":"424-431","title":"Gender, underutilization of cardiac resynchronization therapy, and prognostic impact of QRS prolongation and left bundle branch block in heart failure.","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"²²⁹","plainTextFormattedCitation":"229","previouslyFormattedCitation":"²²⁷"},"properties":{"noteIndex":0},"schema":""}229:When indicated, CRT is used slightly less in women vs. menTHESUS-HFSliwa 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/eht393","ISSN":"0195668X","PMID":"24048728","abstract":"AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population.\\n\\nMETHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown.\\n\\nCONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.","author":[{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okekuchwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-1","issue":"40","issued":{"date-parts":[["2013"]]},"page":"3151-3159","title":"Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry","type":"article-journal","volume":"34"},"uris":[""]}],"mendeley":{"formattedCitation":"²³⁸","plainTextFormattedCitation":"238","previouslyFormattedCitation":"²³⁶"},"properties":{"noteIndex":0},"schema":""}238:Sex was not associated with all cause death or readmission through 60 daysAdjusted HR 1.16 (0.83-1.63)Sex was not associated with all cause mortality to 180 days1.38 (0.97-1.96)Sex bottom line: In large registry studies, sex does not appear to be associated with a difference in mortality. However, with respect to performance & quality of care measures (evidence based heart failure therapies), women consistently have lower odds of receiving many/most of these therapies. Also, the clinical heart failure picture appears to be different between men/women (see Nieminen 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejheart.2007.12.012","ISSN":"1388-9842","PMID":"18279769","abstract":"This analysis evaluates the gender differences in patients hospitalised for acute heart failure (AHF) in the EuroHeart Failure Survey II (EHFS).","author":[{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose Luis","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2008"]]},"page":"140-148","title":"Gender related differences in patients presenting with acute heart failure. Results from EuroHeart Failure Survey II.","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁴","plainTextFormattedCitation":"74","previouslyFormattedCitation":"⁷²"},"properties":{"noteIndex":0},"schema":""}74), with differences in incidence of comorbidities and demographics which could potentially affect outcomes indirectly. For these reasons sex should be included as a case-mix variable. RACE/ETHNICITYADHEREKamath 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/archinte.168.11.1152","ISBN":"1538-3679","ISSN":"1538-3679","PMID":"18541822","abstract":"BACKGROUND: Outcomes in patients with chronic heart failure vary by race. Racial differences in the characteristics and outcomes of patients with acute decompensated heart failure (ADHF) have not been well characterized. Therefore, we assessed race-related differences in presentation, treatment, in-patient experiences, and short-term mortality due to ADHF before and after accounting for known covariates. METHODS: The Acute Decompensated Heart Failure National Registry database was analyzed to evaluate demographic and mortality differences in African American and white patients with ADHF entered into the database from its initiation in September 2001 to December 31, 2004. Stratified analyses by cause, age, left ventricular function, and history of heart failure subgroups were also conducted. RESULTS: A total of 105,872 episodes of ADHF occurred in white patients and 29,862 occurred in African American patients. African American patients with ADHF were younger than white patients (mean [SD] age, 63.5 [15.4] vs 72.5 [12.5] years) and had lower mean left ventricular ejection fractions. The prevalence of hypertension, diabetes mellitus, and obesity was higher in African American patients. African American race was associated with lower in-hospital mortality after adjustment for known predictors (2.1% vs 4.5%; adjusted odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72-0.87; P < .001). This association persisted for all age cohorts, was independent of the use of intravenous vasoactive drugs, and was especially present in African American patients in the nonischemic subgroup (adjusted OR, 0.74; 95% CI, 0.57-0.96) but not the ischemic subgroup (adjusted OR, 0.91; 95% CI, 0.76-1.09). CONCLUSION: In ADHF, African American race is associated with lower in-hospital mortality compared with white race, despite certain indicators of increased disease severity.","author":[{"dropping-particle":"","family":"Kamath","given":"Sandeep a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drazner","given":"Mark H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wynne","given":"Janet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Archives of internal medicine","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2008"]]},"page":"1152-1158","title":"Characteristics and outcomes in African American patients with decompensated heart failure.","type":"article-journal","volume":"168"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁷","plainTextFormattedCitation":"27","previouslyFormattedCitation":"²⁷"},"properties":{"noteIndex":0},"schema":""}27:African American race was associated with lower adjusted odds of mortality relative to the Caucasian populationAll patients: 0.77 (0.70-0.85)Non ischemic origin: 0.74 (0.57-0.96)Previous HF history: 0.77 (0.69-0.85)If ischemic etiology or past MI, no mortality difference between race0.88 (0.74-1.05)ADHERE-IntWest 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfr064","ISBN":"1879-0844","ISSN":"13889842","PMID":"21712289","abstract":"To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF).","author":[{"dropping-particle":"","family":"West","given":"Ryenn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kociol","given":"Robb","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oconnor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2011"]]},"page":"945-952","title":"Characterization of heart failure patients with preserved ejection fraction: A comparison between ADHERE-US registry and ADHERE-International registry","type":"article-journal","volume":"13"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁸","plainTextFormattedCitation":"28","previouslyFormattedCitation":"²⁸"},"properties":{"noteIndex":0},"schema":""}28:Between ADHERE (USA) and ADHERE-Int (Asia-Pacific & Latin America), a difference in risk of all cause in hospital mortality was not observed0.80 (0.61-1.05)However, a differential illness pattern was suggested by differences in baseline characteristics between the two registry populationsADHERE showed more CAD/IHD, past MI, renal failure, etc.Suarez 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2012.02.008","ISBN":"1097-6744","ISSN":"00028703","PMID":"22607858","abstract":"Background: We sought to characterize patient factors and regional variations associated with vitamin K antagonist (VKA) use in patients with heart failure (HF) and atrial fibrillation (AF) in areas outside the United States and Europe. Methods: The ADHERE-International registry enrolled patients with decompensated HF from 10 Asia Pacific and Latin American countries from December 2005 to January 2009. Rates of VKA use in patients with HF and either new-onset AF or a history of AF were determined and compared according to CHADS 2 scores. Multivariable logistic regression and hierarchical modeling with random effects for hospitals were used to determine clinical and regional factors associated with VKA use at discharge. Results: Among 9,706 admissions, there were 2,358 (24.3%) with prior AF and 674 (6.9%) with new-onset AF. The median age was 71 years (25th-75th percentiles 59-79) for prior AF and 69 (57-80) for new-onset AF patients. The overall rate of VKA use at discharge was 39.5%. Vitamin K antagonist use at discharge was 36.2% in patients with CHADS 2 scores ≥2 versus 50.2% in patients with CHADS 2 score equal to 1 (P <.0001). Vitamin K antagonist use was 36.4% in patients with hypertension, 28.1% in patients >75 years old, 34.8% in diabetics, and 44.4% in those with prior stroke/transient ischemic attack. After adjusting for patient characteristics, the highest and lowest rates of anticoagulation were in Australia (65.2%) and Taiwan (25.1%). Conclusion: International use of guidelines-recommended anticoagulation in HF patients with AF varies significantly across countries and represents an important opportunity for improving quality of care. ? 2012 Mosby, Inc.","author":[{"dropping-particle":"","family":"Suarez","given":"Jorge","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Atherton","given":"John J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hayward","given":"Christopher S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krum","given":"Henry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopes","given":"Renato D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2012"]]},"page":"804-811","publisher":"Mosby, Inc.","title":"International variation in use of oral anticoagulation among heart failure patients with atrial fibrillation","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"³²","plainTextFormattedCitation":"32","previouslyFormattedCitation":"³²"},"properties":{"noteIndex":0},"schema":""}32:Adjusted odds of receiving warfarin in a.fib in the heart failure population varied across Latin American and Asia-Pacific countries, though this was not tested formally between countriesCOHEREAbraham 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1527-5299.2007.888111.x","ISSN":"1527-5299","abstract":"Heart failure (HF) clinical trials suggest different responses of blacks and whites to beta-blockers. Differences between clinical trial and community settings may also have an impact. The Carvedilol Heart Failure Registry (COHERE) observed experience with carvedilol in 4280 patients with HF in a community setting. This analysis compares characteristics, outcomes, and carvedilol dosing of blacks and whites in COHERE. Compared with whites (n=3433), blacks (n=523) had more severe HF symptoms despite similar systolic function. At similar carvedilol maintenance doses, symptoms improved in 33% of blacks vs 28% of whites, while worsening in 10% and 11%, respectively (both nonsignificant), and HF hospitalization rates were reduced comparably in both groups (-58% vs -56%, respectively; both P<.001). Incidence and hazard ratios of death were similar in blacks and whites (6.9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Congestive Heart Failure","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2007"]]},"page":"16-21","title":"Tolerability, Safety, and Efficacy of Beta-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective Beta-Blocker Registry","type":"article-journal","volume":"13"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁷","plainTextFormattedCitation":"67","previouslyFormattedCitation":"⁶⁵"},"properties":{"noteIndex":0},"schema":""}67:No difference between African Americans and Caucasians in terms of Kaplan-Meier mortality rates up to 15 months. At 15 months, age & sex adjusted HR for mortality was 1.3 (0.9-1.9)African Americans had more hospitalizations in the year following enrolment (15 vs. 11% - p=0.007)Race was not associated with a significant difference in NYHA or patient reported symptoms after 1 yearGreenberg 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2006.06.050","ISSN":"00029149","PMID":"17126654","abstract":"Risk factors for outcomes in heart failure (HF) were derived from populations in clinical trials, at hospital discharge, or in localized geographic or socioeconomic strata before the widespread use of beta blockers. This study observed 4,280 patients in a community-based HF registry for 1 year after completing carvedilol titration. Independent risk factors for death, hospitalization for HF, or hospitalization for cardiovascular reasons other than HF were first identified by age-, gender-, and race-adjusted analyses, then by multivariate analysis adjusted simultaneously for all factors. Over this period, 7% of patients died, 11% were hospitalized for HF, 12% were hospitalized for other cardiovascular reasons, and 27% had > or =1 of these events. The most significant outcome predictors were New York Heart Association class III or IV, history of hospitalization for HF or other cardiovascular reasons, and angina pectoris, all associated with increased odds of having an adverse outcome (all p < or =0.001). The left ventricular ejection fraction was not a significant outcome predictor by multivariate analysis. The odds ratio for an adverse outcome was significantly reduced for patients with hypertensive or idiopathic causes of HF and for those whose physicians had graduated from medical school > or =24 years earlier compared with <14 years earlier (all p <0.005). In conclusion, easily obtained historical information predicts clinical outcomes in patients with HF in the year after initiating carvedilol. In this unselected community population, these historical factors were better predictors of risk than the left ventricular ejection fraction.","author":[{"dropping-particle":"","family":"Greenberg","given":"Barry","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lottes","given":"Sandra R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nelson","given":"Jeanenne J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lukas","given":"Mary Ann","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fowler","given":"Michael B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Massie","given":"Barry M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbert","given":"Edward M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Franciosa","given":"Joseph a","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2006"]]},"page":"1480-1484","title":"Predictors of clinical outcomes in patients given carvedilol for heart failure.","type":"article-journal","volume":"98"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁴","plainTextFormattedCitation":"64","previouslyFormattedCitation":"⁶²"},"properties":{"noteIndex":0},"schema":""}64:Race (vs. Caucasian) was not associated with risk of the composite of all cause mortality, HF hospitalization, non-HF cardiovascular hospitalizationAsian: 1.058 (0.675-1.659)African American: 1.016 (0.802-1.288)Hispanic: 0.906 (0.623-1.318)GWTG-HFHernandez 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.298.13.1525","ISSN":"1538-3598","PMID":"17911497","abstract":"CONTEXT: Practice guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for patients with heart failure and left ventricular ejection fraction of 30% or less. The influence of sex and race on ICD use among eligible patients is unknown. OBJECTIVE: To examine sex and racial differences in the use of ICD therapy. DESIGN, SETTING, AND PATIENTS: Observational analysis of 13,034 patients admitted with heart failure and left ventricular ejection fraction of 30% or less and discharged alive from hospitals in the American Heart Association's Get With the Guidelines-Heart Failure quality-improvement program. Patients were treated between January 2005 and June 2007 at 217 participating hospitals. MAIN OUTCOME MEASURES: Use of ICD therapy or planned ICD therapy at discharge. RESULTS: Among patients eligible for ICD therapy, 4615 (35.4%) had ICD therapy at discharge (1614 with new ICDs, 527 with planned ICDs, and 2474 with prior ICDs). ICDs were used in 375 of 1329 eligible black women (28.2%), 754 of 2531 white women (29.8%), 660 of 1977 black men (33.4%), and 2356 of 5403 white men (43.6%) (P < .001). After adjustment for patient characteristics and hospital factors, the adjusted odds of ICD use were 0.73 (95% confidence interval, 0.60-0.88) for black men, 0.62 (95% confidence interval, 0.56-0.68) for white women, and 0.56 (95% confidence interval, 0.44-0.71) for black women, compared with white men. The differences were not attributable to the proportions of women and black patients at participating hospitals or to differences in the reporting of left ventricular ejection fraction. CONCLUSIONS: Less than 40% of potentially eligible patients hospitalized for heart failure received ICD therapy, and rates of use were lower among eligible women and black patients than among white men.","author":[{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Khatib","given":"Sana M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"LaBresh","given":"Kenneth a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-1","issue":"13","issued":{"date-parts":[["2007"]]},"page":"1525-1532","title":"Sex and racial differences in the use of implantable cardioverter-defibrillators among patients hospitalized with heart failure.","type":"article-journal","volume":"298"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸¹","plainTextFormattedCitation":"81","previouslyFormattedCitation":"⁷⁹"},"properties":{"noteIndex":0},"schema":""}81:Non-Caucasian race associated with lower odds of having an ICD placed/planned if clinically indicatedAfrican American: 0.58 (0.52-0.65)Other: 0.68 (0.59-0.86)Significant interaction for (sex (female) ? race (non-Caucasian))Ambardekar 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2009.07.034","ISSN":"00028703","PMID":"19781426","abstract":"Background: Medication and dietary nonadherence are precipitating factors for heart failure (HF) hospitalization; however, the characteristics, outcomes, and quality of care of patients with nonadherence are unknown. Recognizing features of nonadherent patients may provide a means to reduce rehospitalization for this population. Methods: GWTG-HF registry data were collected from 236 hospitals and 54,322 patients from January 1, 2005 to December 30, 2007. Demographics, clinical characteristics, in-hospital outcomes, and quality of care were stratified by precipitating factor for HF admission. Multivariate logistic regression analysis was used to determine the association of nonadherence with length of stay (LOS) and in-hospital mortality. Results: Clinicians documented dietary and/or medication nonadherence as the reason for admission in 5576 (10.3%) of HF hospitalizations. Nonadherent patients were younger and more likely to be male, minority, uninsured, and have nonischemic HF. These patients had lower ejection fractions (34.9% vs 39.6%, P < .0001), more frequent previous HF hospitalizations, higher brain natriuretic peptide levels (1813 vs 1371 pg/mL, P < .0001), and presented with greater signs of congestion. Despite this, nonadherent patients had shorter LOS (odds ratio 0.94, 95% CI 0.92-0.97) and lower in-hospital mortality (odds ratio 0.65, 95% CI 0.51-0.83) in multivariate analysis. Although nonadherent patients received high rates of Joint Commission core measures, rates of other evidence-based treatments were less optimal. Conclusions: Nonadherence is a common precipitant for HF admission. Despite a higher risk profile, nonadherent patients had lower in-hospital mortality and LOS, suggesting that it may be easier to stabilize nonadherent patients by reinstituting sodium and/or fluid restriction and resuming medical therapy. ? 2009 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pan","given":"Wenqin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2009"]]},"page":"644-652","publisher":"Mosby, Inc.","title":"Characteristics and in-hospital outcomes for nonadherent patients with heart failure: Findings from Get With The Guidelines-Heart Failure (GWTG-HF)","type":"article-journal","volume":"158"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁸","plainTextFormattedCitation":"88","previouslyFormattedCitation":"⁸⁶"},"properties":{"noteIndex":0},"schema":""}88:Non-Caucasian race was associated with a higher adjusted odds of non-adherence to therapy1.489 (1.358-1.632)Albert 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1001/jama.2009.1493","ISBN":"1538-3598 (Electronic)\\n0098-7484 (Linking)","ISSN":"0098-7484","PMID":"19843900","abstract":"CONTEXT: Aldosterone antagonists are recommended for patients with moderate to severe heart failure (HF) and systolic dysfunction. Prior studies suggest underuse of aldosterone antagonists in eligible patients as well as overuse in settings in which therapy may be harmful. OBJECTIVE: To examine aldosterone antagonist prescription based on HF management guideline criteria, investigator-defined appropriateness criteria, and trends over time in patients hospitalized with heart failure. DESIGN, SETTING, AND PATIENTS: Observational analysis of 43,625 patients admitted with HF and discharged home from 241 hospitals participating in the Get With The Guidelines-HF quality improvement registry between January 2005 and December 2007. MAIN OUTCOME MEASURES: Prescription and predictors of use of aldosterone antagonists, based on guideline criteria. RESULTS: Among 12,565 patients eligible for aldosterone antagonist therapy, 4087 (32.5%) received an aldosterone antagonist at discharge, and treatment increased modestly from 28% to 34% over the study period. There was also wide variation in aldosterone antagonist use among hospitals (0%-90.6%). Aldosterone antagonist use in eligible patients was associated with younger age (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.82-0.88), African American race/ethnicity (adjusted OR, 1.17; 95% CI, 1.04-1.32), lower systolic blood pressure (adjusted OR, 0.94; 95% CI, 0.92-0.95), history of implantable cardioverter-defibrillator use (adjusted OR, 1.51; 95% CI, 1.34-1.69), depression (adjusted OR, 1.15; 95% CI, 1.01-1.30), alcohol use (adjusted OR, 1.23; 95% CI, 1.02-1.50), and pacemaker implantation (adjusted OR, 1.21; 95% CI, 1.06-1.38), and with having no history of renal insufficiency (adjusted OR, 0.85; 95% CI, 0.75-0.96). Applying serum creatinine and potassium appropriateness criteria, inappropriate and potentially inappropriate use of aldosterone antagonist therapy was low and did not change over the 3-year study period. CONCLUSIONS: Less than one-third of eligible patients hospitalized for HF and participating in a quality improvement registry received HF guideline-recommended aldosterone antagonist therapy. Use of aldosterone antagonist therapy among patients with documented contraindications was low.","author":[{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cannon","given":"Christopher P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JAMA : the journal of the American Medical Association","id":"ITEM-1","issue":"15","issued":{"date-parts":[["2009"]]},"page":"1658-1665","title":"Use of aldosterone antagonists in heart failure.","type":"article-journal","volume":"302"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁹","plainTextFormattedCitation":"89","previouslyFormattedCitation":"⁸⁷"},"properties":{"noteIndex":0},"schema":""}89:African Americans had higher adjusted odds of receiving aldosterone antagonists vs. Caucasians1.17 (1.04-1.32)Whellan 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2011.04.005","ISBN":"1532-8414 (Electronic)\\r1071-9164 (Linking)","ISSN":"10719164","PMID":"21807326","abstract":"Background: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. Methods and Results: A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With The Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r 2 of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation. Conclusions: Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2011"]]},"page":"649-656","publisher":"Elsevier Inc","title":"Predictors of hospital length of stay in heart failure: Findings from get with the guidelines","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁵","plainTextFormattedCitation":"95","previouslyFormattedCitation":"⁹³"},"properties":{"noteIndex":0},"schema":""}95:When adjusting for patient characteristics, Caucasians had a lower length of stay ratio relative to African Americans0.97 (0.95-1.0)However: this was not significant on further adjustment for hospital characteristics and laboratory values1.01 (0.98-1.04)Kociol 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2011.05.032","ISBN":"1879-1913 (Electronic)\\n0002-9149 (Linking)","ISSN":"00029149","PMID":"21791327","abstract":"Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF <65 years at 225 hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE) registry or the Get With The Guidelines-Heart Failure (GWTG-HF) registry from January 1, 2003 through December 31, 2006. We linked these clinical data to Medicare claims data for longitudinal follow-up. Using logistic regression models with site-level random effects, we identified predictors of physician follow-up within 7 days of hospital discharge. Overall 11,420 patients (37.9%) had early physician follow-up. Patients residing in hospital referral regions with higher physician concentration were significantly more likely to have early follow-up (odds ratio 1.29, 95% confidence interval 1.12 to 1.48, for highest vs lowest quartile). Patients in rural areas (0.84, 0.78 to 0.91) and patients with lower socioeconomic status (0.79, 0.74 to 0.85) were less likely to have early follow-up. Women (0.87, 0.83 to 0.91) and black patients (0.84, 0.77 to 0.92) were less likely to receive early follow-up. Patients with greater co-morbidity were less likely to receive early follow-up. In conclusion, physician follow-up within 7 days after discharge from a HF hospitalization varied according to regional physician density, rural location, socioeconomic status, gender, race, and co-morbid conditions. Strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2011"]]},"page":"985-991","publisher":"Elsevier Inc.","title":"Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure","type":"article-journal","volume":"108"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁶","plainTextFormattedCitation":"96","previouslyFormattedCitation":"⁹⁴"},"properties":{"noteIndex":0},"schema":""}96:African Americans had a lower adjusted odds of early follow-up post heart failure discharge0.84 (0.77-0.92)Thomas 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.01.012","ISSN":"00028703","PMID":"21473975","abstract":"Background: Black and Hispanic populations are at increased risk for developing heart failure (HF) at a younger age and experience differential morbidity and possibly differential mortality compared with whites. Yet, there have been insufficient data characterizing the clinical presentation, quality of care, and outcomes of patients hospitalized with HF as a function of race/ethnicity. Methods: We analyzed 78,801 patients from 257 hospitals voluntarily participating in the American Heart Association's Get With The Guidelines-HF Program from January 2005 thru December 2008. There were 56,266 (71.4%) white, 17,775 (22.6%) black, and 4,760 (6.0%) Hispanic patients. In patients hospitalized with HF, we sought to assess clinical characteristics, adherence to core and other guideline-based HF care measures, and in-hospital mortality as a function of race and ethnicity. Results: Relative to white patients, Hispanic and black patients were significantly younger (median age 78.0, 63.0, 64.0 years, respectively), had lower left ventricular ejection fractions, and had more diabetes mellitus and hypertension. With few exceptions, the provision of guideline-based care was comparable for black, Hispanic, and white patients. Black and Hispanic patients had lower in-hospital mortality than white patients: black/white odds ratio 0.69, 95% CI 0.62-0.78, P < .001 and Hispanic/white odds ratio 0.81, 95% CI 0.67-0.98, P = .03. Conclusions: Hispanic and black patients hospitalized with HF have more cardiovascular risk factors than white patients; however; they have similar or better in-hospital mortality rates. Within the context of a national HF quality improvement program, HF care was equitable and improved in all racial/ethnic groups over time. ? 2011, Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Thomas","given":"Kevin L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2011"]]},"page":"746-754","publisher":"Mosby, Inc.","title":"Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure","type":"article-journal","volume":"161"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁸","plainTextFormattedCitation":"98","previouslyFormattedCitation":"⁹⁶"},"properties":{"noteIndex":0},"schema":""}98:African Americans and Hispanics vs. Caucasians were compared in terms of the following quality of care/performance measures (evidence-based / guideline driven):Non-significant (African American or Hispanic vs. Caucasian):Discharge instructionsSmoking cessation counsellingAldosterone antagonist use if LV systolic dysfunction ACEI/ARB if LV systolic dysfunctionLV function assessment:African American: 1.35 (1.19-1.54)Hispanic: not significantBeta blocker if LV systolic dysfunctionAf. American: 0.84 (0.74-0.96)Hispanic: not significantIsosorbide/hydralazine if LVSDAf. American: 1.97 (1.8-2.15)Hispanic: 1.3 (1.12-1.5)Discharge BP< 140/90Af. American: 0.82 (0.77-0.87)Hispanic: Not significantICD placed if indicatedAf. American: 0.452 (0.375-0.545)Hispanic: 0.589 (0.474-0.732)Mortality in hospital (adjusted odds)Af. American: 0.69 (0.62-0.78)Hispanic: 0.81 (0.67-0.99)Quick summary: many evidence-based therapies are differentially utilized between races. However, African American and Hispanic patients showed lower odds of in hospital mortality relative to white patients despite these differences. Allen 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁰","plainTextFormattedCitation":"100","previouslyFormattedCitation":"⁹⁸"},"properties":{"noteIndex":0},"schema":""}100:Caucasian race not associated with increased adjusted odds of discharge to skilled nursing facility1.15 (1.00-1.32)Whellan 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2012.02.006","ISSN":"10719164","PMID":"22633304","abstract":"Background: Guidelines recommend hospice care as a treatment option for end-stage heart failure (HF) patients. Little is known regarding utilization of hospice care in a contemporary cohort of patients hospitalized with HF and how this may vary by estimated mortality risk. Methods: We analyzed HF patients ≥65 years (n = 58,330) from 214 hospitals participating in the Get With the Guidelines-HF program. Univariate analysis comparing patients discharged to hospice versus other patients was performed. Hospice utilization was evaluated for deciles of estimated 90-day mortality risk using a validated model. Multivariate analysis using admission patient and hospital characteristics was also performed to determine factors associated with hospice discharge. Results: There were 1,442 patients discharged to hospice, and rates of referral varied widely by hospital (interquartile range 0-3.7%) as shown in the univariate analysis. Patients discharged to hospice were significantly older and more often white, had lower left ventricular ejection fraction, higher B-type natriuretic peptide, and lower systolic blood pressure on admission. Utilization rates for each decile of 90-day estimated mortality risk ranged from 0.3% to 8.6%. Multivariable analysis found that factors associated with hospice utilization included increased age, low systolic blood pressure on admission, and increased blood urea nitrogen. Conclusions: Hospice utilization remains low among HF patients, even those with the highest predicted risk of death. ? 2012 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2012"]]},"page":"471-477","publisher":"Elsevier Inc","title":"Utilization of hospice and predicted mortality risk among older patients hospitalized with heart failure: Findings from GWTG-HF","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁸","plainTextFormattedCitation":"108","previouslyFormattedCitation":"¹⁰⁶"},"properties":{"noteIndex":0},"schema":""}108:Caucasian patients (vs. non) had higher adjusted odds of discharge to hospice care1.5254 (1.277-1.822)Those with higher predicted risk of 90 day mortality had a higher proportion discharged to hospice (not formally tested)Thomas 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/JAHA.113.000200","ISSN":"2047-9980","PMID":"24072530","abstract":"BACKGROUND: The intersection of heart failure (HF) and atrial fibrillation (AF) is common, but the burden of AF among black patients with HF is poorly characterized. We sought to determine the prevalence of AF, characteristics, in-hospital outcomes, and warfarin use associated with AF in patients hospitalized with HF as a function of race.\\n\\nMETHODS AND RESULTS: We analyzed data on 135 494 hospitalizations from January 2006 through January 2012 at 276 hospitals participating in the American Heart Association's Get With The Guidelines HF Program. Multivariable logistic regression models using generalized estimating equations approach for risk-adjusted comparison of AF prevalence, in-hospital outcomes, and warfarin use. In this HF population, 53 389 (39.4%) had AF. Black patients had markedly less AF than white patients (20.8% versus 44.8%, P < 0.001). Adjusting for risk factors and hospital characteristics, black race was associated with significantly lower odds of AF (adjusted odds ratio 0.52, 95% CI 0.48 to 0.55, P < 0.0001). There were no racial differences in in-hospital mortality; however, black patients had a longer length of stay relative to white patients. Black patients compared with white patients with AF were less likely to be discharged on warfarin (adjusted odds ratio 0.76, 95% CI 0.69 to 0.85, P < 0.001).\\n\\nCONCLUSIONS: Despite having many risk factors for AF, black patients, relative to white patients hospitalized for HF, had a lower prevalence of AF and lower prescription of guideline-recommended warfarin therapy.","author":[{"dropping-particle":"","family":"Thomas","given":"Kevin L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piccini","given":"Jonathan P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2013"]]},"page":"e000200","title":"Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure.","type":"article-journal","volume":"2"},"uris":[""]}],"mendeley":{"formattedCitation":"¹¹⁷","plainTextFormattedCitation":"117","previouslyFormattedCitation":"¹¹⁵"},"properties":{"noteIndex":0},"schema":""}117:African Americans had lower adjusted odds of a.fib vs. Caucasians0.52 (0.48-0.55)No significance of adjusted odds of in hospital mortality between African American and Caucasian patients0.79 (0.61-1.02)African Americans had a slightly longer length of stay vs Caucasian1.04 (1.01-1.07)African Americans had a lower odds of receiving warfarin if in atrial fibrillation and not contraindicated0.76 (0.69-0.85)Vivo 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/JAHA.114.001134","ISSN":"2047-9980","author":[{"dropping-particle":"","family":"Vivo","given":"R. P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"S. R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Neely","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"a. F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eapen","given":"Z. J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"E. D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"D. L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"P. a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"C. W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"G. C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American Heart Association","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2014"]]},"page":"e001134-e001134","title":"Short- and Long-term Rehospitalization and Mortality for Heart Failure in 4 Racial/Ethnic Populations","type":"article-journal","volume":"3"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³⁰","plainTextFormattedCitation":"130","previouslyFormattedCitation":"¹²⁸"},"properties":{"noteIndex":0},"schema":""}130:Compared to Caucasian patients, African American patients had:Lower adjusted HR for mortality30 day post admission: 0.73 (0.65-0.83)1 year post admission: 0.88 (0.83-0.93)1 year post discharge: 0.93 (0.87-1.0)Higher adjusted HR for readmission 1 year post discharge, all cause: 1.1 (1.04-1.16)1 year post discharge, cardiovascular: 1.2 (1.13-1.28)Compared to Caucasian patients, Hispanic patients had:Higher adjusted HR for cardiovascular readmission 1 year post discharge1.15 (1.06-1.24)No mortality differences were noted between Hispanic and Caucasian patientsQian 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ijcard.2015.03.400","ISSN":"01675273","author":[{"dropping-particle":"","family":"Qian","given":"Feng","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krim","given":"Selim R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vivo","given":"Rey P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hannan","given":"Edward L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaw","given":"Benjamin a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-1","issue":"September 2010","issued":{"date-parts":[["2015"]]},"page":"141-147","publisher":"Elsevier Ireland Ltd","title":"Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program","type":"article-journal","volume":"189"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³²","plainTextFormattedCitation":"132","previouslyFormattedCitation":"¹³⁰"},"properties":{"noteIndex":0},"schema":""}132Asian American patients vs. Caucasian, adjusted RR of:Aldosterone antagonist at discharge: 0.878 (0.775-0.994)Anticoagulation if a.fib and not contraindicated: 0.908 (0.853-0.967)Follow-up within 7 days: 1.108 (1.013-1.085)Discharge home: 1.081 (1.055-1.108)Overall the Asian patients tended to be healthier based on comparison of baseline characteristics, which may account for the differences we see above. That said, the RR for being Asian was independent of adjustment for patient and hospital factors. IMPROVE-HFZiaeian 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2014.05.060","ISSN":"07351097","PMID":"25145524","abstract":"BACKGROUND: Clinical trials have demonstrated benefit for cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillator (ICD) therapies in patients with heart failure with reduced ejection fraction (HFrEF); yet, questions have been raised with regard to the benefit of device therapy for minorities.\\n\\nOBJECTIVES: The purpose of this study was to determine the clinical effectiveness of CRT and ICD therapies as a function of race/ethnicity in outpatients with HFrEF (ejection fraction?≤35%).\\n\\nMETHODS: Data from IMPROVE HF (Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting) were analyzed by device status and race/ethnicity among guideline-eligible patients for mortality at 24 months. Multivariate Generalized Estimating Equations analyses were conducted, adjusting for patient and practice characteristics.\\n\\nRESULTS: The ICD/cardiac resynchronization defibrillator (CRT-D)-eligible cohort (n?= 7,748) included 3,391 (44%) non-Hispanic white, 719 (9%) non-Hispanic black, and 3,638 (47%) other racial/ethnic minorities or race-not-documented patients. The cardiac resynchronization pacemaker (CRT-P)/CRT-D-eligible cohort (n?= 1,188) included 596 (50%) non-Hispanic white, 99 (8%) non-Hispanic black, and 493 (41%) other/not-documented patients. There was clinical benefit associated with ICD/CRT-D therapy (adjusted odds ratio: 0.64, 95% confidence interval: 0.52 to 0.79, p?= 0.0002 for 24-month mortality), which was of similar proportion in white, black, and other minority/not-documented patients (device-race/ethnicity interaction p?= 0.7861). For CRT-P/CRT-D therapy, there were also associated mortality benefits (adjusted odds ratio: 0.55, 95% confidence interval: 0.33 to 0.91, p?= 0.0222), and the device-race/ethnicity interaction was not significant (p?= 0.5413).\\n\\nCONCLUSIONS: The use of guideline-directed CRT and ICD therapy was associated with reduced 24-month mortality without significant interaction by racial/ethnic group. Device therapies should be offered to eligible heart failure patients, without modification based on race/ethnicity.","author":[{"dropping-particle":"","family":"Ziaeian","given":"Boback","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhang","given":"Yan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O’Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2014"]]},"page":"797-807","title":"Clinical Effectiveness of CRT and ICD?Therapy in Heart Failure Patients by?Racial/Ethnic Classification","type":"article-journal","volume":"64"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵²","plainTextFormattedCitation":"152","previouslyFormattedCitation":"¹⁵⁰"},"properties":{"noteIndex":0},"schema":""}152ICD/CRT decreased 24 month mortality in eligible patients with HFrEFNo significant interaction with ICD/CRT by race/ethnicityNo meaningful differences between Caucasian, African American, other (Hispanic, other, not documented)OPTIMIZE-HFYancy 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2008.01.028","ISBN":"1558-3597 (Electronic)\\r0735-1097 (Linking)","ISSN":"07351097","PMID":"18436120","abstract":"Objectives: We sought to examine the characteristics, quality of care, and clinical outcomes for a large cohort of African-American patients hospitalized with heart failure (HF) in centers participating in a quality improvement initiative. Background: Heart failure in African Americans is characterized by variations in natural history, lesser response to evidence-based therapies, and disparate health care. We hypothesized that a performance improvement program will achieve similar adherence to quality measures in African Americans admitted with HF compared with non-African Americans. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry-based performance-improvement program includes a pre-specified 10% subgroup with 60- to 90-day follow-up. Data on quality of care measures and outcomes were analyzed for 8,608 African-American patients compared with 38,501 non-African-American patients. Results: African Americans were significantly younger and more likely to receive evidence-based medications but less likely to receive discharge instructions and smoking cessation counseling. In multivariable analyses, African-American race was an independent predictor of lower in-hospital mortality (odds ratio 0.71; 95% confidence interval 0.57 to 0.87; p < 0.001) but similar hospital length of stay. After multivariable adjustment, post-discharge outcomes were similar for American-American and non-African-American patients, but African-American race was associated with higher angiotensin-converting enzyme inhibitor prescription and left ventricular function assessment; no other HF quality indicators were influenced by race. Conclusions: In the context of a performance-improvement program, African Americans with HF received similar or better treatment with evidence-based medications, less discharge counseling, had better in-hospital survival, and similar adjusted risk of follow-up death/repeat hospital stay. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"She","given":"Lilin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"17","issued":{"date-parts":[["2008"]]},"page":"1675-1684","title":"Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure. Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry","type":"article-journal","volume":"51"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰³","plainTextFormattedCitation":"203","previouslyFormattedCitation":"²⁰¹"},"properties":{"noteIndex":0},"schema":""}203:African American patients typically younger vs. non-African Americans63.6±15.4 vs. 75.2±12.7 (p<0.0001)Af. American had higher adjusted odds of:LV assessment: 1.19 (1.05-1.34)ACEI at discharge: 1.18 (1.0-1.39)Other quality of care indicators non-significantBeta blocker at dischargeACEI or ARB at dischargeSmoking cessation counsellingDelivery of discharge instructionsAf. Americans had lower adjusted odds of in hospital mortality0.71 (0.57-0.87)Af. American race was not associated with: Length of hospital stayPost discharge mortalityRehospitalisation Abraham 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2008.04.028","ISBN":"1558-3597 (Electronic) 0735-1097 (Linking)","ISSN":"07351097","PMID":"18652942","abstract":"Objectives: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. Background: Heart failure patients experience high rates of hospital stays and poor outcomes. Although predictors of mortality have been identified in HF clinical trials, hospitalized patients might differ greatly from trial populations, and such predictors might underestimate mortality in a real-world population. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) is a registry/performance improvement program for patients hospitalized with HF in 259 U.S. hospitals. Forty-five potential predictor variables were used in a stepwise logistic regression model for in-hospital mortality. Continuous variables that did not meet linearity assumptions were transformed. All significant variables (p < 0.05) were entered into multivariate analysis. Generalized estimating equations were used to account for the correlation of data within the same hospital in the adjusted models. Results: Of 48,612 patients enrolled, mean age was 73.1 years, 52% were women, 74% were Caucasian, and 46% had ischemic etiology. Mean left ventricular ejection fraction was 0.39 ± 0.18. In-hospital mortality occurred in 1,834 (3.8%). Multivariable predictors of mortality included age, heart rate, systolic blood pressure (SBP), sodium, creatinine, HF as primary cause of hospitalization, and presence/absence of left ventricular systolic dysfunction. A scoring system was developed to predict mortality. Conclusions: Risk of in-hospital mortality for patients hospitalized with HF remains high and is increased in patients who are older and have low SBP or sodium levels and elevated heart rate or creatinine at admission. Application of this risk-prediction algorithm might help identify patients at high risk for in-hospital mortality who might benefit from aggressive monitoring and intervention. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2008"]]},"page":"347-356","title":"Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure. Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"52"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁴","plainTextFormattedCitation":"204","previouslyFormattedCitation":"²⁰²"},"properties":{"noteIndex":0},"schema":""}204:Af. American race was associated with a decreased adjusted odds of in-hospital mortality0.71 (0.57-0.87)Race bottom line:Evidence exists that there is a differential morbidity and mortality pattern between people of different race. This effect is seen independent of potential confounding variables and persists after adjustment. This is largely supported by American data comparing African American, Asian, Hispanic, and Caucasian patients. Registries from countries / regions with more homogenous populations (Sweden, continental Europe, Japan, Thailand) typically do not include race breakdowns. However, there is some evidence of differential health and practice patterns between the affiliated ADHERE (USA) and ADHERE-Int (Latin America and Asia-Pacific) registries. Also, there appears to be an independent effect of race on practice patterns, whereby certain evidence-based therapies (such as ICD/CRT) are consistently seen less often in the African American population and persist after adjustment for confounding variables. For these reasons race/ethnicity should be included as a case-mix variable.PAST MIAHEADParencia 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejim.2012.11.005","ISSN":"09536205","PMID":"23219321","abstract":"Background The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival. ? 2012 European Federation of Internal Medicine.","author":[{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horakova","given":"Katerina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Internal Medicine","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2013"]]},"page":"151-160","title":"Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)","type":"article-journal","volume":"24"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁷","plainTextFormattedCitation":"37","previouslyFormattedCitation":"³⁷"},"properties":{"noteIndex":0},"schema":""}37:If surviving to 30 days post discharge, past MI associated with adjusted risk of long term mortality of 1.204 (1.024-1.417)Past MI had proportionally more patients in the HFrEF (<50%) vs HFpEF (≥50%) 33.7% vs. 17.2% respectively (p<0.001)Those with EF ≤50% shown by KM analysis to have worse survival to 60 months (p<0.001)EFICAZannad 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejheart.2006.01.001","ISSN":"13889842","PMID":"16516552","abstract":"Background: Little is known about the epidemiology of acute decompensated heart failure (ADHF) in patients admitted to intensive and coronary care units (ICU/CCU). Observational data may improve disease management and guide the design of clinical trials. Aims: EFICA is an observational study of the clinical profile, management and survival of ADHF patients admitted to ICU/CCU. Methods: The study included 599 patients admitted to 60 ICU/CCUs across France. Relevant data was recorded during hospitalisation. Survival was assessed at 4 weeks and 1 year. Results: The main cause of ADHF was ischaemic heart disease (61%); 29% of patients had cardiogenic shock. Mortality was 27.4% at 4 weeks and 46.5% at 1 year, increasing to 43.2% and 62.5%, respectively, when including pre-admission deaths. Shock patients had the highest [57.8% vs. 15.2% without shock (p < 0.001)] and patients with hypertension and pulmonary oedema had the lowest 4-week mortality: (7%). Pre-admission NYHA class III-IV heart failure, not initial clinical presentation, influenced 1-year mortality. Conclusion: ADHF is a heterogeneous syndrome. Based on initial clinical presentation, three entities with distinct features and outcome may be described: cardiogenic shock, pulmonary oedema with hypertension, and 'decompensated' chronic heart failure. This should be taken into account in future observational studies, guidelines and clinical trials. ? 2006 European Society of Cardiology.","author":[{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Juillière","given":"Yves","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cohen-Solal","given":"Alain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guize","given":"Louis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alla","given":"Fran?ois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rougé","given":"Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Blin","given":"Patrick","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Barlet","given":"Marie Hélène","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paolozzi","given":"Laurence","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vincent","given":"Catherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Desnos","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Samii","given":"Kamran","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2006"]]},"page":"697-705","title":"Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study","type":"article-journal","volume":"8"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁹","plainTextFormattedCitation":"69","previouslyFormattedCitation":"⁶⁷"},"properties":{"noteIndex":0},"schema":""}69:Proportions of patients with past MI were not significantly different in terms of severity of presentation (cardiogenic shock vs. not): p=0.28EHFS IIHarjola 2010 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfq002","ISSN":"1879-0844","PMID":"20156940","abstract":"Acute heart failure (AHF) has a poor prognosis. We evaluated 3- and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II.","author":[{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2010"]]},"page":"239-248","title":"Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure.","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁵","plainTextFormattedCitation":"75","previouslyFormattedCitation":"⁷³"},"properties":{"noteIndex":0},"schema":""}75Past MI was associated with an increased adjusted risk of mortalityDischarge to 3 months: 1.36 (1.04–1.77)3-12 months: 1.38 (1.08–1.78)GWTG-HFWhellan 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2011.04.005","ISBN":"1532-8414 (Electronic)\\r1071-9164 (Linking)","ISSN":"10719164","PMID":"21807326","abstract":"Background: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. Methods and Results: A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With The Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r 2 of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation. Conclusions: Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2011"]]},"page":"649-656","publisher":"Elsevier Inc","title":"Predictors of hospital length of stay in heart failure: Findings from get with the guidelines","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁵","plainTextFormattedCitation":"95","previouslyFormattedCitation":"⁹³"},"properties":{"noteIndex":0},"schema":""}95:Previous MI was associated with a decreased hospital LOS after adjustment for patient factors0.96 (0.94-0.98)This persisted after additional adjustment for hospital characteristics and lab values0.97 (0.96-0.99)However this was not a primary outcome of the study, and these regression models contained high numbers of parameters. Due to this, the result may be spurious and should be treated with scrutinyAllen 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁰","plainTextFormattedCitation":"100","previouslyFormattedCitation":"⁹⁸"},"properties":{"noteIndex":0},"schema":""}100 Previous MI was associated with a decreased adjusted odds of discharge to a skilled nursing facility 0.86 (0.75-0.98)Those discharged to a nursing facility demonstrated increased odds of mortality and hospitalization to 900 days on KM analysisp<0.001 in both casesHeidenreich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.10.008","ISBN":"0002-8703 1097-6744","ISSN":"00028703","PMID":"22305842","abstract":"Background: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare and Medicaid Services) and the main hospital accrediting organization (The Joint Commission). Methods: We used data from Get With The Guidelines Program for patients hospitalized with heart failure. Eligibility for receiving care based on the Center for Medicare and Medicaid Services performance measures was determined for assessment of left ventricular ejection fraction (LVEF; n = 60,601), use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) if LVEF<40% and no contraindications (24,130), discharge instructions (49,383), and smoking cessation counseling (10,152). Patient and hospital characteristics that were significantly associated with performance measures in univariate analyses were entered into multivariate logistic regression models. Results: Overall, documentation for LVEF assessment was noted in 95%, ACEi/ARB use in 87%, discharge instruction in 82%, and smoking cessation counseling in 91% of eligible patients. In adjusted analyses, older patients and those with evidence of renal failure were significantly less likely to receive each care measure except for discharge instructions (no age effect). Patients with higher body mass index were more likely to receive ACEi/ARB and discharge instructions but less likely to have LVEF documented or to receive smoking cessation counseling. Small hospitals (<200 beds) were less likely to provide each of the performance measures compared with larger hospitals. Conclusion: Recommended heart failure care is less likely in patients with certain characteristics (older age and abnormal renal function) and those cared for in smaller hospitals. Programs to improve evidence-based care for heart failure should consider interventions specifically targeting and tailored to smaller facilities and patients who are older with comorbidities. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012"]]},"page":"239-245.e3","publisher":"Elsevier B.V.","title":"Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁵","plainTextFormattedCitation":"105","previouslyFormattedCitation":"¹⁰³"},"properties":{"noteIndex":0},"schema":""}105:Past MI was associated with a higher adjusted odds of the following quality of care measuresSmoking cessation counselling1.28 (1.07-1.53)LVEF documentation1.31 (1.19-1.44)ACEI/ARB1.14 (1.01-1.30)Discharge instructions1.14 (1.03-1.25)Past MI Bottom Line:Past MI appears to be associated with a higher risk of mortality, but also increased odds of receiving certain heart failure quality of care measures (evidence-based therapies, etc.). Many studies report a history of ischemic heart disease or ischemic HF etiology. However, this is quite broad and may include everything from mild angina to crippling IHD symptoms and life threatening coronary disease. The rationale for using past MI as a variable, is that it provides greater concrete evidence of an underlying ischemic process. Also, myocardial damage as a result of an MI may be the ultimate underlying feature of the HF process and/or EF picture. In contrast, simply having coronary disease may affect myocardial function and LVEF, giving a heart failure picture clinically. However, functional decline and symptoms often can be easily reversed with revascularization procedures (PCI, CABG) which following would take patients out of the HF picture. Recall discussions when defining the scope of the HF standard set (HF symptoms / signs with a correctable cause). For these reasons past MI is favoured and should be included as a case-mix variable. RENAL FAILUREADHEREYancy 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2005.09.022","ISSN":"07351097","PMID":"16386668","abstract":"OBJECTIVES: The aims of this analysis were to describe the clinical characteristics, management, and outcomes of patients hospitalized for acute decompensated heart failure (HF) with preserved systolic function (PSF). BACKGROUND: Clinically meaningful characteristics of these patients have not been fully studied in a large database. METHODS: Data from >100,000 hospitalizations from the Acute Decompensated Heart Failure National Registry (ADHERE) database were analyzed. RESULTS: Heart failure with PSF was present in 50.4% of patients with in-hospital assessment of left ventricular function. When compared with patients with systolic dysfunction, patients with PSF were more likely to be older, women, and hypertensive and less likely to have had a prior myocardial infarction or be receiving an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. In-hospital mortality was lower in patients with PSF compared with patients with systolic dysfunction (2.8% vs. 3.9%; adjusted odds ratio [OR]: 0.86; p = 0.005), but duration of intensive care unit stay and total hospital length of stay were similar. Serum creatinine >2 mg/dl was associated with increased in-hospital mortality in both systolic function groups (PSF: 4.8%; systolic dysfunction: 8.4%; p < 0.0001), and the most powerful predictors of in-hospital mortality in both groups were blood urea nitrogen >37 mg/dl (OR: 2.53; 95% confidence interval [CI]: 2.22 to 2.87) and systolic blood pressure ≤125 mm Hg (OR: 2.58; 95% CI: 2.33 to 2.86). CONCLUSIONS: Heart failure with PSF is common and is characterized by a unique patient profile. Event rates are worrisome and reflect a need for more effective management strategies. ? 2006 by the American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stevenson","given":"Lynne Warner","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marco","given":"Teresa","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2006"]]},"page":"76-84","title":"Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) database","type":"article-journal","volume":"47"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰","plainTextFormattedCitation":"10","previouslyFormattedCitation":"¹⁰"},"properties":{"noteIndex":0},"schema":""}10:Elevated SCr (>1.5) mg/dL (Approx 133 umol/L) was associated with an increased adjusted odds of in hospital mortality1.37 (1.23-1.51)West 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfr064","ISBN":"1879-0844","ISSN":"13889842","PMID":"21712289","abstract":"To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF).","author":[{"dropping-particle":"","family":"West","given":"Ryenn","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kociol","given":"Robb","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mills","given":"Roger M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oconnor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2011"]]},"page":"945-952","title":"Characterization of heart failure patients with preserved ejection fraction: A comparison between ADHERE-US registry and ADHERE-International registry","type":"article-journal","volume":"13"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁸","plainTextFormattedCitation":"28","previouslyFormattedCitation":"²⁸"},"properties":{"noteIndex":0},"schema":""}28:A 10 unit increase in BUN was associated with an increased adjusted risk of all-cause in-hospital mortality1.13 (1.09-1.17)AHEADSpinar 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/cc10584","ISBN":"0195-668X","ISSN":"1364-8535","PMID":"22152228","abstract":"INTRODUCTION: The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.\\n\\nMETHODS: The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.\\n\\nRESULTS: Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.\\n\\nCONCLUSIONS: The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.","author":[{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmír","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarová","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Critical Care","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2011"]]},"page":"R291","publisher":"BioMed Central Ltd","title":"Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁴","plainTextFormattedCitation":"34","previouslyFormattedCitation":"³⁴"},"properties":{"noteIndex":0},"schema":""}34:Admission SCr >120 umol/L was associated with an increase in adjusted odds of in hospital mortality1.5 (1.0-2.2)Parencia 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejim.2012.11.005","ISSN":"09536205","PMID":"23219321","abstract":"Background The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival. ? 2012 European Federation of Internal Medicine.","author":[{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horakova","given":"Katerina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Internal Medicine","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2013"]]},"page":"151-160","title":"Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)","type":"article-journal","volume":"24"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁷","plainTextFormattedCitation":"37","previouslyFormattedCitation":"³⁷"},"properties":{"noteIndex":0},"schema":""}37:In both patients with preserved and reduced EF, max SCr >145 umol/L was associated with increased adjusted odds of long-term mortality1.660 (1.353-2.036) – EF<50%1.577 (1.105-2.250) – EF≥50%In patients with and without BNP measurements taken and surviving until post admission day 30, SCr was similarly associated with increased adjusted odds of long term mortality1.812 (1.544-2.125) – Without 1.535 (1.071-2.199) – With ATTENDKajimoto 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2215/CJN.04400514","ISSN":"1555-9041","author":[{"dropping-particle":"","family":"Kajimoto","given":"K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sakata","given":"Y.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical Journal of the American Society of Nephrology","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2014"]]},"page":"1912-1921","title":"Associations of Anemia and Renal Dysfunction with Outcomes among Patients Hospitalized for Acute Decompensated Heart Failure with Preserved or Reduced Ejection Fraction","type":"article-journal","volume":"9"},"uris":[""]}],"mendeley":{"formattedCitation":"⁵⁶","plainTextFormattedCitation":"56","previouslyFormattedCitation":"⁵⁴"},"properties":{"noteIndex":0},"schema":""}56:In patients with preserved EF (>40%) and renal dysfunction (eGFR <60 mL/min/1.73m2), the adjusted odds of post-discharge mortality and readmission:0.87 (0.59-1.26)Inpatients with reduced EF (≤40%) and renal dysfunction, the adjusted odds of post-discharge mortality and readmission:1.65 (1.21-2.25)Inohara 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1371/journal.pone.0105596","ISSN":"1932-6203","author":[{"dropping-particle":"","family":"Inohara","given":"Taku","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kohsaka","given":"Shun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keida","given":"Takehiko","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mizuno","given":"Masayuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PLoS ONE","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2014"]]},"page":"e105596","title":"Prognostic Impact of Renal Dysfunction Does Not Differ According to the Clinical Profiles of Patients: Insight from the Acute Decompensated Heart Failure Syndromes (ATTEND) Registry","type":"article-journal","volume":"9"},"uris":[""]}],"mendeley":{"formattedCitation":"⁵³","plainTextFormattedCitation":"53","previouslyFormattedCitation":"⁵¹"},"properties":{"noteIndex":0},"schema":""}53:Renal dysfunction (GFR ≤50 mL/min/1.73 m2) was an independent predictor of all-cause deathAdjusted OR: 2.36 (1.75–3.18)EFICAZannad 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejheart.2006.01.001","ISSN":"13889842","PMID":"16516552","abstract":"Background: Little is known about the epidemiology of acute decompensated heart failure (ADHF) in patients admitted to intensive and coronary care units (ICU/CCU). Observational data may improve disease management and guide the design of clinical trials. Aims: EFICA is an observational study of the clinical profile, management and survival of ADHF patients admitted to ICU/CCU. Methods: The study included 599 patients admitted to 60 ICU/CCUs across France. Relevant data was recorded during hospitalisation. Survival was assessed at 4 weeks and 1 year. Results: The main cause of ADHF was ischaemic heart disease (61%); 29% of patients had cardiogenic shock. Mortality was 27.4% at 4 weeks and 46.5% at 1 year, increasing to 43.2% and 62.5%, respectively, when including pre-admission deaths. Shock patients had the highest [57.8% vs. 15.2% without shock (p < 0.001)] and patients with hypertension and pulmonary oedema had the lowest 4-week mortality: (7%). Pre-admission NYHA class III-IV heart failure, not initial clinical presentation, influenced 1-year mortality. Conclusion: ADHF is a heterogeneous syndrome. Based on initial clinical presentation, three entities with distinct features and outcome may be described: cardiogenic shock, pulmonary oedema with hypertension, and 'decompensated' chronic heart failure. This should be taken into account in future observational studies, guidelines and clinical trials. ? 2006 European Society of Cardiology.","author":[{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Juillière","given":"Yves","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cohen-Solal","given":"Alain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guize","given":"Louis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alla","given":"Fran?ois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rougé","given":"Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Blin","given":"Patrick","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Barlet","given":"Marie Hélène","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paolozzi","given":"Laurence","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vincent","given":"Catherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Desnos","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Samii","given":"Kamran","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2006"]]},"page":"697-705","title":"Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study","type":"article-journal","volume":"8"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶⁹","plainTextFormattedCitation":"69","previouslyFormattedCitation":"⁶⁷"},"properties":{"noteIndex":0},"schema":""}69:In a group of chronic HF patients who were not suffering from cardiogenic shock, elevated SCr on admission or a history of chronic renal failure (values not defined) was independently associated with higher 4 week mortalityAdjusted OR 3.25 (1.69-6.44)EHFS-IIHarjola 2010 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hfq002","ISSN":"1879-0844","PMID":"20156940","abstract":"Acute heart failure (AHF) has a poor prognosis. We evaluated 3- and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II.","author":[{"dropping-particle":"","family":"Harjola","given":"Veli-Pekka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nieminen","given":"Markku S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brutsaert","given":"Dirk","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drexler","given":"Helmut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hochadel","given":"Matthias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Komajda","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopez-Sendon","given":"Jose L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2010"]]},"page":"239-248","title":"Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure.","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁵","plainTextFormattedCitation":"75","previouslyFormattedCitation":"⁷³"},"properties":{"noteIndex":0},"schema":""}75:A 50 umol/L increase in SCr was associated with an increased adjusted risk of post discharge mortalityDischarge to 3 months: HR 1.17 (1.09-1.26)3-12 months: HR 1.20 (1.12-1.29)ESC-HFMaggioni 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hft050","ISBN":"1879-0844","ISSN":"13889842","PMID":"23537547","abstract":"AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.\\n\\nMETHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.\\n\\nCONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.","author":[{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Leiro","given":"Marisa Crespo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drozdz","given":"Jaroslaw","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fruhwald","given":"Friedrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gullestad","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Logeart","given":"Damien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fabbri","given":"Gianna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Persson","given":"Hans","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rauchhaus","given":"Mathias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nielsen","given":"Olav Wendelboe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2013"]]},"page":"808-817","title":"EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁸","plainTextFormattedCitation":"78","previouslyFormattedCitation":"⁷⁶"},"properties":{"noteIndex":0},"schema":""}78:Chronic kidney dysfunction (values not defined) was independently associated with an increased adjusted risk of all cause 1 year mortalityAcute HF: HR 1.48 (1.13–1.95)Chronic HF: HR 1.48 (1.10–1.99)GWTG-HFPiccini 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCULATIONAHA.108.773838","ISSN":"00097322","PMID":"18697821","abstract":"BACKGROUND: The frequency and characterization of patients receiving cardiac resynchronization therapy (CRT) are largely unknown since the publication of pivotal clinical trials and subsequent incorporation of CRT into the American College of Cardiology/American Heart Association guidelines for heart failure. METHODS AND RESULTS: We analyzed 33,898 patients admitted from January 2005 through September 2007 to 228 hospitals participating in the American Heart Association's Get With the Guidelines-Heart Failure program. There were 4201 patients (12.4%) discharged alive with CRT, including 811 new implants. Patients discharged with CRT were older (median age, 75 versus 72 years) and had lower median left ventricular ejection fraction (30% versus 38%), more frequent ischemic cardiomyopathy (58% versus 45%), more history of atrial fibrillation (38% versus 27%), and higher rates of beta-blocker and aldosterone antagonist use (P<0.0001 for all) than those without CRT. We found that 4.8% of patients with left ventricular ejection fraction <or=35% were discharged with a new CRT implant, which varied greatly by hospital. Ten percent of patients discharged with a new CRT implant had a left ventricular ejection fraction >35%. Major factors associated with lower rates of new CRT placement were treatment in the northeast (odds ratio, 0.40; 95% confidence interval, 0.30 to 0.53), black race (odds ratio, 0.45; 95% confidence interval, 0.36 to 0.57), increasing left ventricular ejection fraction per 10% (odds ratio, 0.56; 95% confidence interval, 0.52 to 0.60), and increasing age per 10 years in those >70 years of age (odds ratio, 0.56; 95% confidence interval, 0.48 to 0.65). CONCLUSIONS: Although CRT is a recent evidence-based therapy for heart failure, patterns of use differ significantly from clinical trials and published guidelines. Important variations also exist for CRT therapy based on race, geographic region, comorbidities, and age and need to be addressed through further study and/or quality-of-care initiatives.","author":[{"dropping-particle":"","family":"Piccini","given":"Jonathan P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Thomas","given":"Kevin L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lewis","given":"William R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2008"]]},"page":"926-933","title":"Use of cardiac resynchronization therapy in patients hospitalized with heart failure","type":"article-journal","volume":"118"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸⁵","plainTextFormattedCitation":"85","previouslyFormattedCitation":"⁸³"},"properties":{"noteIndex":0},"schema":""}85:Both renal insufficiency (SCr >2mg/Dl) and chronic dialysis were associated with decreased adjusted odds of receiving CRT if eleigibleRenal failure New CRTOR: 0.67 (0.53–0.86)Dialysis New CRTOR: 0.33 (0.15–0.74) All CRT OR: 0.67 (0.53–0.86)Allen 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁰","plainTextFormattedCitation":"100","previouslyFormattedCitation":"⁹⁸"},"properties":{"noteIndex":0},"schema":""}100:Per 5mg/dL increase in BUN, the adjusted odds of discharge to a nursing facility were1.03 (1.01-1.05)Chronic dialysis and SCr were not associated with discharge to a nursing facilityDialysis: 1.27 (0.84-1.91)SCr (Per 1 unit increase): 0.97 (0.88-1.07)Those discharged to nursing facilities had increased risk of death or rehospitalisation on Kaplan-Meier analysis to 900 days (p<0.001)Kociol 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2011.05.032","ISBN":"1879-1913 (Electronic)\\n0002-9149 (Linking)","ISSN":"00029149","PMID":"21791327","abstract":"Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF <65 years at 225 hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE) registry or the Get With The Guidelines-Heart Failure (GWTG-HF) registry from January 1, 2003 through December 31, 2006. We linked these clinical data to Medicare claims data for longitudinal follow-up. Using logistic regression models with site-level random effects, we identified predictors of physician follow-up within 7 days of hospital discharge. Overall 11,420 patients (37.9%) had early physician follow-up. Patients residing in hospital referral regions with higher physician concentration were significantly more likely to have early follow-up (odds ratio 1.29, 95% confidence interval 1.12 to 1.48, for highest vs lowest quartile). Patients in rural areas (0.84, 0.78 to 0.91) and patients with lower socioeconomic status (0.79, 0.74 to 0.85) were less likely to have early follow-up. Women (0.87, 0.83 to 0.91) and black patients (0.84, 0.77 to 0.92) were less likely to receive early follow-up. Patients with greater co-morbidity were less likely to receive early follow-up. In conclusion, physician follow-up within 7 days after discharge from a HF hospitalization varied according to regional physician density, rural location, socioeconomic status, gender, race, and co-morbid conditions. Strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Kociol","given":"Robb D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greiner","given":"Melissa a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hammill","given":"Bradley G.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2011"]]},"page":"985-991","publisher":"Elsevier Inc.","title":"Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure","type":"article-journal","volume":"108"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁶","plainTextFormattedCitation":"96","previouslyFormattedCitation":"⁹⁴"},"properties":{"noteIndex":0},"schema":""}96:Serum creatinine of ≥ 2mg/dL associated with lower adjusted odds of 7 day physician follow-upOR 0.88 (0.82–0.94)1.5 - <2 mg/dL not significant 0.97 (0.91–1.03) Whellan 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2011.04.005","ISBN":"1532-8414 (Electronic)\\r1071-9164 (Linking)","ISSN":"10719164","PMID":"21807326","abstract":"Background: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. Methods and Results: A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With The Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r 2 of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation. Conclusions: Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Li","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2011"]]},"page":"649-656","publisher":"Elsevier Inc","title":"Predictors of hospital length of stay in heart failure: Findings from get with the guidelines","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁵","plainTextFormattedCitation":"95","previouslyFormattedCitation":"⁹³"},"properties":{"noteIndex":0},"schema":""}95:Renal insufficiency associated with increased adjusted length of stay ratio after adjustment for patient & hospital characteristics as well as standard labs10 unit increase in BUN: 1.05 (1.04-1.05)Medical history of renal insufficiency 1.05 (1.03-1.08)Krantz 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2011.02.322","ISBN":"1879-1913 (Electronic) 0002-9149 (Linking)","ISSN":"00029149","PMID":"21482418","abstract":"Hospitalized patients with heart failure and decreased ejection fraction are at substantial risk for mortality and rehospitalization, yet no acute therapies are proven to decrease this risk. Therefore, in-hospital use of medications proved to decrease long-term mortality is a critical strategy to improve outcomes. Although endorsed in guidelines, predictors of initiation and continuation of angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), β blockers, and aldosterone antagonists have not been well studied. We assessed noncontraindicated use patterns for the 3 medications using the Get With the GuidelinesHeart Failure (GWTG-HF) registry from February 2009 through March 2010. Medication continuation was defined as treatment on admission and discharge. Multivariable logistic regression using generalized estimating equations was used to determine factors associated with discharge use. In total 9,474 patients were enrolled during the study period. Of those treated before hospitalization, overall continuation rates were 88.5% for ACE inhibitors/ARBs, 91.6% for β blockers, and 71.9% for aldosterone-antagonists. Of patients untreated before admission, 87.4% had ACE inhibitors/ARBs and 90.1% had β blocker initiated during hospitalization or at discharge, whereas only 25.2% were started on an aldosterone antagonist. In multivariate analysis, admission therapy was most strongly associated with discharge use (adjusted odds ratios 7.4, 6.0, and 20.9 for ACE inhibitors/ARBs, β blockers, and aldosterone antagonists, respectively). Western region, younger age, and academic affiliation were also associated with higher discharge use. Although ACE inhibitor/ARB and β-blocker continuation rates were high, aldosterone antagonist use was lower despite potential eligibility. In conclusion, being admitted on evidence-based medications is the most powerful, independent predictor of discharge use. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Krantz","given":"Mori J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Ambardekar","given":"Amrut","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kaltenbach","given":"Lisa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2011"]]},"page":"1818-1823","publisher":"Elsevier Inc.","title":"Patterns and predictors of evidence-based medication continuation among hospitalized heart failure patients (from get with the guidelines-heart failure)","type":"article-journal","volume":"107"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹⁷","plainTextFormattedCitation":"97","previouslyFormattedCitation":"⁹⁵"},"properties":{"noteIndex":0},"schema":""}97:Not having renal insufficiency increased the adjusted odds of receiving evidence based medication at discharge (ACEI/ARB or beta blocker)ACEI/ARB: OR 2.7 (2.1–3.4)Beta blocker: OR 1.43 (1.15–1.78)Aldosterone antagonist use not significantOR 1.21 (0.97–1.52) Gharacholou 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2010.12.005","ISBN":"1071-9164","ISSN":"10719164","PMID":"21549302","abstract":"Background: Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. Methods and Results: Get With the Guidelines (GWTG) program data was used to analyze 57,969 patients hospitalized with HF from January 2005 through January 2010 from 235 sites. Factors associated with referral to HFDM and rates of HF quality measures by referral status were studied. Mean age of patients was 69.7 ± 14.5 years, 52% were men, and 65% were white. HFDM referral occurred in 11,150 (19.2%) patients. The median rate of HFDM referral among all hospitals was 3.5% (25th-75th percentiles 0%-16.7%) and 8.7% (2.8%-27.7%) among hospitals with at least one previous HFDM referral. Quality and performance measures were higher in patients referred to HFDM. HFDM referral was associated with atrial fibrillation, implanted cardiac device, depression, and treatment at larger hospitals. Patients at higher 90-day mortality risk were paradoxically less likely to receive HFDM referral. Conclusions: HFDM referral occurred in less than one-fifth of hospitalized HF patients and was more frequently recommended to lower-risk patients. Increasing use and optimizing selection of patients for HFDM referral is a potential target for quality improvement. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Gharacholou","given":"S. Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2011"]]},"page":"431-439","publisher":"Elsevier Inc","title":"Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: Insights from the get with the guidelines program","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰¹","plainTextFormattedCitation":"101","previouslyFormattedCitation":"⁹⁹"},"properties":{"noteIndex":0},"schema":""}101:Being on dialysis was independently associated with a lower odds of referral to a heart failure disease management programOR: 0.703 (0.577-0.857)Whellan 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2012.02.006","ISSN":"10719164","PMID":"22633304","abstract":"Background: Guidelines recommend hospice care as a treatment option for end-stage heart failure (HF) patients. Little is known regarding utilization of hospice care in a contemporary cohort of patients hospitalized with HF and how this may vary by estimated mortality risk. Methods: We analyzed HF patients ≥65 years (n = 58,330) from 214 hospitals participating in the Get With the Guidelines-HF program. Univariate analysis comparing patients discharged to hospice versus other patients was performed. Hospice utilization was evaluated for deciles of estimated 90-day mortality risk using a validated model. Multivariate analysis using admission patient and hospital characteristics was also performed to determine factors associated with hospice discharge. Results: There were 1,442 patients discharged to hospice, and rates of referral varied widely by hospital (interquartile range 0-3.7%) as shown in the univariate analysis. Patients discharged to hospice were significantly older and more often white, had lower left ventricular ejection fraction, higher B-type natriuretic peptide, and lower systolic blood pressure on admission. Utilization rates for each decile of 90-day estimated mortality risk ranged from 0.3% to 8.6%. Multivariable analysis found that factors associated with hospice utilization included increased age, low systolic blood pressure on admission, and increased blood urea nitrogen. Conclusions: Hospice utilization remains low among HF patients, even those with the highest predicted risk of death. ? 2012 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2012"]]},"page":"471-477","publisher":"Elsevier Inc","title":"Utilization of hospice and predicted mortality risk among older patients hospitalized with heart failure: Findings from GWTG-HF","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁸","plainTextFormattedCitation":"108","previouslyFormattedCitation":"¹⁰⁶"},"properties":{"noteIndex":0},"schema":""}108:Both presence of renal failure and a 10 mg/dL increase in BUN were independently associated with an increased risk of discharge to hospice careBUN: 1.1626 (1.1285- 1.1977)Renal failure: 1.2379 (1.0719- 1.4297)Hsich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.12.013","ISSN":"00028703","PMID":"22424014","abstract":"Background: There are no sex-specific survival comparisons between patients with heart failure (HF) with reduced and those with preserved ejection fraction. Large registries noting women have better survival than men combined HF patients with reduced and preserved EF. Other registries that compared patients with reduced and preserved EF did not analyze their data by sex. We sought to evaluate sex/EF differences in mortality and risk factors for survival in hospitalized patients with HF. Methods: We included hospitals fully participating in Get With The Guidelines-Heart Failure that admitted HF patients with reduced (EF <40%) or preserved (EF ≥50%) EF. The primary end point was in-hospital mortality. Multivariate generalized estimating equation logistic models were used to compute odds ratios accounting for hospital clustering. Results: The study cohort consisted of 51,428 patients with EF <40% (36% women, 64% men) and 37,699 patients with EF ≥50% (65% women, 35% men). Women compared with men with reduced and preserved EF were older and more likely to have hypertension, depression, or valvular heart disease and less likely to have coronary artery disease or peripheral vascular disease. There were no sex differences in in-hospital mortality (EF <40%, 2.69% women vs 2.89% men, P =.20; EF ≥50%, 2.61% women vs 2.62% men, P =.96), and risk factors such as age, systolic blood pressure, heart rate, and history of renal failure/dialysis were highly predictive of death for each sex/EF subgroup. Conclusions: In a large, multicenter registry, we found that despite differences in baseline characteristics, women and men with reduced and preserved EF have similar in-hospital mortality and risk factors predicting death. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Hsich","given":"Eileen M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwamm","given":"Lee H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2012"]]},"page":"430-437.e3","publisher":"Mosby, Inc.","title":"Sex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"¹¹¹","plainTextFormattedCitation":"111","previouslyFormattedCitation":"¹⁰⁹"},"properties":{"noteIndex":0},"schema":""}111:Between men and women with preserved (≥50%) and reduced (<40%) EF, renal failure/dialysis (composite) was associated with in-hospital mortality. The adjusted odds of in hospital mortality were higher in the reduced EF groupMenpEF: 1.36 (1.10-1.69)rEF: 2.03 (1.74-2.37)WomenpEF: 1.72 (1.40-2.12)rEF: 2.12 (1.71-2.62)Quiroz 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2013.11.014","ISSN":"1879-1913","PMID":"24484862","abstract":"Despite significant advances in therapies for patients with heart failure with reduced ejection fraction (HFrEF), there are no evidence-based therapies for heart failure with preserved ejection fraction (HFpEF), also known as diastolic heart failure (HF). Differences in pathophysiologic mechanisms are touted as to why patients with HFpEF purportedly do not derive similar therapeutic benefits compared with HFrEF. Similarly, the relative frequencies of HFpEF and HFrEF may differ between hospitalized and ambulatory settings. There are limited data on the prevalence, characteristics, treatment, and short-term outcomes of patients hospitalized with HFpEF. We sought to investigate these in patients hospitalized with HFpEF in an urban, hospitalized setting using the Get With The Guidelines registry. We retrospectively reviewed all consecutive discharges (n = 1,701) with a diagnosis of acute decompensated HF from December 1, 2006 to September 30, 2008. Patients with HFpEF (n = 499) were older, overweight, predominantly women, and had underlying hypertension and dyslipidemia. Presenting blood pressure and levels of creatinine were higher, with lower brain natriuretic peptide levels compared with patients with HFrEF (n = 598). Length of stay and 30-day mortality were comparable between patients with HFpEF and HFrEF. Thirty-day readmission was initially lower in patients with HFpEF. However 30-day mortality from any cause after the index HF hospitalization and survival curve at 1-year was no different between patients with HFpEF and HFrEF. In conclusion, lower 30-day readmissions do not translate into improved long-term outcome in patients with HFpEF.","author":[{"dropping-particle":"","family":"Quiroz","given":"Rene","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Doros","given":"Gheorghe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaw","given":"Peter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Chang-Seng","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gauthier","given":"Diane F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sam","given":"Flora","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2014"]]},"page":"691-6","publisher":"Elsevier Inc.","title":"Comparison of characteristics and outcomes of patients with heart failure preserved ejection fraction versus reduced left ventricular ejection fraction in an urban cohort.","type":"article-journal","volume":"113"},"uris":[""]}],"mendeley":{"formattedCitation":"¹²²","plainTextFormattedCitation":"122","previouslyFormattedCitation":"¹²⁰"},"properties":{"noteIndex":0},"schema":""}122:SCr (value undefined) was an independent predictor of 30-day heart failure readmissionAdj HR 1.07 (1.01-1.112)BUN (value undefined) was an independent predictor of 30 day all cause mortality post dischargeAdj HR 1.007 (1.00-1.014)Eapen 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ijcard.2013.12.161","ISSN":"01675273","PMID":"24444488","author":[{"dropping-particle":"","family":"Eapen","given":"Zubin J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2014"]]},"page":"e322-e323","publisher":"Elsevier Ireland Ltd","title":"Prescribing warfarin at discharge for heart failure patients: Findings from the Get with the Guidelines-Heart Failure Registry","type":"article-journal","volume":"172"},"uris":[""]}],"mendeley":{"formattedCitation":"¹²⁴","plainTextFormattedCitation":"124","previouslyFormattedCitation":"¹²²"},"properties":{"noteIndex":0},"schema":""}124:A history of chronic kidney disease was associated with a lower adjusted odds of receiving warfarin if in a.fib and eligibleOR: 0.82 (0.75–0.90)HIJC-HFKawashiro 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1346-9843","PMID":"18931450","abstract":"BACKGROUND: Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.","author":[{"dropping-particle":"","family":"Kawashiro","given":"Naomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogawa","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsuda","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"Nobuhisa","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2008"]]},"page":"2015-2020","title":"Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry.","type":"article-journal","volume":"72"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³⁵","plainTextFormattedCitation":"135","previouslyFormattedCitation":"¹³³"},"properties":{"noteIndex":0},"schema":""}135:SCr ≥1.5 m/dL associated with increased adjusted risk of both all-cause and cardiac mortalityAll cause: HR 1.96 (1.50–2.57)Cardiac: HR 2.41 (1.62–3.58)IMPACT-HFO’Connor 2005 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2004.08.160","ISBN":"1071-9164","ISSN":"10719164","PMID":"15812748","abstract":"Background: Hospitalizations for decompensated heart failure are frequent. The Initiation Management Pre-discharge Assessment of Carvedilol Heart Failure (IMPACT-HF) registry collected observational data in patients hospitalized for worsening heart failure to characterize an unselected group of patients and to confirm the generalizability of the IMPACT-HF main trial population. Methods and Results: The IMPACT-HF registry was conducted concurrently with the IMPACT-HF study, a randomized trial of in-hospital initiation of carvedilol compared with the standard practice of postdischarge β-blocker initiation. Patients were eligible for registry enrollment if they were hospitalized for heart failure regardless of ejection fraction. There were no exclusions to participation. Patients were followed for 60 days. The IMPACT-HF Registry enrolled 567 patients. The mean age was 71 years, 52% of the patients were men and 82% were Caucasian. At discharge, 71% received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 41% received digoxin, and 62% received β-blockers. The 60-day rate of rehospitalization or death was 31%. Conclusion: The IMPACT-HF registry enrolled elderly patients admitted for worsening heart failure primarily resulting from progressive volume overload. The 60-day rate of death or rehospitalization was high despite the use of evidence-based therapies. New treatments for this population are needed to decrease the morbidity and mortality associated with decompensated heart failure. ? 2005 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gallup","given":"Dianne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hasselblad","given":"Vic","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2005"]]},"page":"200-205","title":"Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: Observations from the IMPACT-HF registry","type":"article-journal","volume":"11"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁴⁰","plainTextFormattedCitation":"140","previouslyFormattedCitation":"¹³⁸"},"properties":{"noteIndex":0},"schema":""}140:In an adjusted model for 60 day mortality and rehospitalisation, a GFR of 60 mL/min was not associated with and increased riskOR 1.026 (0.715–1.472)IMPROVE-HFHeywood 2010 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2009.12.016","ISBN":"1879-1913 (Electronic)\r0002-9149 (Linking)","ISSN":"00029149","PMID":"20381667","abstract":"Guidelines have been established for the treatment of patients with heart failure (HF) and left ventricular dysfunction, but renal dysfunction might limit adherence to these guidelines. Few data have characterized the use of guideline-recommended therapy for patients with HF, left ventricular dysfunction, and renal dysfunction who are treated in outpatient settings. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) was a prospective study of patients receiving treatment as outpatients in cardiology practices in the United States. The rates of adherence to 7 guideline-recommended therapies were evaluated for patients with a left ventricular ejection fraction of < or = 35%. The estimated glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula for 13,164 patients who were categorized as having stage 1 through stage 4/5 chronic kidney disease (CKD). More than 1/2 (52.2%) of the patients had stage 3 or 4/5 CKD. Older patients and women were at increased risk of higher stage CKD, and the rates of co-morbid health conditions were significantly greater among patients with more severe CKD. The patients with more severe CKD were significantly less likely to receive all interventions except cardiac resynchronization therapy. However, multivariate analysis controlling for patient characteristics revealed that the severity of CKD was an independent predictor of adherence to angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy but not to any of the 6 other guideline-recommended measures. In conclusion, these results confirm that CKD is common in patients with HF and left ventricular dysfunction but is not independently associated with adherence to guideline-recommended therapy in outpatient cardiology practices, with the exception of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy.","author":[{"dropping-particle":"","family":"Heywood","given":"J Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Mark L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2010"]]},"page":"1140-1146","publisher":"Elsevier Inc.","title":"Influence of renal function on the use of guideline-recommended therapies for patients with heart failure.","type":"article-journal","volume":"105"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁴³","plainTextFormattedCitation":"143","previouslyFormattedCitation":"¹⁴¹"},"properties":{"noteIndex":0},"schema":""}143:For 7 evidence based quality of care measures, a 10 mL/min increase in eGFR was only associated with a lower adjusted odds of receiving an ACEI/ARBACEI/ARB: 0.94 (0.88–0.99) – Predictable given the risk of worsening renal function with these medications Beta blocker: 1.00 (0.96–1.04) Aldosterone antagonist: 1.01 (0.93–1.09) Anticoagulation if a.fib and not contraindicated: 1.01 (0.93–1.10) CRT: 0.98 (0.96–1.01) ICD/CRT-D: 1.04 (0.99–1.08) HF Education: 1.01 (0.98–1.04) Shukla 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/pace.12090","ISBN":"1540-8159 (Electronic)\\n0147-8389 (Linking)","ISSN":"01478389","PMID":"23380000","abstract":"BACKGROUND: There is a well-recognized gap between the number of patients in whom cardiac resynchronization therapy (CRT) is indicated based on current guidelines and its actual utilization. In the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) study, there was a significant increase in the use of CRT at 24 months in patients with heart failure (HF) in comparison to baseline. This study evaluated patient, physician, and practice factors associated with this increase in CRT utilization.\\n\\nMETHODS: Patients with reduced left ventricular ejection fraction and chronic HF who met the eligibility criteria for CRT at baseline and 24 months were analyzed. Multivariate analyses using patient, physician, and practice characteristics were performed to evaluate factors associated with increased CRT utilization at 24 months.\\n\\nRESULTS: There were 440 patients eligible for CRT both at baseline and 24 months, with 217 (49.3%) treated at baseline and 374 (85%) treated at 24 months, leading to an absolute increase in use of CRT of 35.7%, P < 0.001. Although serum sodium and the absence of rales had modest associations, none of the patient, physician, or practice characteristics had any significant association with the extent of increase in CRT utilization. There was a significant reduction in the variation of CRT utilization across practice sites after the implementation of the performance improvement initiative.\\n\\nCONCLUSIONS: The performance improvement initiative in IMPROVE HF was the most important factor associated with an increase in guideline-recommended CRT utilization. This improvement in CRT utilization and reduced practice variability was found across a variety of cardiology and multispecialty practice sites.","author":[{"dropping-particle":"","family":"Shukla","given":"Ashish","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liu","given":"Yang","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PACE - Pacing and Clinical Electrophysiology","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2013"]]},"page":"433-443","title":"Factors associated with improvement in utilization of cardiac resynchronization therapy in eligible heart failure patients: Findings from IMPROVE HF","type":"article-journal","volume":"36"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵¹","plainTextFormattedCitation":"151","previouslyFormattedCitation":"¹⁴⁹"},"properties":{"noteIndex":0},"schema":""}151:BUN (mg/dL) level was associated with a decreased odds of receiving CRT by 24 months follow-up0.968 (0.944–0.993)IN-HFMortara 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.healun.2014.05.015","ISSN":"10532498","author":[{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Carbonieri","given":"Emanuele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gorini","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Midi","given":"Paolo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Journal of Heart and Lung Transplantation","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2014"]]},"page":"1056-1065","publisher":"Elsevier","title":"Treatment with inotropes and related prognosis in acute heart failure: Contemporary data from the Italian Network on Heart Failure (IN-HF) Outcome registry","type":"article-journal","volume":"33"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵⁷","plainTextFormattedCitation":"157","previouslyFormattedCitation":"¹⁵⁵"},"properties":{"noteIndex":0},"schema":""}157:In the acute HF population, increased SCr (SCr >1.5 vs. ≤1.5 mg/dL) was independently associated with increased all cause 1-year mortality Adjusted HR 1.63 (1.29–2.07)JCAREHamaguchi 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1253/circj.CJ-09-0062","ISBN":"1347-4820 (Electronic)\\r1346-9843 (Linking)","ISSN":"1347-4820","PMID":"19521016","abstract":"BACKGROUND: Previous studies have demonstrated that renal dysfunction is common in patients with heart failure (HF), but it is not known whether chronic kidney disease (CKD) is associated with increased risks of long-term adverse outcomes in unselected HF patients encountered in current routine clinical practice in Japan. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied a broad sample of patients hospitalized with worsening HF and their outcomes with an average of 2.4 years of follow-up. The study cohort (n=2,013) were classified into 3 groups by estimated glomerular filtration rate (eGFR): > or =60 (n=579), 30-59 (n=1,025), and <30 ml x min(-1) x 1.73 m(-2) or patients with dialysis (n=409); 1,372 patients (70.3%) had an eGFR <60 ml x min(-1) x 1.73 m(-2) and 62 patients were treated with dialysis. The multivariable adjusted risk for all-cause death or rehospitalization increased with reduced eGFR; an adjusted hazard ratio (HR) 1.520 (95% confidence interval (CI) 1.186-1.949) for eGFR 30-59 ml x min(-1) x 1.73 m(-2) (P=0.001) and HR 2.566 (95%CI 1.885-3.492) for eGFR <30 ml x min(-1) x 1.73 m(-2) or patients with dialysis (P<0.001). CONCLUSIONS: CKD is common in HF and was independently associated with long-term adverse outcomes in a broad cohort of Japanese patients.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ide","given":"Tomomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2009"]]},"page":"1442-1447","title":"Chronic kidney disease as an independent risk for long-term adverse outcomes in patients hospitalized with heart failure in Japan. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).","type":"article-journal","volume":"73"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁶³","plainTextFormattedCitation":"163","previouslyFormattedCitation":"¹⁶¹"},"properties":{"noteIndex":0},"schema":""}163:Kaplan-Meier analysis demonstrated that decreased eGFR (>60 vs. 30-59 vs. <30 mL/min/1.73m2) was associated with decreased all 3 ofAll cause mortalityHeart failure related rehospitalisationThe composite of aboveA 1 mL/min/1.73m2 decrease in eGFR was associated with an increased adjusted risk of death or rehospitalisationHR 1.014 (1.009–1.020)Hamaguchi 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1253/circj.CJ-11-0267","ISSN":"1347-4820","PMID":"21778592","abstract":"BACKGROUND: Aging is associated with adverse outcomes in patients with cardiac diseases. Whether elderly patients hospitalized with heart failure (HF) had increased risks for mortality and rehospitalization compared with younger patients during the long-term follow-up was examined. The predictors of these adverse outcomes were also identified. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF and the outcomes were followed up. The majority of elderly patients were female, had lower body mass index (BMI), a higher rate of ischemic, valvular, and hypertensive heart disease as etiologies of HF, a lower estimated glomerular filtration rate (eGFR), lower hemoglobin, and higher left ventricular ejection fraction values. Even after adjustment for covariates, the elderly patients were associated with higher risks of adverse outcomes. The predictors for all-cause death were: lower eGFR, lower BMI, male sex, sustained ventricular tachycardia or fibrillation (VT/VF), and the use of diuretics at discharge. CONCLUSIONS: Among patients hospitalized with HF, elderly patients had a worse prognosis than younger patients. Lower eGFR, lower BMI, male sex, sustained VT/VF, and diuretic use were independent predictors for all-cause death in these patients with higher risk.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2011"]]},"page":"2403-10","title":"Predictors of long-term adverse outcomes in elderly patients over 80 years hospitalized with heart failure. - A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)-.","type":"article-journal","volume":"75"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁶⁸","plainTextFormattedCitation":"168","previouslyFormattedCitation":"¹⁶⁶"},"properties":{"noteIndex":0},"schema":""}168:In elderly patients (>80) a 1 mL/min/1.73m2 decrease in eGFR was independently associated with an increased adjusted risk of:All cause mortalityHR: 1.024 (1.011–1.037)Cardiac mortalityHR: 1.025 (1.009–1.041)HF related rehospitalisationHR: 1.024 (1.013–1.034)Hamaguchi 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"","ISBN":"1347-4820","ISSN":"1347-4820","PMID":"22481105","abstract":"BACKGROUND: The mode of death has not been investigated in the registry data of patients with heart failure and reduced ejection fraction (HFREF) vs. preserved ejection fraction (HFPEF). The aim of the present study was therefore to carry out this comparison. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF, and followed them for an average of 2.1 years. This study included 323 patients in whom information on both the mode of death and left ventricular EF on echocardiography could be obtained. The mode of death was cardiovascular (CV) in 63% (including 17% sudden, 36% HF, 3% myocardial infarction, and 3% stroke), non-CV in 23%, and unknown in 14%. The prevalence of CV death including sudden death was high in patients with HFREF compared to HFPEF (68% vs. 58%, P=0.020). HF death, the most common mode of death, was similar between groups (37% vs. 35%, P=0.694). In contrast, non-CV mortality was significantly higher in HFPEF than those with HFREF (28% vs. 18%, P=0.021). CONCLUSIONS: In 60-70% of deaths the mode was CV, and HF death was the most common mode of death in either HFREF or HFPEF. The prevalence of sudden death was lower, and that of non-CV death higher, in HFPEF compared with HFREF.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sobirin","given":"Mochamad Ali","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Investigators","given":"Jcare-Card","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation Journal","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2012"]]},"page":"1662-1669","title":"Mode of death in patients with heart failure and reduced vs. preserved ejection fraction: report from the registry of hospitalized heart failure patients","type":"article-journal","volume":"76"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁷¹","plainTextFormattedCitation":"171","previouslyFormattedCitation":"¹⁶⁹"},"properties":{"noteIndex":0},"schema":""}171:A 1 mL/min/1.73m2 decrease in eGFR was associated with:An increased adjusted risk of sudden death in HFpEFHR: 1.026 (1.001–1.051)An increased adjusted risk of heart failure death in HFrEFHR: 1.035 (1.013–1.057)Hamaguchi 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jjcc.2013.03.009","ISSN":"09145087","PMID":"23672787","abstract":"Background: The characteristics, in-hospital management, and outcomes of patients hospitalized with worsening heart failure (HF) have been described by large-scale registries performed mainly in the USA and Europe. However, little information is available in Japan. We thus clarified the characteristics and clinical status as well as in-hospital management and outcomes among patients hospitalized with worsening HF in Japan and compared them with those reported in previous studies. Methods: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in patients hospitalized with worsening HF. From the total cohort of JCARE-CARD, 1677 patients were randomly selected and their detailed data during acute phase were collected as another registry database in the present study. The characteristics, in-hospital management, and outcomes were analyzed. Results: The mean age was 70.7 years and 59.4% were male. Etiology was ischemic in 34.0% and mean left ventricular ejection fraction was 42.5%. Carperitide was highly used as in-hospital management in Japan (33.5%) compared to the use of nesiritide in the USA (8-11%). The use of angiotensin-converting enzyme inhibitors was lower and angiotensin II receptor blockers (ARB) were more commonly used in this study compared to other studies in the USA and Europe. In-hospital crude mortality rate was comparable among studies (4-8%), however, length of stay was longer in Japan (15-20 versus 4-9 days). Conclusions: The characteristics, clinical status, and laboratory data on admission in patients hospitalized with worsening HF were similar between the present study and previous Japanese and western studies. Management was also similar except for higher use of carperitide and ARB. The most striking difference between Japanese registries and those from the USA and Europe was the longer length of stay. ? 2013 Japanese College of Cardiology.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiology","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2013"]]},"page":"95-101","publisher":"Japanese College of Cardiology","title":"Characteristics, management, and outcomes for patients during hospitalization due to worsening heart failure-A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)","type":"article-journal","volume":"62"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁷²","plainTextFormattedCitation":"172","previouslyFormattedCitation":"¹⁷⁰"},"properties":{"noteIndex":0},"schema":""}172:Increased eGFR on admission was associated with increased adjusted risk of long-term mortalityHR: 1.494 (1.092–2.044)KorHFPark 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2013.10.022","ISSN":"00029149","PMID":"24315115","abstract":"The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3%) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4%, Q2 9.5%, Q3 16.9%, Q4 19.3%, p <0.001) and NT-proBNP quartiles (Q1 7.0%, Q2 13.4%, Q3 11.6%, Q4 20.4%, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95% confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95% CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95% CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF. ? 2014 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Park","given":"Jin Joo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoon","given":"Chang Hwan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Il Young","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu Hyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung Hee","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2014"]]},"page":"511-517","publisher":"Elsevier Inc.","title":"Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry)","type":"article-journal","volume":"113"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁸⁵","plainTextFormattedCitation":"185","previouslyFormattedCitation":"¹⁸³"},"properties":{"noteIndex":0},"schema":""}185:A 1 mg/dL increase in SCr was associated with an independent risk of 12 month mortalityAdj. HR: 1.132 (1.013-1.265)Oh 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2015.01.014","ISSN":"00028703","author":[{"dropping-particle":"","family":"Oh","given":"Jaewon","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Song","given":"Mi Kyung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hong","given":"Namki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Youn","given":"Jong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2015"]]},"page":"713-720.e3","publisher":"Elsevier Inc.","title":"Clinical benefit of spironolactone in patients with acute decompensated heart failure and severe renal dysfunction: Data from the Korean Heart Failure (KorHF) Registry","type":"article-journal","volume":"169"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁸⁶","plainTextFormattedCitation":"186","previouslyFormattedCitation":"¹⁸⁴"},"properties":{"noteIndex":0},"schema":""}186:BUN associated with a slight increase in risk of all cause mortalityHR: 1.009 (1.000-1.019)OPTIMIZE-HFO’Connor 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2008.04.030","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"18926148","abstract":"Background: Patients with heart failure (HF) are at high risk for mortality and rehospitalization in the early period after hospital discharge. We developed clinical models predictive of short-term clinical outcomes in a broad patient population discharged after hospitalization for HF. Methods: The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry is a comprehensive hospital-based registry and performance-improvement program for patients hospitalized with HF. Follow-up data were scheduled to be prospectively collected at 60 to 90 days postdischarge in a prespecified 10% sample. For the 4,402 patients included in this analysis, 19 prespecified potential predictor variables were used in a stepwise Cox proportional hazards model for all-cause mortality. Logistic regression including 45 potential variables was used to model mortality or rehospitalization. Results: The 60- to 90-day postdischarge mortality rate was 8.6% (n = 481), and 29.6% (n = 1,715) were rehospitalized. Factors predicting early postdischarge mortality include age, serum creatinine, reactive airway disease, liver disease, lower systolic blood pressure, lower serum sodium, lower admission weight, and depression. Use of statins and β-blockers at discharge was associated with significantly decreased mortality. The C-index of the model was 0.74. The most important predictors for the combined end point of death or rehospitalization were admission serum creatinine, systolic blood pressure, admission hemoglobin, discharge use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and pulmonary disease. From this analysis, 8 factors identified to carry significant risk were selected for use in a point scoring system to predict the risk of mortality within 60 days after discharge, with a C-index of 0.72. Conclusions: A substantial risk of mortality and mortality or rehospitalization is present in the first 60 to 90 days after discharge from a hospitalization for HF. Several factors were identified that signal high-risk patients. Application of these findings with a simple algorithm can distinguish patients who are low risk from those at high risk who may benefit from closer monitoring and aggressive evidence-based treatment. ? 2008 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2008"]]},"page":"662-673","title":"Predictors of mortality after discharge in patients hospitalized with heart failure: An analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"156"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁰","plainTextFormattedCitation":"200","previouslyFormattedCitation":"¹⁹⁸"},"properties":{"noteIndex":0},"schema":""}200:Adjusted HR for mortality from discharge to follow-up for: 1 mg/dL increase in admission SCr (up to 4mg/dL)1.32 (1.08-1.60)1 mg/dL increase in discharge SCr (up to 3 mg/dL)1.37 (1.05-1.77)Adjusted odds of mortality or rehospitalization 1 mg/dL increase in admission SCr (up to 4 mg/dL)1.26 (1.16-1.37)Abraham 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2008.04.028","ISBN":"1558-3597 (Electronic) 0735-1097 (Linking)","ISSN":"07351097","PMID":"18652942","abstract":"Objectives: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. Background: Heart failure patients experience high rates of hospital stays and poor outcomes. Although predictors of mortality have been identified in HF clinical trials, hospitalized patients might differ greatly from trial populations, and such predictors might underestimate mortality in a real-world population. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) is a registry/performance improvement program for patients hospitalized with HF in 259 U.S. hospitals. Forty-five potential predictor variables were used in a stepwise logistic regression model for in-hospital mortality. Continuous variables that did not meet linearity assumptions were transformed. All significant variables (p < 0.05) were entered into multivariate analysis. Generalized estimating equations were used to account for the correlation of data within the same hospital in the adjusted models. Results: Of 48,612 patients enrolled, mean age was 73.1 years, 52% were women, 74% were Caucasian, and 46% had ischemic etiology. Mean left ventricular ejection fraction was 0.39 ± 0.18. In-hospital mortality occurred in 1,834 (3.8%). Multivariable predictors of mortality included age, heart rate, systolic blood pressure (SBP), sodium, creatinine, HF as primary cause of hospitalization, and presence/absence of left ventricular systolic dysfunction. A scoring system was developed to predict mortality. Conclusions: Risk of in-hospital mortality for patients hospitalized with HF remains high and is increased in patients who are older and have low SBP or sodium levels and elevated heart rate or creatinine at admission. Application of this risk-prediction algorithm might help identify patients at high risk for in-hospital mortality who might benefit from aggressive monitoring and intervention. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2008"]]},"page":"347-356","title":"Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure. Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"52"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁴","plainTextFormattedCitation":"204","previouslyFormattedCitation":"²⁰²"},"properties":{"noteIndex":0},"schema":""}204:Adjusted odds of in hospital mortality per SCr increase of 0.3 mg/dL (up to 3.5mg/dL)1.18 (1.16-1.20)RO-AHFSChioncel 2011Adjusted odds of all cause in hospital mortality for a 1 unit increase in BUN at presentation1.009 (1.002-1.015)S-HFRThorvaldsen 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2013.10.017","ISSN":"07351097","PMID":"24161453","abstract":"Objectives The purpose of this study was to evaluate simple criteria for referral of patients from the general practitioner to a heart failure (HF) center. Background In advanced HF, the criteria for heart transplantation, left ventricular assist device, and palliative care are well known among HF specialists, but criteria for referral to an advanced HF center have not been developed for generalists. Methods We assessed observed and expected all-cause mortality in 10,062 patients with New York Heart Association (NYHA) functional class III to IV HF and ejection fraction <40% registered in the Swedish Heart Failure Registry between 2000 and 2013. Next, 5 pre-specified universally available risk factors were assessed as potential triggers for referral, using multivariable Cox regression: systolic blood pressure ≤90 mm Hg; creatinine ≥160 μmol/l; hemoglobin ≤120 g/l; no renin-angiotensin system antagonist; and no beta-blocker. Results In NYHA functional class III to IV and age groups ≤65 years, 66 to 80 years, and >80 years, there were 2,247, 4,632, and 3,183 patients, with 1-year observed versus expected survivals of 90% versus 99%, 79% versus 97%, and 61% versus 89%, respectively. In the age ≤80 years group, the presence of 1, 2, or 3 to 5 of these risk factors conferred an independent hazard ratio for all-cause mortality of 1.40, 2.30, and 4.07, and a 1-year survival of 79%, 60%, and 39%, respectively (p < 0.001). Conclusions In patients ≤80 years of age with NYHA functional class III to IV HF and ejection fraction <40%, mortality is predominantly related to HF or its comorbidities. Potential heart transplantation/left ventricular assist device candidacy is suggested by ≥1 risk factor and potential palliative care by multiple universally available risk factors. These patients may benefit from referral to an advanced HF center.","author":[{"dropping-particle":"","family":"Thorvaldsen","given":"Tonje","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benson","given":"Lina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"St?hlberg","given":"Marcus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lund","given":"Lars H.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2014"]]},"page":"661-671","title":"Triage of patients with moderate to severe heart failure: Who should be referred to a heart failure center?","type":"article-journal","volume":"63"},"uris":[""]}],"mendeley":{"formattedCitation":"²³⁰","plainTextFormattedCitation":"230","previouslyFormattedCitation":"²²⁸"},"properties":{"noteIndex":0},"schema":""}230:SCr >160 mg/dL demonstrated the greatest adjusted risk of all cause mortalityNo formal numbers given, but in forest plot, the point estimate lay between 1.75 and 2.00, without the 95% CI crossing 1 (null)Johansson 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1002/ejhf.44","ISBN":"1879-0844 (Electronic) 1388-9842 (Linking)","PMID":"24464683","abstract":"AIMS: To analyse the long-term outcome, risk factor panorama, and treatment pattern in patients with heart failure (HF) with and without type 2 diabetes (T2DM) from a daily healthcare perspective. METHODS AND RESULTS: Patients with (n=8809) and without (n=27,465) T2DM included in the Swedish Heart Failure Registry (S-HFR) 2003-2011 due to a physician-based HF diagnosis were prospectively followed for long-term mortality (median follow-up time: 1.9 years, range 0-8.7 years). Left ventricular function expressed as EF did not differ between patients with and without T2DM. Survival was significantly shorter in patients with T2DM, who had a median survival time of 3.5 years compared with 4.6 years (P<0.0001). In subjects with T2DM. unadjusted and adjusted odds ratios (ORs) for mortality were 1.37 [95% confidence interval (CI) 1.30-1.44) and 1.60 (95% CI 1.50-1.71), and T2DM predicted mortality in all age groups. Ischaemic heart disease was an important predictor for mortality (OR 1.68, 95% CI 1.47-1.94), more abundant in patients with T2DM (59% vs. 45%) among whom only 35% had been subjected to coronary angiography and 32% to revascularization. Evidence-based pharmacological HF treatment was somewhat more extensive in patients with T2DM. CONCLUSION: The combination of T2DM and HF seriously compromises long-term prognosis. Ischaemic heart disease was identified as one major contributor; however, underutilization of available diagnostic and therapeutic facilities for ischaemic heart disease was obvious and may be an important area for future improvement in patients with T2DM and HF.","author":[{"dropping-particle":"","family":"Johansson","given":"Isabelle","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstrom","given":"U","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nasman","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryden","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Norhammar","given":"Anna","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Eur J Heart Fail","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2014"]]},"page":"409-418","title":"Is the prognosis in patients with diabetes and heart failure a matter of unsatisfactory management? An observational study from the Swedish Heart Failure Registry","type":"article-journal","volume":"16"},"uris":[""]}],"mendeley":{"formattedCitation":"²²⁸","plainTextFormattedCitation":"228","previouslyFormattedCitation":"²²⁶"},"properties":{"noteIndex":0},"schema":""}228:In patients with T2DM and acute HF, decreased creatinine clearance (<90 mL/min) was associated with an increased adjusted odds of all cause mortalitySCr 60-89 mL/min: 1.13 (0.94-1.36)SCr 30-59 mL/min: 2.08 (1.72-2.53)SCr <30 mL/min: 4.43 (3.41-5.75)So, mild renal insufficiency does not appear to affect all cause mortality, though odds worsen as renal insufficiency progressesTHESUSSliwa 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/eht393","ISSN":"0195668X","PMID":"24048728","abstract":"AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population.\\n\\nMETHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown.\\n\\nCONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.","author":[{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okekuchwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-1","issue":"40","issued":{"date-parts":[["2013"]]},"page":"3151-3159","title":"Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry","type":"article-journal","volume":"34"},"uris":[""]}],"mendeley":{"formattedCitation":"²³⁸","plainTextFormattedCitation":"238","previouslyFormattedCitation":"²³⁶"},"properties":{"noteIndex":0},"schema":""}238:For doubling BUN, the adjusted hazard for all cause death or readmission through 60 days:HR 1.46 (1.23-1.73)For all cause mortality through 180 days, SCr (1.55 vs. 90 mg/dL) was associated with an adjusted HR of 1.36 (1.12-1.64)Renal failure bottom line:Renal insufficiency has been shown to be an independent predictor of mortality as well as rehospitalisation in the heart failure population. Also, it has been associated with a lower likelihood of receiving certain evidence-based heart failure therapies. Given the potential exacerbation of both conditions concomitantly, the cardio-renal syndrome, it is important to identify renal failure in heart failure patients. For this reason renal failure should be included as a case-mix variable.PRESERVED/REDUCED EF ADHEREYancy 2006 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2005.09.022","ISSN":"07351097","PMID":"16386668","abstract":"OBJECTIVES: The aims of this analysis were to describe the clinical characteristics, management, and outcomes of patients hospitalized for acute decompensated heart failure (HF) with preserved systolic function (PSF). BACKGROUND: Clinically meaningful characteristics of these patients have not been fully studied in a large database. METHODS: Data from >100,000 hospitalizations from the Acute Decompensated Heart Failure National Registry (ADHERE) database were analyzed. RESULTS: Heart failure with PSF was present in 50.4% of patients with in-hospital assessment of left ventricular function. When compared with patients with systolic dysfunction, patients with PSF were more likely to be older, women, and hypertensive and less likely to have had a prior myocardial infarction or be receiving an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. In-hospital mortality was lower in patients with PSF compared with patients with systolic dysfunction (2.8% vs. 3.9%; adjusted odds ratio [OR]: 0.86; p = 0.005), but duration of intensive care unit stay and total hospital length of stay were similar. Serum creatinine >2 mg/dl was associated with increased in-hospital mortality in both systolic function groups (PSF: 4.8%; systolic dysfunction: 8.4%; p < 0.0001), and the most powerful predictors of in-hospital mortality in both groups were blood urea nitrogen >37 mg/dl (OR: 2.53; 95% confidence interval [CI]: 2.22 to 2.87) and systolic blood pressure ≤125 mm Hg (OR: 2.58; 95% CI: 2.33 to 2.86). CONCLUSIONS: Heart failure with PSF is common and is characterized by a unique patient profile. Event rates are worrisome and reflect a need for more effective management strategies. ? 2006 by the American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stevenson","given":"Lynne Warner","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marco","given":"Teresa","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2006"]]},"page":"76-84","title":"Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) database","type":"article-journal","volume":"47"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰","plainTextFormattedCitation":"10","previouslyFormattedCitation":"¹⁰"},"properties":{"noteIndex":0},"schema":""}10:Patients with HFrEF (<40%) experienced higher incidence of mortality, length of hospital stay, ICU admission, and length of stay in ICU/CCU (p<0.0001 for each)AHEADSpinar 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/cc10584","ISBN":"0195-668X","ISSN":"1364-8535","PMID":"22152228","abstract":"INTRODUCTION: The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.\\n\\nMETHODS: The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.\\n\\nRESULTS: Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.\\n\\nCONCLUSIONS: The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.","author":[{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmír","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarová","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Critical Care","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2011"]]},"page":"R291","publisher":"BioMed Central Ltd","title":"Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁴","plainTextFormattedCitation":"34","previouslyFormattedCitation":"³⁴"},"properties":{"noteIndex":0},"schema":""}34:EF ≤30% was not found to be associated with in hospital mortality in patients presenting without cardiogenic shockOR: 1.1 (0.8-1.7)Parenica 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejim.2012.11.005","ISSN":"09536205","PMID":"23219321","abstract":"Background The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival. ? 2012 European Federation of Internal Medicine.","author":[{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horakova","given":"Katerina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Internal Medicine","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2013"]]},"page":"151-160","title":"Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)","type":"article-journal","volume":"24"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁷","plainTextFormattedCitation":"37","previouslyFormattedCitation":"³⁷"},"properties":{"noteIndex":0},"schema":""}37:Kaplan-Meier analysis demonstrated patients with pEF (>50%) had higher 1 & 3 year survival vs. those with rEF (≤50%)Parissis 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2010.08.044","ISBN":"1879-1913 (Electronic)\r0002-9149 (Linking)","ISSN":"00029149","PMID":"21146691","abstract":"Acute heart failure (AHF) with preserved left ventricular ejection fraction (PLVEF) represents a significant part of AHF syndromes featuring particular characteristics. We sought to determine the clinical profile and predictors of in-hospital mortality in patients with AHF and PLVEF in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). This survey is an international observational study of 4,953 patients admitted for AHF in 9 countries (6 European countries, Mexico, and Australia) from October 2006 to March 2007. Patients with PLVEF were defined by an LVEF ≥ 45%. Of the total cohort, 25% of patients had PLVEF. In-hospital mortality was significantly lower in this subgroup (7% vs 11% in patients with decreased LVEF, p = 0.013). Candidate variables included demographics, baseline clinical findings, and treatment. Multivariate logistic regression analysis showed that the variables independently associated with in-hospital mortality included systolic blood pressure at admission (p <0.001), serum sodium (p = 0.041), positive troponin result (p = 0.023), serum creatinine >2 mg/dl (p = 0.042), history of peripheral vascular disease and anemia (p = 0.004 and p = 0.015, respectively), secondary (hospitalization for other reason) versus primary AHF diagnosis (p = 0.043), and previous treatment with diuretics (p = 0.023) and angiotensin-converting enzyme inhibitors (p = 0.021). In conclusion, patients with AHF and PLVEF have lower in-hospital mortality than those with decreased LVEF. Low systolic blood pressure, low serum sodium, renal dysfunction, positive markers of myocardial injury, presence of co-morbidities such as peripheral vascular disease and anemia, secondary versus primary AHF diagnosis, and absence of treatment with diuretics and angiotensin-converting enzyme inhibitors at admission may identify high-risk patients with AHF and PLVEF.","author":[{"dropping-particle":"","family":"Parissis","given":"John T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ikonomidis","given":"Ignatios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rafouli-Stergiou","given":"Pinelopi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Delgado","given":"Juan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Farmakis","given":"Dimitrios","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vilas-Boas","given":"Fabio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paraskevaidis","given":"Ioannis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anastasiou-Nana","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Follath","given":"Ferenc","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2011"]]},"page":"79-84","publisher":"Elsevier Inc.","title":"Clinical characteristics and predictors of in-hospital mortality in acute heart failure with preserved left ventricular ejection fraction.","type":"article-journal","volume":"107"},"uris":[""]}],"mendeley":{"formattedCitation":"⁴⁴","plainTextFormattedCitation":"44","previouslyFormattedCitation":"⁴⁴"},"properties":{"noteIndex":0},"schema":""}44:Versus patients with rEF, acute HF patients with pEF experienced lower in-hospital mortality (7% vs 11%, p= 0.013), and a higher percentage of patients with pEF were discharged home (65% vs 62%, p=0.013)ATTENDKajimoto 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2014.11.007","ISSN":"00029149","author":[{"dropping-particle":"","family":"Kajimoto","given":"Katsuya","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sato","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takano","given":"Teruo","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American Journal of Cardiology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2015"]]},"page":"334-340","publisher":"Elsevier Inc.","title":"Relation of Left Ventricular Ejection Fraction and Clinical Features or Co-morbidities to Outcomes Among Patients Hospitalized for Acute Heart Failure Syndromes","type":"article-journal","volume":"115"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶¹","plainTextFormattedCitation":"61","previouslyFormattedCitation":"⁵⁹"},"properties":{"noteIndex":0},"schema":""}61:Kaplan-Meier analysis did not demonstrate significant differences in all cause mortality or all cause mortality & HR readmission between pEF and rEF groupsp=0.514 & p=0.223 respectivelyEFICAAdamopoulos 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejheart.2007.06.001","ISBN":"1388-9842 (Print)\\r1388-9842 (Linking)","ISSN":"13889842","PMID":"17627880","abstract":"Background: In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and mean arterial pressure (MAP) are independent risk factors in patients with AHFS. Methods and results: The EFICA study enrolled 581 AHFS patients admitted to 60 CCU/ICUs. Survival at 4?weeks was analyzed for all cases with echocardiographic LVEF available on admission (n = 355). Four-week mortality was 23%. Multivariable analysis identified lower LVEF, lower MAP and serum creatinine > 1.5?mg/dl as independent correlates of mortality (respectively, OR: 1.27?per 10% decrease, CI: 1.05-1.53, p = 0.012; OR: 1.30?per 10?mmHg decrease, CI: 1.15-1.48, p < 0.0001; OR: 2.84, CI: 1.64-4.93, p = 0.0002). LVEF interacted significantly with MAP (p < 0.0001) and the subgroup analysis showed that reduced LVEF was a strong risk factor in patients with MAP ≤ 90?mmHg (OR: 2.73, CI: 1.23-5.98, p = 0.01) but did not reach statistical significance in patients with MAP > 90?mmHg. Conclusions: Both LVEF and MAP are important predictors of death in severe AHFS. LVEF can provide additional prognostic information on top of MAP but mainly in patients with low MAP (≤ 90?mmHg) at admission. ? 2007 European Society of Cardiology.","author":[{"dropping-particle":"","family":"Adamopoulos","given":"Chris","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fay","given":"Renaud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mebazaa","given":"Alexandre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cohen-Solal","given":"Alain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guize","given":"Louis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Juillière","given":"Yves","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alla","given":"Fran?ois","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"9","issued":{"date-parts":[["2007"]]},"page":"935-941","title":"Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure","type":"article-journal","volume":"9"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷¹","plainTextFormattedCitation":"71","previouslyFormattedCitation":"⁶⁹"},"properties":{"noteIndex":0},"schema":""}71:Decreased EF was associated with an increased adjusted odds of 4 week mortalityPer 10% decrease: OR 1.27 (1.05–1.53)EF ≤40% vs. >40%: OR 2.24 (1.17–4.31)ESC-HFMaggioni 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurjhf/hft050","ISBN":"1879-0844","ISSN":"13889842","PMID":"23537547","abstract":"AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.\\n\\nMETHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.\\n\\nCONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.","author":[{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstr?m","given":"Ulf","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Leiro","given":"Marisa Crespo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drozdz","given":"Jaroslaw","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fruhwald","given":"Friedrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gullestad","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Logeart","given":"Damien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fabbri","given":"Gianna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parissis","given":"John","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Persson","given":"Hans","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponikowski","given":"Piotr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rauchhaus","given":"Mathias","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nielsen","given":"Olav Wendelboe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Heart Failure","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2013"]]},"page":"808-817","title":"EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷⁸","plainTextFormattedCitation":"78","previouslyFormattedCitation":"⁷⁶"},"properties":{"noteIndex":0},"schema":""}78:EF <40 vs. ≥40% was independently associated with all cause 1 year mortalityAcute HF: HR 1.66 (1.14–2.44)Chronic HF: HR 1.51 (1.10–2.08)GWTG-HFAllen 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.110.959171","ISBN":"1941-3297 (Electronic)\r1941-3289 (Linking)","ISSN":"19413289","PMID":"21447803","abstract":"Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dai","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2011"]]},"page":"293-300","title":"Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure","type":"article-journal","volume":"4"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁰","plainTextFormattedCitation":"100","previouslyFormattedCitation":"⁹⁸"},"properties":{"noteIndex":0},"schema":""}100:EF <40% was independently associated with a lower odds of discharge to a nursing facility Adj OR: 0.91 (0.83-0.99)Gharacholou 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2010.12.005","ISBN":"1071-9164","ISSN":"10719164","PMID":"21549302","abstract":"Background: Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. Methods and Results: Get With the Guidelines (GWTG) program data was used to analyze 57,969 patients hospitalized with HF from January 2005 through January 2010 from 235 sites. Factors associated with referral to HFDM and rates of HF quality measures by referral status were studied. Mean age of patients was 69.7 ± 14.5 years, 52% were men, and 65% were white. HFDM referral occurred in 11,150 (19.2%) patients. The median rate of HFDM referral among all hospitals was 3.5% (25th-75th percentiles 0%-16.7%) and 8.7% (2.8%-27.7%) among hospitals with at least one previous HFDM referral. Quality and performance measures were higher in patients referred to HFDM. HFDM referral was associated with atrial fibrillation, implanted cardiac device, depression, and treatment at larger hospitals. Patients at higher 90-day mortality risk were paradoxically less likely to receive HFDM referral. Conclusions: HFDM referral occurred in less than one-fifth of hospitalized HF patients and was more frequently recommended to lower-risk patients. Increasing use and optimizing selection of patients for HFDM referral is a potential target for quality improvement. ? 2011 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Gharacholou","given":"S. Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hellkamp","given":"Anne S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2011"]]},"page":"431-439","publisher":"Elsevier Inc","title":"Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: Insights from the get with the guidelines program","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰¹","plainTextFormattedCitation":"101","previouslyFormattedCitation":"⁹⁹"},"properties":{"noteIndex":0},"schema":""}101:Increased EF (per 5% increase, up to 50%) was associated with a decreased adjusted odds of referral to a heart failure disease management programOR: 0.941 (0.921-0.962)Whellan 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.cardfail.2012.02.006","ISSN":"10719164","PMID":"22633304","abstract":"Background: Guidelines recommend hospice care as a treatment option for end-stage heart failure (HF) patients. Little is known regarding utilization of hospice care in a contemporary cohort of patients hospitalized with HF and how this may vary by estimated mortality risk. Methods: We analyzed HF patients ≥65 years (n = 58,330) from 214 hospitals participating in the Get With the Guidelines-HF program. Univariate analysis comparing patients discharged to hospice versus other patients was performed. Hospice utilization was evaluated for deciles of estimated 90-day mortality risk using a validated model. Multivariate analysis using admission patient and hospital characteristics was also performed to determine factors associated with hospice discharge. Results: There were 1,442 patients discharged to hospice, and rates of referral varied widely by hospital (interquartile range 0-3.7%) as shown in the univariate analysis. Patients discharged to hospice were significantly older and more often white, had lower left ventricular ejection fraction, higher B-type natriuretic peptide, and lower systolic blood pressure on admission. Utilization rates for each decile of 90-day estimated mortality risk ranged from 0.3% to 8.6%. Multivariable analysis found that factors associated with hospice utilization included increased age, low systolic blood pressure on admission, and increased blood urea nitrogen. Conclusions: Hospice utilization remains low among HF patients, even those with the highest predicted risk of death. ? 2012 Elsevier Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Whellan","given":"David J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Lesley H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiac Failure","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2012"]]},"page":"471-477","publisher":"Elsevier Inc","title":"Utilization of hospice and predicted mortality risk among older patients hospitalized with heart failure: Findings from GWTG-HF","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁸","plainTextFormattedCitation":"108","previouslyFormattedCitation":"¹⁰⁶"},"properties":{"noteIndex":0},"schema":""}108:LVEF was independently associated with a lower of discharge to hospice careAdj OR: 0.9818 (0.9771-0.9865)Heidenreich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.10.008","ISBN":"0002-8703 1097-6744","ISSN":"00028703","PMID":"22305842","abstract":"Background: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare and Medicaid Services) and the main hospital accrediting organization (The Joint Commission). Methods: We used data from Get With The Guidelines Program for patients hospitalized with heart failure. Eligibility for receiving care based on the Center for Medicare and Medicaid Services performance measures was determined for assessment of left ventricular ejection fraction (LVEF; n = 60,601), use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) if LVEF<40% and no contraindications (24,130), discharge instructions (49,383), and smoking cessation counseling (10,152). Patient and hospital characteristics that were significantly associated with performance measures in univariate analyses were entered into multivariate logistic regression models. Results: Overall, documentation for LVEF assessment was noted in 95%, ACEi/ARB use in 87%, discharge instruction in 82%, and smoking cessation counseling in 91% of eligible patients. In adjusted analyses, older patients and those with evidence of renal failure were significantly less likely to receive each care measure except for discharge instructions (no age effect). Patients with higher body mass index were more likely to receive ACEi/ARB and discharge instructions but less likely to have LVEF documented or to receive smoking cessation counseling. Small hospitals (<200 beds) were less likely to provide each of the performance measures compared with larger hospitals. Conclusion: Recommended heart failure care is less likely in patients with certain characteristics (older age and abnormal renal function) and those cared for in smaller hospitals. Programs to improve evidence-based care for heart failure should consider interventions specifically targeting and tailored to smaller facilities and patients who are older with comorbidities. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012"]]},"page":"239-245.e3","publisher":"Elsevier B.V.","title":"Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁵","plainTextFormattedCitation":"105","previouslyFormattedCitation":"¹⁰³"},"properties":{"noteIndex":0},"schema":""}105:A 10% increase in LVEF was independently associated with lower odds of receiving the following evidence-based therapies:ACEI/ARB if EF <40%: Adj OR 0.88 (0.83-0.92) – predictable given indications Discharge instructions: Adj OR 0.94 (0.92-0.95)Quiroz 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amjcard.2013.11.014","ISSN":"1879-1913","PMID":"24484862","abstract":"Despite significant advances in therapies for patients with heart failure with reduced ejection fraction (HFrEF), there are no evidence-based therapies for heart failure with preserved ejection fraction (HFpEF), also known as diastolic heart failure (HF). Differences in pathophysiologic mechanisms are touted as to why patients with HFpEF purportedly do not derive similar therapeutic benefits compared with HFrEF. Similarly, the relative frequencies of HFpEF and HFrEF may differ between hospitalized and ambulatory settings. There are limited data on the prevalence, characteristics, treatment, and short-term outcomes of patients hospitalized with HFpEF. We sought to investigate these in patients hospitalized with HFpEF in an urban, hospitalized setting using the Get With The Guidelines registry. We retrospectively reviewed all consecutive discharges (n = 1,701) with a diagnosis of acute decompensated HF from December 1, 2006 to September 30, 2008. Patients with HFpEF (n = 499) were older, overweight, predominantly women, and had underlying hypertension and dyslipidemia. Presenting blood pressure and levels of creatinine were higher, with lower brain natriuretic peptide levels compared with patients with HFrEF (n = 598). Length of stay and 30-day mortality were comparable between patients with HFpEF and HFrEF. Thirty-day readmission was initially lower in patients with HFpEF. However 30-day mortality from any cause after the index HF hospitalization and survival curve at 1-year was no different between patients with HFpEF and HFrEF. In conclusion, lower 30-day readmissions do not translate into improved long-term outcome in patients with HFpEF.","author":[{"dropping-particle":"","family":"Quiroz","given":"Rene","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Doros","given":"Gheorghe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaw","given":"Peter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liang","given":"Chang-Seng","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gauthier","given":"Diane F","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sam","given":"Flora","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The American journal of cardiology","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2014"]]},"page":"691-6","publisher":"Elsevier Inc.","title":"Comparison of characteristics and outcomes of patients with heart failure preserved ejection fraction versus reduced left ventricular ejection fraction in an urban cohort.","type":"article-journal","volume":"113"},"uris":[""]}],"mendeley":{"formattedCitation":"¹²²","plainTextFormattedCitation":"122","previouslyFormattedCitation":"¹²⁰"},"properties":{"noteIndex":0},"schema":""}122:pEF: ≥50%, rEF: <50%Kaplan-Meier analysis failed to demonstrate significant differences between EF groups for:Rehospitalization free survival to 4 years p=0.18Overall survival to 4 yearsp=0.34EF group was not associated with ReadmissionAdj HR: 1.14 (0.95-1.36)MortalityAdj HR: 1.19 (0.94-1.50)Allen 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCHEARTFAILURE.113.000761","ISSN":"19413297","PMID":"24488983","abstract":"BACKGROUND: Prior claims analyses suggest that the use of intravenous inotropic therapy for patients hospitalized with heart failure varies substantially by hospital. Whether differences in the clinical characteristics of the patients explain observed differences in the use of inotropic therapy is not known.\\n\\nMETHODS AND RESULTS: We sought to characterize institutional variation in inotrope use among patients hospitalized with heart failure before and after accounting for clinical factors of patients. Hierarchical generalized linear regression models estimated risk-standardized hospital-level rates of inotrope use within 209 hospitals participating in Get With The Guidelines-Heart Failure (GWTG-HF) registry between 2005 and 2011. The association between risk-standardized rates of inotrope use and clinical outcomes was determined. Overall, an inotropic agent was administered in 7691 of 126 564 (6.1%) heart failure hospitalizations: dobutamine 43%, dopamine 24%, milrinone 17%, or a combination 16%. Patterns of inotrope use were stable during the 7-year study period. Use of inotropes varied significantly between hospitals even after accounting for patient and hospital characteristics (median risk-standardized hospital rate, 5.9%; interquartile range, 3.7%-8.6%; range, 1.3%-32.9%). After adjusting for case-mix and hospital structural differences, model intraclass correlation indicated that 21% of the observed variation in inotrope use was potentially attributable to random hospital effects (ie, institutional preferences). Hospitals with higher risk-standardized inotrope use had modestly longer risk-standardized length of stay (P=0.005) but had no difference in risk-standardized inpatient mortality (P=0.12).\\n\\nCONCLUSIONS: Use of intravenous inotropic agents during hospitalization for heart failure varies significantly among US hospitals even after accounting for patient and hospital factors.","author":[{"dropping-particle":"","family":"Allen","given":"Larry a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V.","family":"Grau-Sepulveda","given":"Maria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Pamela N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Partovian","given":"Chohreh","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Li","given":"Shu Xia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bhatt","given":"Deepak L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Eric D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Krumholz","given":"Harlan M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation: Heart Failure","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2014"]]},"page":"251-260","title":"Hospital variation in intravenous inotrope use for patients hospitalized with heart failure insights from get with the guidelines","type":"article-journal","volume":"7"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³¹","plainTextFormattedCitation":"131","previouslyFormattedCitation":"¹²⁹"},"properties":{"noteIndex":0},"schema":""}131:LVEF, per 5% decrease from 60%, was associated with an increased adjusted odds of receiving inotrope therapy1.18 (1.17-1.19)Cheng 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2014.07.008","ISSN":"00028703","PMID":"25440801","author":[{"dropping-particle":"","family":"Cheng","given":"Richard K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cox","given":"Margueritte","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Neely","given":"Megan L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heidenreich","given":"Paul A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2014"]]},"page":"721-730.e3","publisher":"Elsevier Inc.","title":"Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population","type":"article-journal","volume":"168"},"uris":[""]}],"mendeley":{"formattedCitation":"¹²³","plainTextFormattedCitation":"123","previouslyFormattedCitation":"¹²¹"},"properties":{"noteIndex":0},"schema":""}123:rEF: <40%; pEF:≥50rEF was not associated with mortalityAdj. HR: 1.04 (0.998-1.084)rEF was associated withCardiovascular readmissionAdj. HR: 1.179 (1.132-1.228) HF readmissionAdj. HR: 1.348 (1.284-1.416)HIJC-HFKawashiro 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"1346-9843","PMID":"18931450","abstract":"BACKGROUND: Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.","author":[{"dropping-particle":"","family":"Kawashiro","given":"Naomi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasanuki","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogawa","given":"Hiroshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Matsuda","given":"Naoki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hagiwara","given":"Nobuhisa","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2008"]]},"page":"2015-2020","title":"Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry.","type":"article-journal","volume":"72"},"uris":[""]}],"mendeley":{"formattedCitation":"¹³⁵","plainTextFormattedCitation":"135","previouslyFormattedCitation":"¹³³"},"properties":{"noteIndex":0},"schema":""}135:EF ≤35% associated with increased mortalityTotal deathAdj HR: 1.65 (1.25–2.17)Cardiac DeathAdj. HR: 1.62 (1.11–2.38)IMPROVE-HFShukla 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/pace.12090","ISBN":"1540-8159 (Electronic)\\n0147-8389 (Linking)","ISSN":"01478389","PMID":"23380000","abstract":"BACKGROUND: There is a well-recognized gap between the number of patients in whom cardiac resynchronization therapy (CRT) is indicated based on current guidelines and its actual utilization. In the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) study, there was a significant increase in the use of CRT at 24 months in patients with heart failure (HF) in comparison to baseline. This study evaluated patient, physician, and practice factors associated with this increase in CRT utilization.\\n\\nMETHODS: Patients with reduced left ventricular ejection fraction and chronic HF who met the eligibility criteria for CRT at baseline and 24 months were analyzed. Multivariate analyses using patient, physician, and practice characteristics were performed to evaluate factors associated with increased CRT utilization at 24 months.\\n\\nRESULTS: There were 440 patients eligible for CRT both at baseline and 24 months, with 217 (49.3%) treated at baseline and 374 (85%) treated at 24 months, leading to an absolute increase in use of CRT of 35.7%, P < 0.001. Although serum sodium and the absence of rales had modest associations, none of the patient, physician, or practice characteristics had any significant association with the extent of increase in CRT utilization. There was a significant reduction in the variation of CRT utilization across practice sites after the implementation of the performance improvement initiative.\\n\\nCONCLUSIONS: The performance improvement initiative in IMPROVE HF was the most important factor associated with an increase in guideline-recommended CRT utilization. This improvement in CRT utilization and reduced practice variability was found across a variety of cardiology and multispecialty practice sites.","author":[{"dropping-particle":"","family":"Shukla","given":"Ashish","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Curtis","given":"Anne B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mehra","given":"Mandeep R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heywood","given":"J. Thomas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Liu","given":"Yang","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reynolds","given":"Dwight","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Walsh","given":"Mary Norine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PACE - Pacing and Clinical Electrophysiology","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2013"]]},"page":"433-443","title":"Factors associated with improvement in utilization of cardiac resynchronization therapy in eligible heart failure patients: Findings from IMPROVE HF","type":"article-journal","volume":"36"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵¹","plainTextFormattedCitation":"151","previouslyFormattedCitation":"¹⁴⁹"},"properties":{"noteIndex":0},"schema":""}151:Patients with a higher EF had higher odds of receiving CRT at 24 monthsAdj OR: 1.088 (1.036–1.143)IN-HFSenni 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ijcard.2014.02.018","ISSN":"18741754","PMID":"24630337","abstract":"Background To investigate the outcomes of hospitalized patients with both de-novo and worsening heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HFpEF) (LVEF ??? 50%), compared to those with reduced LVEF (HFrEF). Methods and results We studied 1669 patients (22.6% HFpEF) hospitalized for acute HF in the prospective multi-center nationwide Italian Network on Heart Failure (IN-HF) Outcome Registry. In all patients LVEF was assessed during hospitalization. De-novo HF presentations constituted 49.6% of HFpEF and 43.1% of HFrEF hospitalizations. All-cause mortality during hospitalization was lower in HFpEF than HFrEF (2.9% vs 6.5%, p = 0.01), but this mortality difference was not significant at 1 year (19.6% vs 24.4%, p = 0.06), even after adjusting for clinical covariates. Similarly, there were no differences in 1-year mortality between HFpEF and HFrEF when compared by cause of death (cardiovascular vs non-cardiovascular) or mode of presentation (worsening HF vs de novo). Rehospitalization rates (all-cause, non-cardiovascular, cardiovascular, HF-related) at 90 days and 1 year were also similar. Mode of presentation influenced rehospitalizations in HFpEF, where those presenting with worsening HFpEF had higher all-cause (36.8% vs 21.6%, p = 0.001), cardiovascular (28.1% vs 14.9%, p = 0.002), and HF-related (21.1% vs 7.7%, p = 0.0003) rehospitalization rates at 1 year compared to those with de novo presentations. Conclusions Outcomes at 1 year following hospitalization for HFpEF are as poor as that of HFrEF. A prior history of HF decompensation or hospitalization identifies patients with HFpEF at particularly high risk of recurrent events. These findings may have implications for clinical practice, quality and process improvements and trial design. ?? 2014 Elsevier Ireland Ltd.","author":[{"dropping-particle":"","family":"Senni","given":"Michele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gavazzi","given":"Antonello","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oliva","given":"Fabrizio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mortara","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urso","given":"Renato","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pozzoli","given":"Massimo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Metra","given":"Marco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lucci","given":"Donata","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gonzini","given":"Lucio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cirrincione","given":"Vincenzo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Montagna","given":"Laura","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lenarda","given":"Andrea","non-dropping-particle":"Di","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maggioni","given":"Aldo P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tavazzi","given":"Luigi","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cardiology","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2014"]]},"page":"163-169","publisher":"Elsevier Ireland Ltd","title":"In-hospital and 1-year outcomes of acute heart failure patients according to presentation (de novo vs. worsening) and ejection fraction. Results from IN-HF Outcome Registry","type":"article-journal","volume":"173"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁵⁸","plainTextFormattedCitation":"158","previouslyFormattedCitation":"¹⁵⁶"},"properties":{"noteIndex":0},"schema":""}158:rHF (<50%) significantly more likely to receive certain treatments vs. pEF (≥50%)ACEI/ARBBeta blockerAldosterone antagonistDiureticsPredictable given these are recommended in cases of LV systolic dysfunction (beta-blockade, afterload reduction, etc.)JCARETsuchihashi-Makaya 2009 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"JST.JSTAGE/circj/CJ-09-0254 [pii]","ISBN":"1347-4820 (Electronic)\\n1346-9843 (Linking)","ISSN":"1347-4820","PMID":"19644216","abstract":"BACKGROUND: Heart failure (HF) with preserved ejection fraction (EF) is common. We compared the characteristics, treatments, and outcomes in HF patients with reduced vs preserved EF by using the national registry database in Japan. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) is a prospective observational study in a broad sample of patients hospitalized with worsening HF. The study enrolled 2,675 patients from 164 hospitals with an average of 2.4 years of follow-up. Patients with preserved EF (EF >or=50% by echocardiography; n=429) were more likely to be older, female, have hypertension and atrial fibrillation, and less likely to have ischemic etiology compared with those with reduced EF (EF <40%; n=985). Unadjusted risk of in-hospital mortality (6.5% vs 3.9%; P=0.03) and post-discharge mortality (22.7% vs 17.8%; P=0.058) was slightly higher in patients with preserved EF, which, however, were not different after multivariable adjustment. Patients with preserved EF had similar rehospitalization rates (36.2% vs 33.4%; P=0.515) compared with patients with reduced EF. CONCLUSIONS: HF patients with preserved EF had a similar mortality risk and equally high rates of rehospitalization as those with reduced EF. Effective management strategies are critically needed to be established for this type of HF.","author":[{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kato","given":"Norihiro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2009"]]},"page":"1893-1900","title":"Characteristics and outcomes of hospitalized patients with heart failure and reduced vs preserved ejection fraction. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).","type":"article-journal","volume":"73"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁶¹","plainTextFormattedCitation":"161","previouslyFormattedCitation":"¹⁵⁹"},"properties":{"noteIndex":0},"schema":""}161:rEF (<40%) vs. pEF (≥50)No differences on Kaplan-Meier analysis between groups in terms of:All cause mortalityRehospitalizationCardiac mortalityReflected in non-significant hazard ratios for the aboveHamaguchi 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"","ISBN":"1347-4820","ISSN":"1347-4820","PMID":"22481105","abstract":"BACKGROUND: The mode of death has not been investigated in the registry data of patients with heart failure and reduced ejection fraction (HFREF) vs. preserved ejection fraction (HFPEF). The aim of the present study was therefore to carry out this comparison. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF, and followed them for an average of 2.1 years. This study included 323 patients in whom information on both the mode of death and left ventricular EF on echocardiography could be obtained. The mode of death was cardiovascular (CV) in 63% (including 17% sudden, 36% HF, 3% myocardial infarction, and 3% stroke), non-CV in 23%, and unknown in 14%. The prevalence of CV death including sudden death was high in patients with HFREF compared to HFPEF (68% vs. 58%, P=0.020). HF death, the most common mode of death, was similar between groups (37% vs. 35%, P=0.694). In contrast, non-CV mortality was significantly higher in HFPEF than those with HFREF (28% vs. 18%, P=0.021). CONCLUSIONS: In 60-70% of deaths the mode was CV, and HF death was the most common mode of death in either HFREF or HFPEF. The prevalence of sudden death was lower, and that of non-CV death higher, in HFPEF compared with HFREF.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sobirin","given":"Mochamad Ali","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Investigators","given":"Jcare-Card","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation Journal","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2012"]]},"page":"1662-1669","title":"Mode of death in patients with heart failure and reduced vs. preserved ejection fraction: report from the registry of hospitalized heart failure patients","type":"article-journal","volume":"76"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁷¹","plainTextFormattedCitation":"171","previouslyFormattedCitation":"¹⁶⁹"},"properties":{"noteIndex":0},"schema":""}171:Do not define rEF or pEF – assuming the same as previously defined by JCARE (<40% & ≥50 respectively)No difference between groups in Kaplan-Meier survival to 1400 daysp=0.924No differences between groups in cumulative incidence of:All cause deathp=0.528HF deathp=0.931rEF had increased cumulative incidence of sudden deathp=0.038pEF had increased cumulative incidence of non-cardiovascular deathp=0.012OPTIMIZE-HFFonarow 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2007.04.064","ISSN":"07351097","PMID":"17707182","abstract":"Objectives: We sought to evaluate the characteristics, treatments, and outcomes of patients with preserved and reduced systolic function heart failure (HF). Background: Heart failure with preserved systolic function (PSF) is common but not well understood. Methods: This analysis of the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry compared 20,118 patients with left ventricular systolic dysfunction (LVSD) and 21,149 patients with PSF (left ventricular ejection fraction [EF] ≥40%). Sixty- to 90-day follow-up was obtained in a pre-specified 10% sample of patients. Analyses of patients with PSF defined as EF >50% were also performed for comparison. Results: Patients with PSF (EF ≥40%) were more likely to be older, female, and Caucasian and to have a nonischemic etiology. Although length of hospital stay was the same in both groups, risk of in-hospital mortality was lower in patients with PSF (EF ≥40%) (2.9% vs. 3.9%; p < 0.0001). During 60- to 90-day post-discharge follow-up, patients with PSF (EF ≥40%) had a similar mortality risk (9.5% vs. 9.8%; p = 0.459) and rehospitalization rates (29.2% vs. 29.9%; p = 0.591) compared with patients with LVSD. Findings were comparable with those with PSF defined as EF >50%. In a risk- and propensity-adjusted model, there were no significant relationships between discharge use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or beta-blocker and 60- to 90-day mortality and rehospitalization rates in patients with PSF. Conclusions: Data from the OPTIMIZE-HF registry reveal a high prevalence of HF with PSF, and these patients have a similar post-discharge mortality risk and equally high rates of rehospitalization as patients with HF and LVSD. Despite the burden to patients and health care systems, data are lacking on effective management strategies for patients with HF and PSF. (Organized Program To Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]); ; NCT00344513). ? 2007 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2007"]]},"page":"768-777","title":"Characteristics, Treatments, and Outcomes of Patients With Preserved Systolic Function Hospitalized for Heart Failure. A Report From the OPTIMIZE-HF Registry","type":"article-journal","volume":"50"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁹⁵","plainTextFormattedCitation":"195","previouslyFormattedCitation":"¹⁹³"},"properties":{"noteIndex":0},"schema":""}195:pEF defined as ≥40%Unadjusted comparisons of LVSD vs. pEFIncreased in-hospital mortality if LVSD (p<0.0001)No difference between groups forPost-discharge mortality at 60-90 daysRehospitalization at 60-90 daysNo significant differences in above outcomes between EF 40-50% and >50%Abraham 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jacc.2008.04.028","ISBN":"1558-3597 (Electronic) 0735-1097 (Linking)","ISSN":"07351097","PMID":"18652942","abstract":"Objectives: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. Background: Heart failure patients experience high rates of hospital stays and poor outcomes. Although predictors of mortality have been identified in HF clinical trials, hospitalized patients might differ greatly from trial populations, and such predictors might underestimate mortality in a real-world population. Methods: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) is a registry/performance improvement program for patients hospitalized with HF in 259 U.S. hospitals. Forty-five potential predictor variables were used in a stepwise logistic regression model for in-hospital mortality. Continuous variables that did not meet linearity assumptions were transformed. All significant variables (p < 0.05) were entered into multivariate analysis. Generalized estimating equations were used to account for the correlation of data within the same hospital in the adjusted models. Results: Of 48,612 patients enrolled, mean age was 73.1 years, 52% were women, 74% were Caucasian, and 46% had ischemic etiology. Mean left ventricular ejection fraction was 0.39 ± 0.18. In-hospital mortality occurred in 1,834 (3.8%). Multivariable predictors of mortality included age, heart rate, systolic blood pressure (SBP), sodium, creatinine, HF as primary cause of hospitalization, and presence/absence of left ventricular systolic dysfunction. A scoring system was developed to predict mortality. Conclusions: Risk of in-hospital mortality for patients hospitalized with HF remains high and is increased in patients who are older and have low SBP or sodium levels and elevated heart rate or creatinine at admission. Application of this risk-prediction algorithm might help identify patients at high risk for in-hospital mortality who might benefit from aggressive monitoring and intervention. (Organized Program to Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure [OPTIMIZE-HF]; NCT00344513). ? 2008 American College of Cardiology Foundation.","author":[{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stough","given":"Wendy Gattis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sun","given":"Jie Lena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of the American College of Cardiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2008"]]},"page":"347-356","title":"Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure. Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"52"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁴","plainTextFormattedCitation":"204","previouslyFormattedCitation":"²⁰²"},"properties":{"noteIndex":0},"schema":""}204:LVSD (undefined) was associated with an adjusted OR for in hospital mortality of 1.28 (1.13-1.46)RO-AHFSChioncel 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2459/JCM.0000000000000030","ISBN":"0000000000000","ISSN":"1558-2027","author":[{"dropping-particle":"","family":"Chioncel","given":"Ovidiu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ambrosy","given":"Andrew P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filipescu","given":"Daniela","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bubenek","given":"Serban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vinereanu","given":"Dragos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Petris","given":"Antoniu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Collins","given":"Sean P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Macarie","given":"Cezar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Cardiovascular Medicine","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2015"]]},"page":"331-340","title":"Patterns of intensive care unit admissions in patients hospitalized for heart failure","type":"article-journal","volume":"16"},"uris":[""]}],"mendeley":{"formattedCitation":"²²⁰","plainTextFormattedCitation":"220","previouslyFormattedCitation":"²¹⁸"},"properties":{"noteIndex":0},"schema":""}220:LVEF <45% was associated with an increased adjusted risk of ICU admission 1.28 (1.19-1471) – this was how reported, may have missed a decimal point in print or it has a huge SE and therefore a wide CIS-HFRJohnansson 2014 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1002/ejhf.44","ISBN":"1879-0844 (Electronic) 1388-9842 (Linking)","PMID":"24464683","abstract":"AIMS: To analyse the long-term outcome, risk factor panorama, and treatment pattern in patients with heart failure (HF) with and without type 2 diabetes (T2DM) from a daily healthcare perspective. METHODS AND RESULTS: Patients with (n=8809) and without (n=27,465) T2DM included in the Swedish Heart Failure Registry (S-HFR) 2003-2011 due to a physician-based HF diagnosis were prospectively followed for long-term mortality (median follow-up time: 1.9 years, range 0-8.7 years). Left ventricular function expressed as EF did not differ between patients with and without T2DM. Survival was significantly shorter in patients with T2DM, who had a median survival time of 3.5 years compared with 4.6 years (P<0.0001). In subjects with T2DM. unadjusted and adjusted odds ratios (ORs) for mortality were 1.37 [95% confidence interval (CI) 1.30-1.44) and 1.60 (95% CI 1.50-1.71), and T2DM predicted mortality in all age groups. Ischaemic heart disease was an important predictor for mortality (OR 1.68, 95% CI 1.47-1.94), more abundant in patients with T2DM (59% vs. 45%) among whom only 35% had been subjected to coronary angiography and 32% to revascularization. Evidence-based pharmacological HF treatment was somewhat more extensive in patients with T2DM. CONCLUSION: The combination of T2DM and HF seriously compromises long-term prognosis. Ischaemic heart disease was identified as one major contributor; however, underutilization of available diagnostic and therapeutic facilities for ischaemic heart disease was obvious and may be an important area for future improvement in patients with T2DM and HF.","author":[{"dropping-particle":"","family":"Johansson","given":"Isabelle","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edner","given":"Magnus","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dahlstrom","given":"U","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nasman","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryden","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Norhammar","given":"Anna","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Eur J Heart Fail","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2014"]]},"page":"409-418","title":"Is the prognosis in patients with diabetes and heart failure a matter of unsatisfactory management? An observational study from the Swedish Heart Failure Registry","type":"article-journal","volume":"16"},"uris":[""]}],"mendeley":{"formattedCitation":"²²⁸","plainTextFormattedCitation":"228","previouslyFormattedCitation":"²²⁶"},"properties":{"noteIndex":0},"schema":""}228:EF <50% was associated with an increased adj. OR for mortality in patients with T2DM for the following comparator groups40-49% - 1.39 (1.17-1.67)30-39% - 1.34 (1.13-1.6)<30% - 1.75 (1.46-2.07)THESUSSliwa 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/eht393","ISSN":"0195668X","PMID":"24048728","abstract":"AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population.\\n\\nMETHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown.\\n\\nCONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.","author":[{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okekuchwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-1","issue":"40","issued":{"date-parts":[["2013"]]},"page":"3151-3159","title":"Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry","type":"article-journal","volume":"34"},"uris":[""]}],"mendeley":{"formattedCitation":"²³⁸","plainTextFormattedCitation":"238","previouslyFormattedCitation":"²³⁶"},"properties":{"noteIndex":0},"schema":""}238:For EF 50% vs.27%No significant association with all cause death or readmission through 60 daysAdj. HR: 0.89 (0.79-1.14)For a 5% change in EFNo significant univariable association with all cause death through 180 daysHR: 0.96 (0.92-1.02)Preserved/reduced EF bottom line:There is conflicting evidence on EF with respect to whether mortality is affected, though the balance appears to favour rEF conferring a risk of mortality. However, there are variable definitions of pEF and rEF by each registry, and occasionally between publications within the same registry, which may account for this variability in outcome. Additionally, rEF patients are more likely to receive most, if not all, evidence-based medical therapies. However, it should be noted that these therapies (ACEI/ARB, beta blocker, aldosterone antagonist, ICD/CRT) are indicated for those with a rEF/LVSD, so this is a predictable and expected outcome. Given inconsistency in mortality outcomes, and the predictability in the evidence-based therapeutic regimes, pEF/rEF should not be included as a case-mix variable. WEIGHT/BMIADHEREFonarow 2007 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2006.09.007","ISSN":"00028703","PMID":"17174642","abstract":"BACKGROUND: Prior studies on chronic systolic heart failure (HF) have demonstrated that body mass index (BMI) is inversely associated with mortality, the so-called obesity paradox. The aim of this study was to determine whether BMI influences the mortality risk in acute decompensated HF, a subject not previously studied. METHODS: The Acute Decompensated Heart Failure National Registry was analyzed for acute HF hospitalizations in 263 hospitals in the United States from October 2001 through December 2004. Patients with documented height and weight were divided into BMI (measured in kilograms per square meter) quartiles. Inhospital mortality by BMI quartile for all the patients and for those with reduced (n = 43,255) and preserved (n = 37,901) systolic function was assessed. RESULTS: Body mass index quartiles in the 108,927 hospitalizations were QI (16.0-23.6 kg/m2), QII (23.7-27.7 kg/m2), QIII (27.8-33.3 kg/m2), and QIV (33.4-60.0 kg/m2). Patients in the higher BMI quartiles were younger, had more diabetes, and had a higher left ventricular ejection fraction. Inhospital mortality rates decreased in a near-linear fashion across successively higher BMI quartiles. After adjustments for age, sex, blood urea nitrogen, blood pressure, creatinine, sodium, heart rate, and dyspnea at rest, BMI quartile still predicted mortality risk. For every 5-U increase in BMI, the odds of risk-adjusted mortality was 10% lower (95% CI 0.88-0.93, P < .0001). CONCLUSIONS: In this cohort of hospitalized patients with HF, higher BMI was associated with lower inhospital mortality risk. The relationship between BMI and adverse outcomes in HF appears to be complex and deserving of further study.","author":[{"dropping-particle":"","family":"Fonarow","given":"Gregg C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Srikanthan","given":"Preethi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Costanzo","given":"Maria Rosa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cintron","given":"Guillermo B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lopatin","given":"Margarita","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American heart journal","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2007"]]},"page":"74-81","title":"An obesity paradox in acute heart failure: analysis of body mass index and inhospital mortality for 108,927 patients in the Acute Decompensated Heart Failure National Registry.","type":"article-journal","volume":"153"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁶","plainTextFormattedCitation":"16","previouslyFormattedCitation":"¹⁶"},"properties":{"noteIndex":0},"schema":""}16:In hospital mortality decreased linearly with increasing quartile of BMI (inversely related) for all patients, as well as after grouped by EF (≥40 vs. <40%)p<0.0001 for each groupAfter multivariable adjustment, risk of in hospital mortality remained inversely associate with BMIQI versus QII: OR 1.21 (1.11-1.32)QIII versus QII: OR 0.84 (0.76-0.92)QIV versus QII: OR 0.83 (0.75- 0.93)AHEADSpinar 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/cc10584","ISBN":"0195-668X","ISSN":"1364-8535","PMID":"22152228","abstract":"INTRODUCTION: The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.\\n\\nMETHODS: The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.\\n\\nRESULTS: Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.\\n\\nCONCLUSIONS: The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.","author":[{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmír","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarová","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Critical Care","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2011"]]},"page":"R291","publisher":"BioMed Central Ltd","title":"Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry","type":"article-journal","volume":"15"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁴","plainTextFormattedCitation":"34","previouslyFormattedCitation":"³⁴"},"properties":{"noteIndex":0},"schema":""}34:BMI ≤28 was not associated with in hospital mortality on univariable analysis in non-cardiogenic shock patientsOR: 1.0 (0.7-1.4)Parenica 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ejim.2012.11.005","ISSN":"09536205","PMID":"23219321","abstract":"Background The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival. ? 2012 European Federation of Internal Medicine.","author":[{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horakova","given":"Katerina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du?ek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Journal of Internal Medicine","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2013"]]},"page":"151-160","title":"Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)","type":"article-journal","volume":"24"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁷","plainTextFormattedCitation":"37","previouslyFormattedCitation":"³⁷"},"properties":{"noteIndex":0},"schema":""}37:In patients with EF <50%, BMI ≤28 was associated with increased long-term mortalityAdj HR: 1.441 (1.178-1.764)Littnerova 2015 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1371/journal.pone.0117142","ISSN":"1932-6203","author":[{"dropping-particle":"","family":"Littnerova","given":"Simona","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parenica","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinar","given":"Jindrich","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitovec","given":"Jirí","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Linhart","given":"Ales","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widimsky","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jarkovsky","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miklik","given":"Roman","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spinarova","given":"Lenka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeman","given":"Kamil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belohlavek","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Felsoci","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kettner","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ostadal","given":"Petr","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cihalik","given":"Cestmir","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Spac","given":"Jiri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Al-Hiti","given":"Hikmet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fedorco","given":"Marian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fojt","given":"Richard","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kruger","given":"Andreas","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malek","given":"Josef","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mikusová","given":"Tereza","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Monhart","given":"Zdenek","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bohacova","given":"Stanislava","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pohludkova","given":"Lidka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rohac","given":"Filip","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaclavik","given":"Jan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vondrakova","given":"Dagmar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vyskocilova","given":"Klaudia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bambuch","given":"Miroslav","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dusek","given":"Ladislav","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Plos One","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2015"]]},"page":"e0117142","title":"Positive Influence of Being Overweight/Obese on Long Term Survival in Patients Hospitalised Due to Acute Heart Failure","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"⁴⁰","plainTextFormattedCitation":"40","previouslyFormattedCitation":"⁴⁰"},"properties":{"noteIndex":0},"schema":""}40: Normal BMI (<25) was significantly associated with worse cumulative mortality for all and de novo heart failure to 84 months relative to BMI ≥25 after propensity score matching the cohorts All comersHR 1.22 (1.09-1.39)De NovoHR 1.30 (1.11-1.52)Acute decompensatedHR 1.14 (0.98-1.33)GWTG-HFHeidenreich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.10.008","ISBN":"0002-8703 1097-6744","ISSN":"00028703","PMID":"22305842","abstract":"Background: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare and Medicaid Services) and the main hospital accrediting organization (The Joint Commission). Methods: We used data from Get With The Guidelines Program for patients hospitalized with heart failure. Eligibility for receiving care based on the Center for Medicare and Medicaid Services performance measures was determined for assessment of left ventricular ejection fraction (LVEF; n = 60,601), use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) if LVEF<40% and no contraindications (24,130), discharge instructions (49,383), and smoking cessation counseling (10,152). Patient and hospital characteristics that were significantly associated with performance measures in univariate analyses were entered into multivariate logistic regression models. Results: Overall, documentation for LVEF assessment was noted in 95%, ACEi/ARB use in 87%, discharge instruction in 82%, and smoking cessation counseling in 91% of eligible patients. In adjusted analyses, older patients and those with evidence of renal failure were significantly less likely to receive each care measure except for discharge instructions (no age effect). Patients with higher body mass index were more likely to receive ACEi/ARB and discharge instructions but less likely to have LVEF documented or to receive smoking cessation counseling. Small hospitals (<200 beds) were less likely to provide each of the performance measures compared with larger hospitals. Conclusion: Recommended heart failure care is less likely in patients with certain characteristics (older age and abnormal renal function) and those cared for in smaller hospitals. Programs to improve evidence-based care for heart failure should consider interventions specifically targeting and tailored to smaller facilities and patients who are older with comorbidities. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012"]]},"page":"239-245.e3","publisher":"Elsevier B.V.","title":"Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁵","plainTextFormattedCitation":"105","previouslyFormattedCitation":"¹⁰³"},"properties":{"noteIndex":0},"schema":""}105:BMI (per 5 unit increase) was associated withLower adjusted odds of LVEF documentationHR: 0.98 (0.96-0.99) Lower adjusted odds of smoking cessation counsellingHR: 0.87 (0.81-0.94)Higher adjusted odds of ACEI/ARB at discharge if EF<40%HR: 1.04 (1.00-1.07)Higher odds of receiving discharge instructionsHR: 1.03 (1.01-1.04)HIJC-HFBMI <19 was associated with increased adjusted odds of Total mortalityHR: 1.76 (1.43–2.18)Cardiac MortalityHR: 2.02 (1.49–2.75)JCAREHamaguchi 2010 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1253/circj.CJ-10-0599","ISBN":"1347-4820","ISSN":"1347-4820","PMID":"21060207","abstract":"Obesity is a risk factor for cardiovascular disease (CVD) and is also associated with an increased risk of death in subjects without CVD. However, in heart failure (HF), elevated body mass index (BMI) has been shown to be associated with better prognosis, but it is unknown whether this is the case in unselected HF patients encountered in routine clinical practice in Japan.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Kazutomo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2010"]]},"page":"2605-2611","title":"Body mass index is an independent predictor of long-term outcomes in patients hospitalized with heart failure in Japan.","type":"article-journal","volume":"74"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁶⁶","plainTextFormattedCitation":"166","previouslyFormattedCitation":"¹⁶⁴"},"properties":{"noteIndex":0},"schema":""}166:Lower BMI (<23.5) was associated with increased adjusted risk of all cause death and cardiac death, but not rehospitalisationAll cause death: BMI <20.3HR: 1.699 (1.209–2.386) BMI 20.3–23.491.674 (1.199–2.338)Cardiac Death:BMI <20.31.832 (1.193–2.814)BMI 20.3–23.491.708 (1.114–2.619)RehospitalizationBMI <20.31.182 (0.948–1.473) BMI 20.3–23.491.224 (0.991–1.511)Per 1 unit BMI decrease, the adjusted risk of all cause mortality increased1.049 (1.013–1.087)Hamaguchi 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1253/circj.CJ-11-0267","ISSN":"1347-4820","PMID":"21778592","abstract":"BACKGROUND: Aging is associated with adverse outcomes in patients with cardiac diseases. Whether elderly patients hospitalized with heart failure (HF) had increased risks for mortality and rehospitalization compared with younger patients during the long-term follow-up was examined. The predictors of these adverse outcomes were also identified. METHODS AND RESULTS: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF and the outcomes were followed up. The majority of elderly patients were female, had lower body mass index (BMI), a higher rate of ischemic, valvular, and hypertensive heart disease as etiologies of HF, a lower estimated glomerular filtration rate (eGFR), lower hemoglobin, and higher left ventricular ejection fraction values. Even after adjustment for covariates, the elderly patients were associated with higher risks of adverse outcomes. The predictors for all-cause death were: lower eGFR, lower BMI, male sex, sustained ventricular tachycardia or fibrillation (VT/VF), and the use of diuretics at discharge. CONCLUSIONS: Among patients hospitalized with HF, elderly patients had a worse prognosis than younger patients. Lower eGFR, lower BMI, male sex, sustained VT/VF, and diuretic use were independent predictors for all-cause death in these patients with higher risk.","author":[{"dropping-particle":"","family":"Hamaguchi","given":"Sanae","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kinugawa","given":"Shintaro","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goto","given":"Daisuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsuchihashi-Makaya","given":"Miyuki","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokota","given":"Takashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yamada","given":"Satoshi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yokoshiki","given":"Hisashi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Takeshita","given":"Akira","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsutsui","given":"Hiroyuki","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation journal : official journal of the Japanese Circulation Society","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2011"]]},"page":"2403-10","title":"Predictors of long-term adverse outcomes in elderly patients over 80 years hospitalized with heart failure. - A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)-.","type":"article-journal","volume":"75"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁶⁸","plainTextFormattedCitation":"168","previouslyFormattedCitation":"¹⁶⁶"},"properties":{"noteIndex":0},"schema":""}168:In patients >80 years, a 1 unit decrease in BMI was associated with an increased adjusted risk of All cause death1.134 (1.054–1.221)Cardiac death1.118 (1.022–1.224)KorHFChoi 2011 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4070/kcj.2011.41.7.363","ISSN":"1738-5520","PMID":"21860637","abstract":"BACKGROUND AND OBJECTIVES: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea.\\n\\nSUBJECTS AND METHODS: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6±14.3 years and 50% of the patients were female.\\n\\nRESULTS: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5±15.7% and 26.1% of the patients had preserved systolic function (LVEF ≥50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death.\\n\\nCONCLUSION: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.","author":[{"dropping-particle":"","family":"Choi","given":"Dong-Ju","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Han","given":"Seongwoo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jeon","given":"Eun-Seok","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cho","given":"Myeong-Chan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jae-Joong","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yoo","given":"Byung-Su","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shin","given":"Mi-Seung","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Seong","given":"In-Whan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ahn","given":"Youngkeun","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kang","given":"Seok-Min","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Yung-Jo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Hyung Seop","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chae","given":"Shung Chull","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oh","given":"Byung-Hee","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"Myung-Mook","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ryu","given":"Kyu-Hyung","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Korean Circulation Journal","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2011"]]},"page":"363","title":"Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry","type":"article","volume":"41"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁷⁷","plainTextFormattedCitation":"177","previouslyFormattedCitation":"¹⁷⁵"},"properties":{"noteIndex":0},"schema":""}177:On univariable analysis, BMI<23 was associated with an increased risk of all cause mortality1.781 (1.490-2.129)However, this did not appear to be increased on multivariable analysisOPTIMIZE-HFO’Connor 2008 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2008.04.030","ISBN":"1097-6744 (Electronic)\\r0002-8703 (Linking)","ISSN":"00028703","PMID":"18926148","abstract":"Background: Patients with heart failure (HF) are at high risk for mortality and rehospitalization in the early period after hospital discharge. We developed clinical models predictive of short-term clinical outcomes in a broad patient population discharged after hospitalization for HF. Methods: The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry is a comprehensive hospital-based registry and performance-improvement program for patients hospitalized with HF. Follow-up data were scheduled to be prospectively collected at 60 to 90 days postdischarge in a prespecified 10% sample. For the 4,402 patients included in this analysis, 19 prespecified potential predictor variables were used in a stepwise Cox proportional hazards model for all-cause mortality. Logistic regression including 45 potential variables was used to model mortality or rehospitalization. Results: The 60- to 90-day postdischarge mortality rate was 8.6% (n = 481), and 29.6% (n = 1,715) were rehospitalized. Factors predicting early postdischarge mortality include age, serum creatinine, reactive airway disease, liver disease, lower systolic blood pressure, lower serum sodium, lower admission weight, and depression. Use of statins and β-blockers at discharge was associated with significantly decreased mortality. The C-index of the model was 0.74. The most important predictors for the combined end point of death or rehospitalization were admission serum creatinine, systolic blood pressure, admission hemoglobin, discharge use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and pulmonary disease. From this analysis, 8 factors identified to carry significant risk were selected for use in a point scoring system to predict the risk of mortality within 60 days after discharge, with a C-index of 0.72. Conclusions: A substantial risk of mortality and mortality or rehospitalization is present in the first 60 to 90 days after discharge from a hospitalization for HF. Several factors were identified that signal high-risk patients. Application of these findings with a simple algorithm can distinguish patients who are low risk from those at high risk who may benefit from closer monitoring and aggressive evidence-based treatment. ? 2008 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"O'Connor","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Abraham","given":"William T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Albert","given":"Nancy M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"Robert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gattis Stough","given":"Wendy","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gheorghiade","given":"Mihai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenberg","given":"Barry H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Young","given":"James B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2008"]]},"page":"662-673","title":"Predictors of mortality after discharge in patients hospitalized with heart failure: An analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","type":"article-journal","volume":"156"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰⁰","plainTextFormattedCitation":"200","previouslyFormattedCitation":"¹⁹⁸"},"properties":{"noteIndex":0},"schema":""}200:Per 10 kg increase in weight, patients had a lower risk of mortality from discharge to follow-up0.90 (0.86-0.96)THESUSSliwa 2013 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1093/eurheartj/eht393","ISSN":"0195668X","PMID":"24048728","abstract":"AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population.\\n\\nMETHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown.\\n\\nCONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.","author":[{"dropping-particle":"","family":"Sliwa","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Davison","given":"Beth a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mayosi","given":"Bongani M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damasceno","given":"Albertino","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sani","given":"Mahmoud","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ogah","given":"Okekuchwu S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mondo","given":"Charles","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ojji","given":"Dike","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dzudie","given":"Anastase","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kouam","given":"Charles Kouam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Suliman","given":"Ahmed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schrueder","given":"Neshaad","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yonga","given":"Gerald","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ba","given":"Sergine Abdou","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Maru","given":"Fikru","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alemayehu","given":"Bekele","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Christopher","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cotter","given":"Gad","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European Heart Journal","id":"ITEM-1","issue":"40","issued":{"date-parts":[["2013"]]},"page":"3151-3159","title":"Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry","type":"article-journal","volume":"34"},"uris":[""]}],"mendeley":{"formattedCitation":"²³⁸","plainTextFormattedCitation":"238","previouslyFormattedCitation":"²³⁶"},"properties":{"noteIndex":0},"schema":""}238:For a 5 unit change in BMI, there was no association (unadjusted) demonstrated withAll cause death or readmission trough 60 days1.04 (0.90, 1.20)All cause mortality at 180 days1.01 (0.88, 1.16)Weight/BMI bottom line:There appears to be evidence suggesting that lower BMI is associated with increased mortality in heart failure patients. In fact, this seems to hold even in studies that examine weight cohorts that would be classified as obese. Though there is conflicting evidence with respect to BMI, the balance seems to favour the protective effect of a higher BMI. There also appears to be some evidence for differential treatment patterns between patients of different BMI ranges (See GWTG-HF: Heidenreich 2012 ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.ahj.2011.10.008","ISBN":"0002-8703 1097-6744","ISSN":"00028703","PMID":"22305842","abstract":"Background: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare and Medicaid Services) and the main hospital accrediting organization (The Joint Commission). Methods: We used data from Get With The Guidelines Program for patients hospitalized with heart failure. Eligibility for receiving care based on the Center for Medicare and Medicaid Services performance measures was determined for assessment of left ventricular ejection fraction (LVEF; n = 60,601), use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) if LVEF<40% and no contraindications (24,130), discharge instructions (49,383), and smoking cessation counseling (10,152). Patient and hospital characteristics that were significantly associated with performance measures in univariate analyses were entered into multivariate logistic regression models. Results: Overall, documentation for LVEF assessment was noted in 95%, ACEi/ARB use in 87%, discharge instruction in 82%, and smoking cessation counseling in 91% of eligible patients. In adjusted analyses, older patients and those with evidence of renal failure were significantly less likely to receive each care measure except for discharge instructions (no age effect). Patients with higher body mass index were more likely to receive ACEi/ARB and discharge instructions but less likely to have LVEF documented or to receive smoking cessation counseling. Small hospitals (<200 beds) were less likely to provide each of the performance measures compared with larger hospitals. Conclusion: Recommended heart failure care is less likely in patients with certain characteristics (older age and abnormal renal function) and those cared for in smaller hospitals. Programs to improve evidence-based care for heart failure should consider interventions specifically targeting and tailored to smaller facilities and patients who are older with comorbidities. ? 2012 Mosby, Inc. All rights reserved.","author":[{"dropping-particle":"","family":"Heidenreich","given":"Paul a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zhao","given":"Xin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hernandez","given":"Adrian F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Heart Journal","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012"]]},"page":"239-245.e3","publisher":"Elsevier B.V.","title":"Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure","type":"article-journal","volume":"163"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁰⁵","plainTextFormattedCitation":"105","previouslyFormattedCitation":"¹⁰³"},"properties":{"noteIndex":0},"schema":""}105). Overall, this gives good reason to include weight/BMI as a case-mix variable.S8: Case-Mix Definitions:Age: Continuous variable, no definition requiredSex: Male / femaleEthnicity: Will needs consensus on how to define, whether cultural or regional basisAtrial Fibrillation: Standard medical definitionIrregularly irregular heart rhythmAbsence of organized atrial electrical activity on electrocardiogram (no p-waves)Past Myocardial Infarction: Standard medical definitionEvidence of myocardial damage (elevated enzyme levels according to respective assays)Can be ST elevation or non-ST elevation infarction (STEMI or NSTEMI)Smoking: Standard measure of pack-year smoking history. Suggest classification of current vs. former vs. neverHypertension ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"WHO Day 2013","author":[{"dropping-particle":"","family":"Organization","given":"World Health","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2013"]]},"number-of-pages":"9","title":"A global brief on hypertension","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵²","plainTextFormattedCitation":"252","previouslyFormattedCitation":"²⁵⁰"},"properties":{"noteIndex":0},"schema":""}252: Systolic blood pressure ≥140AND / ORDiastolic blood pressure ≥90Obesity ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Organization","given":"World Health","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2000"]]},"number-of-pages":"1-253","publisher-place":"Geneva","title":"Obesity: preventing and managing the global epidemic. Report of a WHO consultation.","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵³","plainTextFormattedCitation":"253","previouslyFormattedCitation":"²⁵¹"},"properties":{"noteIndex":0},"schema":""}253:According to WHO classificationDiabetes ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Organization","given":"World Health","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"IDF consultation","id":"ITEM-1","issued":{"date-parts":[["2006"]]},"title":"Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia","type":"article-journal"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"WHO/NMH/CHP/CPM/11.1","ISBN":"","abstract":"The report on the acceptability of glycated haemoglobin, or HbA1c, as an additional test to diagnose this debilitating and deadly disease.","author":[{"dropping-particle":"","family":"Organization","given":"World Health","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-2","issued":{"date-parts":[["2011"]]},"page":"1-25","title":"Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"^254,255","plainTextFormattedCitation":"254,255","previouslyFormattedCitation":"^252,253"},"properties":{"noteIndex":0},"schema":""}254,255:Fasting plasma glucose ≥7.0 mmol/L (126 mg/dL)OR2 hour plasma glucose ≥11.1 mmol/L (200 mg/dL)2 hours post 75g oral glucose loadORA1C ≥6.5COPD ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/1479972306070070","ISBN":"978 92 4 156346 8","ISSN":"1479-9723","PMID":"17190125","abstract":"The development of chronic respiratory care in France faces the same problems of ageing population, technological advancement and budgeting difficulties as other industrially developed countries. We describe the intermediate and home-care systems for treatment of chronic respiratory diseases.","author":[{"dropping-particle":"","family":"Organization","given":"World Health","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2006"]]},"title":"Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵⁶","plainTextFormattedCitation":"256","previouslyFormattedCitation":"²⁵⁴"},"properties":{"noteIndex":0},"schema":""}256: Defined by spirometric criteria by using the post-bronchodilator forced expiratory volume in one second (FEV1) and its ratio to the forced vital capacity (FVC). The main criterion for COPD is a FEV1/FVC ratio <70%, and can be further sub classifiedRenal Failure ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1523-1755.2005.00365.x","ISBN":"0085-2538 (Print)\\n0085-2538 (Linking)","ISSN":"0085-2538","PMID":"15882252","abstract":"Chronic kidney disease (CKD) is a worldwide public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD), and premature death. A simple definition and classification of kidney disease is necessary for international development and implementation of clinical practice guidelines. Kidney Disease: Improving Global Outcomes (KDIGO) conducted a survey and sponsored a controversies conference to (1) provide a clear understanding to both the nephrology and nonnephrology communities of the evidence base for the definition and classification recommended by Kidney Disease Quality Outcome Initiative (K/DOQI), (2) develop global consensus for the adoption of a simple definition and classification system, and (3) identify a collaborative research agenda and plan that would improve the evidence base and facilitate implementation of the definition and classification of CKD. The K/DOQI definition and classification were accepted, with clarifications. CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) for 3 months or more, irrespective of cause. Kidney damage in many kidney diseases can be ascertained by the presence of albuminuria, defined as albumin-to-creatinine ratio >30 mg/g in two of three spot urine specimens. GFR can be estimated from calibrated serum creatinine and estimating equations, such as the Modification of Diet in Renal Disease (MDRD) Study equation or the Cockcroft-Gault formula. Kidney disease severity is classified into five stages according to the level of GFR. Kidney disease treatment by dialysis and transplantation should be noted. Simple, uniform classifications of CKD by cause and by risks for kidney disease progression and CVD should be developed.","author":[{"dropping-particle":"","family":"Levey","given":"Andrew S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eckardt","given":"Kai-Uwe","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsukamoto","given":"Yusuke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Levin","given":"Adeera","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Coresh","given":"Josef","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rossert","given":"Jerome","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeeuw","given":"Dick","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hostetter","given":"Thomas H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lameire","given":"Norbert","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eknoyan","given":"Garabed","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Kidney international","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2005"]]},"page":"2089-2100","title":"Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO).","type":"article-journal","volume":"67"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵⁷","plainTextFormattedCitation":"257","previouslyFormattedCitation":"²⁵⁵"},"properties":{"noteIndex":0},"schema":""}257: As defined by the Kidney Disease: Improving Global Outcomes (KDIGO) group, based on glomerular filtration rate (GFR) mL/min/1.73m2Stage 1: Kidney damage with normal or increased GFR: ≥90 Stage 2: Kidney damage with mildly decreased GFR: 60-89Stage 3: Moderate decrease in GFR: 30-59 Stage 4: Severe decrease in GFR: 15-29Stage 5: Kidney failure: <15 or dialysisPreserved / Reduced Ejection Fraction ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIR.0b013e31829e8776","ISBN":"1524-4539 (Electronic)\\n0009-7322 (Linking)","ISSN":"00097322","PMID":"23741058","abstract":"HF is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. The cardinal manifestations of HF are dyspnea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary and/or splanchnic congestion and/or peripheral edema. Some patients have exercise intolerance but little evidence of fluid retention, whereas others complain primarily of edema, dyspnea, or fatigue. Because some patients present without signs or symptoms of volume overload, the term “heart failure” is preferred over “congestive heart failure.” There is no single diagnostic test for HF because it is largely a clinical diagnosis based on a careful history and physical examination. The clinical syndrome of HF may result from disorders of the pericardium, myocardium, endocardium, heart valves, or great vessels or from certain metabolic abnormalities, but most patients with HF have symptoms due to impaired left ventricular (LV) myocardial function. It should be emphasized that HF is not synonymous with either cardiomyopathy or LV dysfunction; these latter terms describe possible structural or functional reasons for the development of HF. HF may be associated with a wide spectrum of LV functional abnormalities, which may range from patients with normal LV size and preserved EF to those with severe dilatation and/or markedly reduced EF. In most patients, abnormalities of systolic and diastolic dysfunction coexist, irrespective of EF. EF is considered important in classification of patients with HF because of differing patient demographics, comorbid conditions, prognosis, and response to therapies35 and because most clinical trials selected patients based on EF. EF values are dependent on the imaging technique used, method of analysis, and operator. Because other techniques may indicate abnormalities in systolic function among patients with a preserved EF, it is preferable to use the terms preserved or reduced EF over preserved or reduced systolic function. For the remainder of this guideline, we will consistently refer to HF with preserved EF and HF with reduced EF as HFpEF and HFrEF, respectively","author":[{"dropping-particle":"","family":"Yancy","given":"Clyde W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jessup","given":"Mariell","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bozkurt","given":"Biykem","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Butler","given":"Javed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Casey","given":"Donald E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drazner","given":"Mark H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonarow","given":"Gregg C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Geraci","given":"Stephen a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horwich","given":"Tamara","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Januzzi","given":"James L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Johnson","given":"Maryl R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kasper","given":"Edward K.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Levy","given":"Wayne C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Masoudi","given":"Frederick a.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Patrick E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V","family":"McMurray","given":"John J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mitchell","given":"Judith E.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Peterson","given":"Pamela N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Riegel","given":"Barbara","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sam","given":"Flora","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stevenson","given":"Lynne W.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tang","given":"W. H Wilson","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tsai","given":"Emily J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wilkoff","given":"Bruce L.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-1","issue":"16","issued":{"date-parts":[["2013"]]},"page":"240-327","title":"2013 ACCF/AHA guideline for the management of heart failure: A report of the american college of cardiology foundation/american heart association task force on practice guidelines","type":"article-journal","volume":"128"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1093/eurheartj/ehs104","ISBN":"1879-0844 (Electronic) 1388-9842 (Linking)","ISSN":"1522-9645","PMID":"22611136","abstract":"AIMS: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF).\\n\\nMETHODS AND RESULTS: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%.\\n\\nCONCLUSION: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.","author":[{"dropping-particle":"V","family":"McMurray","given":"John J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Adamopoulos","given":"Stamatis","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Anker","given":"Stefan D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Auricchio","given":"Angelo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"B?hm","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dickstein","given":"Kenneth","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Falk","given":"Volkmar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Filippatos","given":"Gerasimos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fonseca","given":"C?ndida","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gomez-Sanchez","given":"Miguel Angel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jaarsma","given":"Tiny","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"K?ber","given":"Lars","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lip","given":"Gregory Y H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"Pietro","family":"Maggioni","given":"Aldo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Parkhomenko","given":"Alexander","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pieske","given":"Burkert M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Popescu","given":"Bogdan a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"R?nnevik","given":"Per K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rutten","given":"Frans H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwitter","given":"Juerg","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Seferovic","given":"Petar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stepinska","given":"Janina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Trindade","given":"Pedro T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voors","given":"Adriaan a","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zannad","given":"Faiez","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zeiher","given":"Andreas","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"European heart journal","id":"ITEM-2","issue":"14","issued":{"date-parts":[["2012"]]},"page":"1787-847","title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart","type":"article-journal","volume":"33"},"uris":[""]}],"mendeley":{"formattedCitation":"^258,259","plainTextFormattedCitation":"258,259","previouslyFormattedCitation":"^256,257"},"properties":{"noteIndex":0},"schema":""}258,259: Some differences based on guideline definitions:AHA/ACC: pEF: ≥50%rEF: ≤40%Borderline: 41-49%Improved: >40ESC:pEF: ≥40-45rEF: ≤35%ESC guidelines note that the cut off of ≤35% in major trial is the only EF range where treatments show significant effects / improvementsLipids ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/01.cir.0000437738.63853.7a","ISBN":"1558-3597 (Electronic)\\n0735-1097 (Linking)","ISSN":"1524-4539","PMID":"24222016","abstract":"DESCRIPTION: In November 2013, the American College of Cardiology and American Heart Association (ACC/AHA) released a clinical practice guideline on the treatment of blood cholesterol to reduce cardiovascular risk in adults. This synopsis summarizes the major recommendations. METHODS: In 2008, the National Heart, Lung, and Blood Institute convened the Adult Treatment Panel (ATP) IV to update the 2001 ATP-III cholesterol guidelines using a rigorous process to systematically review randomized, controlled trials (RCTs) and meta-analyses of RCTs that examined cardiovascular outcomes. The panel commissioned independent systematic evidence reviews on low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol goals in secondary and primary prevention and the effect of lipid drugs on atherosclerotic cardiovascular disease events and adverse effects. In September 2013, the panel's draft recommendations were transitioned to the ACC/AHA. RECOMMENDATIONS: This synopsis summarizes key features of the guidelines in 8 areas: lifestyle, groups shown to benefit from statins, statin safety, decision making, estimation of cardiovascular disease risk, intensity of statin therapy, treatment targets, and monitoring of statin therapy.","author":[{"dropping-particle":"","family":"Stone","given":"Neil J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Robinson","given":"Jennifer G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lichtenstein","given":"Alice H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bairey Merz","given":"C Noel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Blum","given":"Conrad B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eckel","given":"Robert H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goldberg","given":"Anne C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gordon","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Levy","given":"Daniel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lloyd-Jones","given":"Donald M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McBride","given":"Patrick","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schwartz","given":"J Sanford","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shero","given":"Susan T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"Sidney C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Watson","given":"Karol","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wilson","given":"Peter W F","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-1","issue":"25 Suppl 2","issued":{"date-parts":[["2014"]]},"page":"S1-S45","title":"2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.","type":"article-journal","volume":"129"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁶⁰","plainTextFormattedCitation":"260","previouslyFormattedCitation":"²⁵⁸"},"properties":{"noteIndex":0},"schema":""}260: Blood cholesterol and/or triglyceride levels above normal values on standard assaysReferences:ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY 1. Munger MA, Carter O. Epidemiology and practice patterns of acute decompensated heart failure. Am J Health Syst Pharm. 2003;60 Suppl 4:S3-6.2. Yancy CW, Fonarow GC. Quality of care and outcomes in acute decompensated heart failure: The ADHERE Registry. Curr Heart Fail Rep. 2004;1(3):121-128. doi:10.1007/s11897-004-0021-8.3. Peacock WF, Emerman CL. Emergency department management of patients with acute decompensated heart failure. Heart Fail Rev. 2004;9(3):187-193. doi:10.1007/s10741-005-6128-5.4. Adams KF, Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, Berkowitz RL, Galvao M, Horton DP. Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2005;149(2):209-216. doi:10.1016/j.ahj.2004.08.005.5. Fonarow GC, Yancy CW, Heywood JT. Adherence to heart failure quality-of-care indicators in US hospitals: analysis of the ADHERE Registry. Arch Intern Med. 2005;165(13):1469-1477. doi:10.1016/j.accreview.2005.09.054.6. Fonarow GC. Overview of acutely decompensated congestive heart failure (ADHF): A report from the ADHERE Registry. Heart Fail Rev. 2005;9(3):179-185. doi:10.1007/s10741-005-6127-6.7. Abraham WT, Adams KF, Fonarow GC, Costanzo MR, Berkowitz RL, Lejemtel TH, Cheng ML, Wynne J. In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: An analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). J Am Coll Cardiol. 2005;46(1):57-64. doi:10.1016/j.jacc.2005.03.051.8. Fonarow GC, Adams KF, Abraham WT, Yancy CW, Boscardin WJ. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA. 2005;293(5):572-580. doi:10.1001/jama.293.5.572.9. Heywood JT. The cardiorenal syndrome: Lessons from the ADHERE database and treatment options. Heart Fail Rev. 2005;9(3):195-201. doi:10.1007/s10741-005-6129-4.10. Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC. Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) database. J Am Coll Cardiol. 2006;47(1):76-84. doi:10.1016/j.jacc.2005.09.022.11. Collins SP, Lindsell CJ, Storrow AB, Abraham WT. Prevalence of negative chest radiography results in the emergency department patient with decompensated heart failure. Ann Emerg Med. 2006;47(1):13-18. doi:10.1016/j.annemergmed.2005.04.003.12. Galvao M, Kalman J, Demarco T, Fonarow GC, Galvin C, Ghali JK, Moskowitz RM. Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: Analysis from the acute decompensated heart failure national registry (ADHERE). J Card Fail. 2006;12(2):100-107. doi:10.1016/j.cardfail.2005.09.005.13. Fonarow GC, Heywood JT, Heidenreich P a., Lopatin M, Yancy CW. Temporal trends in clinical characteristics, treatments, and outcomes for heart failure hospitalizations, 2002 to 2004: findings from Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2007;153(6):1021-1028. doi:10.1016/j.ahj.2007.03.012.14. Fonarow GC, Peacock WF, Phillips CO, Givertz MM, Lopatin M. Admission B-Type Natriuretic Peptide Levels and In-Hospital Mortality in Acute Decompensated Heart Failure. J Am Coll Cardiol. 2007;49(19):1943-1950. doi:10.1016/j.jacc.2007.02.037.15. Peacock WF, Fonarow GC, Emerman CL, Mills RM, Wynne J. Impact of early initiation of intravenous therapy for acute decompensated heart failure on outcomes in ADHERE. Cardiology. 2007;107(1):44-51. doi:10.1159/000093612.16. Fonarow GC, Srikanthan P, Costanzo MR, Cintron GB, Lopatin M. An obesity paradox in acute heart failure: analysis of body mass index and inhospital mortality for 108,927 patients in the Acute Decompensated Heart Failure National Registry. Am Heart J. 2007;153(1):74-81. doi:10.1016/j.ahj.2006.09.007.17. Singer AJ, Emerman C, Char DM, Heywood JT, Kirk JD, Hollander JE, Summers R, Lee CC, Wynne J, Kellerman L, Peacock WF. Bronchodilator Therapy in Acute Decompensated Heart Failure Patients Without a History of Chronic Obstructive Pulmonary Disease. Ann Emerg Med. 2008;51(1):25-34. doi:10.1016/j.annemergmed.2007.04.005.18. Tallman T a., Peacock WF, Emerman CL, Lopatin M, Blicker JZ, Weber J, Yancy CW. Noninvasive ventilation outcomes in 2,430 acute decompensated heart failure patients: An ADHERE registry analysis. Acad Emerg Med. 2008;15(4):355-362. doi:10.1111/j.1553-2712.2008.00059.x.19. Maisel AS, Peacock WF, McMullin N, Jessie R, Fonarow GC, Wynne J, Mills RM. Timing of Immunoreactive B-Type Natriuretic Peptide Levels and Treatment Delay in Acute Decompensated Heart Failure. An ADHERE (Acute Decompensated Heart Failure National Registry) Analysis. J Am Coll Cardiol. 2008;52(7):534-540. doi:10.1016/j.jacc.2008.05.010.20. Jois-Bilowich P, Michota F, Bartholomew JR, Glauser J, Diercks D, Weber J, Fonarow GC, Emerman CL, Peacock IV WF. Venous Thromboembolism Prophylaxis in Hospitalized Heart Failure Patients. J Card Fail. 2008;14(2):127-132. doi:10.1016/j.cardfail.2007.10.017.21. Costanzo MR, Mills RM, Wynne J. Characteristics of “Stage D” heart failure: Insights from the Acute Decompensated Heart Failure National Registry Longitudinal Module (ADHERE LM). Am Heart J. 2008;155(2):339-347. doi:10.1016/j.ahj.2007.10.020.22. Adams KF, Uddin N, Herbert Patterson J. Clinical predictors of in-hospital mortality in acutely decompensated heart failure-piecing together the outcome puzzle. Congest Hear Fail. 2008;14(3):127-134. doi:10.1111/j.1751-7133.2008.04641.x.23. Diercks DB, Fonarow GC, Kirk JD, Emerman CL, Hollander JE, Weber JE, Summers RL, Wynne J, Peacock IV WF. Risk stratification in women enrolled in the Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM). Acad Emerg Med. 2008;15(2):151-158. doi:10.1111/j.1553-2712.2008.00030.x.24. Diercks DB, Fonarow GC, Kirk JD, Jois-Bilowich P, Hollander JE, Weber JE, Wynne J, Mills RM, Yancy C, Peacock IV WF. Illicit Stimulant Use in a United States Heart Failure Population Presenting to the Emergency Department (from the Acute Decompensated Heart Failure National Registry Emergency Module). Am J Cardiol. 2008;102(9):1216-1219. doi:10.1016/j.amjcard.2008.06.045.25. Peacock WF, De Marco T, Fonarow GC, Diercks D, Wynne J, Apple FS, Wu AHB. Cardiac troponin and outcome in acute heart failure. N Engl J Med. 2008;358(20):2117-2126. doi:10.1056/NEJMoa0706824.26. Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008;25(4):205-209. doi:10.1136/emj.2007.050419.27. Kamath S a, Drazner MH, Wynne J, Fonarow GC, Yancy CW. Characteristics and outcomes in African American patients with decompensated heart failure. Arch Intern Med. 2008;168(11):1152-1158. doi:10.1001/archinte.168.11.1152.28. West R, Liang L, Fonarow GC, Kociol R, Mills RM, Oconnor CM, Hernandez AF. Characterization of heart failure patients with preserved ejection fraction: A comparison between ADHERE-US registry and ADHERE-International registry. Eur J Heart Fail. 2011;13(9):945-952. doi:10.1093/eurjhf/hfr064.29. Kociol RD, Greiner M a., Hammill BG, Eapen ZJ, Fonarow GC, Klaskala W, Mills RM, Curtis LH, Hernandez AF. B-type natriuretic peptide level and postdischarge thrombotic events in older patients hospitalized with heart failure: Insights from the Acute Decompensated Heart Failure National Registry. Am Heart J. 2012;163(6):994-1001. doi:10.1016/j.ahj.2012.03.009.30. Khazanie P, Hammill BG, Qualls LG, Fonarow GC, Hammill SC, Heidenreich P a., Al-Khatib SM, Piccini JP, Masoudi F a., Peterson PN, Curtis JP, Hernandez a. F, Curtis LH. Clinical Effectiveness of Cardiac Resynchronization Therapy Versus Medical Therapy Alone Among Patients With Heart Failure: Analysis of the ICD Registry and ADHERE. Circ Hear Fail. 2014;7(6):926-934. doi:10.1161/CIRCHEARTFAILURE.113.000838.31. DeVore AD, Hammill BG, Sharma PP, Qualls LG, Mentz RJ, Waltman Johnson K, Fonarow GC, Curtis LH, Hernandez AF. In-Hospital Worsening Heart Failure and Associations With Mortality, Readmission, and Healthcare Utilization. JAHA. 2014;3(4):e001088-. doi:10.1161/JAHA.114.001088.32. Suarez J, Piccini JP, Liang L, Atherton JJ, Hayward CS, Krum H, Fonarow GC, Lopes RD, Hernandez AF. International variation in use of oral anticoagulation among heart failure patients with atrial fibrillation. Am Heart J. 2012;163(5):804-811. doi:10.1016/j.ahj.2012.02.008.33. Atherton JJ, Hayward CS, Wan Ahmad WA, Kwok B, Jorge J, Hernandez AF, Liang L, Kociol RD, Krum H. Patient characteristics from a regional multicenter database of acute decompensated heart failure in Asia Pacific (ADHERE International-Asia Pacific). J Card Fail. 2012;18(1):82-88. doi:10.1016/j.cardfail.2011.09.003.34. Spinar J, Parenica J, Vitovec J, Widimsky P, Linhart A, Fedorco M, Malek F, Cihalik C, Spinarová L, Miklik R, Felsoci M, Bambuch M, Dusek L, Jarkovsky J. Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry. Crit Care. 2011;15(6):R291. doi:10.1186/cc10584.35. Málek F, O??ádal P, Pa?enica J, Jarkovsk? J, Vítovec J, Widimsk? P, Linhart A, Fedorco M, Coufal Z, Miklík R, Kruger A, Vondraková D, ?pinar J. Uric acid, allopurinol therapy, and mortality in patients with acute heart failure-results of the Acute HEart FAilure Database registry. J Crit Care. 2012;27(6). doi:10.1016/j.jcrc.2012.03.011.36. Spinarova L, Spinar J, Vitovec J, Ales L, Widimsky P, Fedorco M, Malek F, Cihalik C, Miklik R, Dusek L, Zidova K, Jarkovsky J, Littnerova S, Parenica J. Gender differences in total cholesterol levels in patients with acute heart failure and its importance for short and long time prognosis. Biomed Pap. 2012;156(1):21-28. doi:10.5507/bp.2012.015.37. Parenica J, Spinar J, Vitovec J, Widimsky P, Linhart A, Fedorco M, Vaclavik J, Miklik R, Felsoci M, Horakova K, Cihalik C, Malek F, Spinarova L, Belohlavek J, Kettner J, Zeman K, Du?ek L, Jarkovsky J. Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main). Eur J Intern Med. 2013;24(2):151-160. doi:10.1016/j.ejim.2012.11.005.38. Vyskocilova K, Spinarova L, Spinar J, Mikusova T, Vitovec J, Malek J, Malek F, Linhart A, Fedorco M, Widimsky P, Cihalik C, Parenica J, Littnerova S, Jarkovsky J. Prevalence and clinical significance of liver function abnormalities in patients with acute heart failure. Biomed Pap. 2014;(Table 1). doi:10.5507/bp.2014.014.39. Václavík J, ?pinar J, Vindi? D, Vítovec J, Widimsk? P, ?íhalík ?, Linhart A, Málek F, Táborsk? M, Du?ek L, Jarkovsk? J, Fedorco M, Fel??ci M, Miklík R, Pa?enica J. ECG in patients with acute heart failure can predict in-hospital and long-term mortality. Intern Emerg Med. 2014;9(3):283-291. doi:10.1007/s11739-012-0862-1.40. Littnerova S, Parenica J, Spinar J, Vitovec J, Linhart A, Widimsky P, Jarkovsky J, Miklik R, Spinarova L, Zeman K, Belohlavek J, Malek F, Felsoci M, Kettner J, Ostadal P, Cihalik C, Spac J, Al-Hiti H, Fedorco M, et al. Positive Influence of Being Overweight/Obese on Long Term Survival in Patients Hospitalised Due to Acute Heart Failure. PLoS One. 2015;10(2):e0117142. doi:10.1371/journal.pone.0117142.41. Parissis JT, Nikolaou M, Mebazaa A, Ikonomidis I, Delgado J, Vilas-Boas F, Paraskevaidis I, Mc Lean A, Kremastinos D, Follath F. Acute pulmonary oedema: Clinical characteristics, prognostic factors, and in-hospital management. Eur J Heart Fail. 2010;12(11):1193-1202. doi:10.1093/eurjhf/hfq138.42. Follath F, Yilmaz MB, Delgado JF, Parissis JT, Porcher R, Gayat E, Burrows N, Mclean a., Vilas-Boas F, Mebazaa a. Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). Intensive Care Med. 2011;37(4):619-626. doi:10.1007/s00134-010-2113-0.43. Mebazaa A, Parissis J, Porcher R, Gayat E, Nikolaou M, Boas FV, Delgado JF, Follath F. Short-term survival by treatment among patients hospitalized with acute heart failure: The global ALARM-HF registry using propensity scoring methods. Intensive Care Med. 2011;37(2):290-301. doi:10.1007/s00134-010-2073-4.44. Parissis JT, Ikonomidis I, Rafouli-Stergiou P, Mebazaa A, Delgado J, Farmakis D, Vilas-Boas F, Paraskevaidis I, Anastasiou-Nana M, Follath F. Clinical characteristics and predictors of in-hospital mortality in acute heart failure with preserved left ventricular ejection fraction. Am J Cardiol. 2011;107(1):79-84. doi:10.1016/j.amjcard.2010.08.044.45. Filippatos G, Farmakis D, Bistola V, Karavidas A, Mebazaa A, Maggioni AP, Parissis JT. Temporal trends in epidemiology, clinical presentation and management of acute heart failure: results from the Greek cohorts of the Acute Heart Failure Global Registry of Standard Treatment and the European Society of Cardiology-Heart Failure pilot survey. Eur Hear journal Acute Cardiovasc care. 2014. doi:10.1177/2048872614527012.46. Lam CSP, Anand I, Zhang S, Shimizu W, Narasimhan C, Park SW, Yu CM, Ngarmukos T, Omar R, Reyes EB, Siswanto B, Ling LH, Richards AM. Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. Eur J Heart Fail. 2013;15(8):928-936. doi:10.1093/eurjhf/hft045.47. Lam CSP, Teng T-HK, Tay WT, Anand I, Zhang S, Shimizu W, Narasimhan C, Park SW, Yu C-M, Ngarmukos T, Omar R, Reyes EB, Siswanto BB, Hung C-L, Ling LH, Yap J, MacDonald M, Richards AM. Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry. Eur Heart J. 2016;37(41):3141-3153. doi:10.1093/eurheartj/ehw331.48. Sato N, Kajimoto K, Asai K, Mizuno M, Minami Y, Nagashima M, Murai K, Muanakata R, Yumino D, Meguro T, Kawana M, Nejima J, Satoh T, Mizuno K, Tanaka K, Kasanuki H, Takano T. Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data. Am Heart J. 2010;159(6):949-955.e1. doi:10.1016/j.ahj.2010.03.019.49. Sato N, Kajimoto K, Keida T, Mizuno M, Minami Y, Yumino D, Asai K, Murai K, Muanakata R, Aokage T, Sakata Y, Mizuno K, Takano T. Clinical Features and Outcome in Hospitalized Heart Failure in Japan (From the ATTEND Registry). Circ J. 2013;77(4):944-951. doi:10.1253/circj.CJ-13-0187.50. Kajimoto K, Sato N, Keida T, Mizuno M, Sakata Y, Asai K, Takano T. Association between length of stay, frequency of in-hospital death, and causes of death in Japanese patients with acute heart failure syndromes. Int J Cardiol. 2013;168(1):554-556. doi:10.1016/j.ijcard.2013.01.187.51. Kajimoto K, Sato N, Sakata Y, Takano T. Relationship between systolic blood pressure and preserved or reduced ejection fraction at admission in patients hospitalized for acute heart failure syndromes. Int J Cardiol. 2013;168(5):4790-4795. doi:10.1016/j.ijcard.2013.07.226.52. Sato N, Gheorghiade M, Kajimoto K, Munakata R, Minami Y, Mizuno M, Aokage T, Asai K, Sakata Y, Yumino D, Mizuno K, Takano T. Hyponatremia and in-hospital mortality in patients admitted for heart failure (from the ATTEND Registry). Am J Cardiol. 2013;111(7):1019-1025. doi:10.1016/j.amjcard.2012.12.019.53. Inohara T, Kohsaka S, Sato N, Kajimoto K, Keida T, Mizuno M, Takano T. Prognostic Impact of Renal Dysfunction Does Not Differ According to the Clinical Profiles of Patients: Insight from the Acute Decompensated Heart Failure Syndromes (ATTEND) Registry. PLoS One. 2014;9(9):e105596. doi:10.1371/journal.pone.0105596.54. Sotomi Y, Sato N, Kajimoto K, Sakata Y, Mizuno M, Minami Y, Fujii K, Takano T. Impact of pulmonary artery catheter on outcome in patients with acute heart failure syndromes with hypotension or receiving inotropes: From the ATTEND Registry. Int J Cardiol. 2014;172(1):165-172. doi:10.1016/j.ijcard.2013.12.174.55. Kajimoto K, Sato N, Keida T, Sakata Y, Asai K, Mizuno M, Takano T. Low admission heart rate is a marker rather than a mediator of increased in-hospital mortality for patients with acute heart failure syndromes in sinus rhythm. Int J Cardiol. 2014;171(1):98-100. doi:10.1016/j.ijcard.2013.11.087.56. Kajimoto K, Sato N, Keida T, Sakata Y, Takano T. Associations of Anemia and Renal Dysfunction with Outcomes among Patients Hospitalized for Acute Decompensated Heart Failure with Preserved or Reduced Ejection Fraction. Clin J Am Soc Nephrol. 2014;9(11):1912-1921. doi:10.2215/CJN.04400514.57. Mizuno M, Sato N, Kajimoto K, Sakata Y, Minami Y, Munakata R, Hagiwara N, Takano T. Intra-aortic balloon counterpulsation for acute decompensated heart failure. Int J Cardiol. 2014;176(3):1444-1446. doi:10.1016/j.ijcard.2014.08.154.58. Kajimoto K, Sato N, Takano T. Association between anemia, clinical features and outcome in patients hospitalized for acute heart failure syndromes. Eur Hear J Acute Cardiovasc Care. 2014. doi:10.1177/2048872614554199.59. Minami Y, Kajimoto K, Sato N, Aokage T, Mizuno M, Asai K, Munakata R, Yumino D, Murai K, Hagiwara N, Mizuno K, Kasanuki H, Takano T. Third heart sound in hospitalised patients with acute heart failure: insights from the ATTEND study. Int J Clin Pract. 2014:n/a-n/a. doi:10.1111/ijcp.12603.60. Kajimoto K, Sato N, Takano T. Association of age and baseline systolic blood pressure with outcomes in patients hospitalized for acute heart failure syndromes. Int J Cardiol. 2015;191:100-106. doi:10.1016/j.ijcard.2015.04.258.61. Kajimoto K, Sato N, Takano T. Relation of Left Ventricular Ejection Fraction and Clinical Features or Co-morbidities to Outcomes Among Patients Hospitalized for Acute Heart Failure Syndromes. Am J Cardiol. 2015;115(3):334-340. doi:10.1016/j.amjcard.2014.11.007.62. Franciosa J a, Abraham WT, Fowler M, Gilbert EM, Greenberg B, Massie BM, Chen T, Lukas M a, Nelson JJ. Rationale, design, and methods for a Coreg (carvedilol) Heart Failure Registry (COHERE). COHERE Participant Physicians. J Card Fail. 2000;6(3):264-271. doi:10.1054/jcaf.2000.9675.63. Franciosa J a., Massie BM, Lukas MA, Nelson JJ, Lottes S, Abraham WT, Fowler M, Gilbert EM, Greenberg B. β-blocker therapy for heart failure outside the clinical trial setting: Findings of a community-based registry. Am Heart J. 2004;148(4):718-726. doi:10.1016/j.ahj.2004.04.006.64. Greenberg B, Lottes SR, Nelson JJ, Lukas MA, Fowler MB, Massie BM, Abraham WT, Gilbert EM, Franciosa J a. Predictors of clinical outcomes in patients given carvedilol for heart failure. Am J Cardiol. 2006;98(11):1480-1484. doi:10.1016/j.amjcard.2006.06.050.65. Franciosa J a., Nelson JJ, Lukas MA, Lottes SR, Massie BM, Fowler MB, Greenberg B, Gilbert EM, Abraham WT. Heart Failure in Community Practice: Relationship to Age and Sex in a Beta-Blocker Registry. Congest Hear Fail. 2006;12(6):317-323. doi:10.1111/j.1527-5299.2006.05804.x.66. Massie BM, Nelson JJ, Lukas MA, Greenberg B, Fowler MB, Gilbert EM, Abraham WT, Lottes SR, Franciosa J a. Comparison of Outcomes and Usefulness of Carvedilol Across a Spectrum of Left Ventricular Ejection Fractions in Patients With Heart Failure in Clinical Practice. Am J Cardiol. 2007;99(9):1263-1268. doi:10.1016/j.amjcard.2006.12.056.67. Abraham WT, Massie BM, Lukas MA, Lottes SR, Nelson JJ, Fowler MB, Greenberg B, Gilbert EM, Franciosa J a. Tolerability, Safety, and Efficacy of Beta-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective Beta-Blocker Registry. Congest Hear Fail. 2007;13(1):16-21. doi:10.1111/j.1527-5299.2007.888111.x.68. Fowler MB, Lottes SR, Nelson JJ, Lukas MA, Gilbert EM, Greenberg B, Massie BM, Abraham WT, Franciosa J a. β-Blocker dosing in community-based treatment of heart failure. Am Heart J. 2007;153(6):1029-1036. doi:10.1016/j.ahj.2007.03.010.69. Zannad F, Mebazaa A, Juillière Y, Cohen-Solal A, Guize L, Alla F, Rougé P, Blin P, Barlet MH, Paolozzi L, Vincent C, Desnos M, Samii K. Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study. Eur J Heart Fail. 2006;8(7):697-705. doi:10.1016/j.ejheart.2006.01.001.70. Zannad F, Adamopoulos C, Mebazaa A, Gheorghiade M. The challenge of acute decompensated heart failure. Heart Fail Rev. 2006;11(2):135-139. doi:10.1007/s10741-006-9484-x.71. Adamopoulos C, Zannad F, Fay R, Mebazaa A, Cohen-Solal A, Guize L, Juillière Y, Alla F. Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure. Eur J Heart Fail. 2007;9(9):935-941. doi:10.1016/j.ejheart.2007.06.001.72. Huvelle E, Fay R, Alla F, Cohen Solal A, Mebazaa A, Zannad F. Left bundle branch block and mortality in patients with acute heart failure syndrome: A substudy of the EFICA cohort. Eur J Heart Fail. 2010;12(2):156-163. doi:10.1093/eurjhf/hfp180.73. Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, Hochadel M, Komajda M, Lassus J, Lopez-Sendon JL, Ponikowski P, Tavazzi L. EuroHeart Failure Survey II (EHFS II): A survey on hospitalized acute heart failure patients: Description of population. Eur Heart J. 2006;27(22):2725-2736. doi:10.1093/eurheartj/ehl193.74. Nieminen MS, Harjola V-P, Hochadel M, Drexler H, Komajda M, Brutsaert D, Dickstein K, Ponikowski P, Tavazzi L, Follath F, Lopez-Sendon JL. Gender related differences in patients presenting with acute heart failure. Results from EuroHeart Failure Survey II. Eur J Hear Fail J Work Gr Hear Fail Eur Soc Cardiol. 2008;10(2):140-148. doi:10.1016/j.ejheart.2007.12.012.75. Harjola V-P, Follath F, Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Hochadel M, Komajda M, Lopez-Sendon JL, Ponikowski P, Tavazzi L. Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure. Eur J Hear Fail J Work Gr Hear Fail Eur Soc Cardiol. 2010;12(3):239-248. doi:10.1093/eurjhf/hfq002.76. Dahlstr?m U, Filippatos G, Maggioni A, Tavazzi L, Zannad F. Heart Failure Pilot protocol. Eur Heart J. 2010;31(18):2184-2186. doi:10.1093/eurheartj/ehq282.77. Maggioni AP, Dahlstr?m U, Filippatos G, Chioncel O, Leiro MC, Drozdz J, Fruhwald F, Gullestad L, Logeart D, Metra M, Parissis J, Persson H, Ponikowski P, Rauchhaus M, Voors A, Nielsen OW, Zannad F, Tavazzi L. EURObservational research programme: The heart failure Pilot survey (ESC-HF Pilot). Eur J Heart Fail. 2010;12(10):1076-1084. doi:10.1093/eurjhf/hfq154.78. Maggioni AP, Dahlstr?m U, Filippatos G, Chioncel O, Leiro MC, Drozdz J, Fruhwald F, Gullestad L, Logeart D, Fabbri G, Urso R, Metra M, Parissis J, Persson H, Ponikowski P, Rauchhaus M, Voors A a., Nielsen OW, Zannad F, et al. EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail. 2013;15(7):808-817. doi:10.1093/eurjhf/hft050.79. Maggioni AP, Anker SD, Dahlstr?m U, Filippatos G, Ponikowski P, Zannad F, Amir O, Chioncel O, Leiro MC, Drozdz J, Erglis A, Fazlibegovic E, Fonseca C, Fruhwald F, Gatzov P, Goncalvesova E, Hassanein M, Hradec J, Kavoliuniene A, et al. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12 440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2013;15(10):1173-1184. doi:10.1093/eurjhf/hft134.80. Hong Y, LaBresh K a. Overview of the American Heart Association “Get with the Guidelines” programs: coronary heart disease, stroke, and heart failure. Crit Pathw Cardiol. 2006;5(4):179-186. doi:10.1097/01.hpc.0000243588.00012.79.81. Hernandez AF, Fonarow GC, Liang L, Al-Khatib SM, Curtis LH, LaBresh K a, Yancy CW, Albert NM, Peterson ED. Sex and racial differences in the use of implantable cardioverter-defibrillators among patients hospitalized with heart failure. JAMA. 2007;298(13):1525-1532. doi:10.1001/jama.298.13.1525.82. Patel UD, Hernandez AF, Liang L, Peterson ED, LaBresh K a., Yancy CW, Albert NM, Ellrodt G, Fonarow GC. Quality of care and outcomes among patients with heart failure and chronic kidney disease: A Get With the Guidelines-Heart Failure Program study. Am Heart J. 2008;156(4):674-681. doi:10.1016/j.ahj.2008.05.028.83. Krantz MJ, Tanner J, Horwich TB, Yancy C, Albert NM, Hernandez AF, Dai D, Fonarow GC. Influence of Hospital Length of Stay for Heart Failure on Quality of Care. Am J Cardiol. 2008;102(12):1693-1697. doi:10.1016/j.amjcard.2008.08.015.84. Horwich TB, Hernandez AF, Dai D, Yancy CW, Fonarow GC. Cholesterol levels and in-hospital mortality in patients with acute decompensated heart failure. Am Heart J. 2008;156(6):1170-1176. doi:10.1016/j.ahj.2008.07.004.85. Piccini JP, Hernandez AF, Dai D, Thomas KL, Lewis WR, Yancy CW, Peterson ED, Fonarow GC. Use of cardiac resynchronization therapy in patients hospitalized with heart failure. Circulation. 2008;118(9):926-933. doi:10.1161/CIRCULATIONAHA.108.773838.86. Piccini JP, Hernandez AF, Zhao X, Patel MR, Lewis WR, Peterson ED, Fonarow GC. Quality of Care for Atrial Fibrillation Among Patients Hospitalized for Heart Failure. J Am Coll Cardiol. 2009;54(14):1280-1289. doi:10.1016/j.jacc.2009.04.091.87. Horwich TB, Hernandez AF, Liang L, Albert NM, LaBresh K a., Yancy CW, Fonarow GC. Weekend hospital admission and discharge for heart failure: Association with quality of care and clinical outcomes. Am Heart J. 2009;158(3):451-458. doi:10.1016/j.ahj.2009.06.025.88. Ambardekar A V., Fonarow GC, Hernandez AF, Pan W, Yancy CW, Krantz MJ. Characteristics and in-hospital outcomes for nonadherent patients with heart failure: Findings from Get With The Guidelines-Heart Failure (GWTG-HF). Am Heart J. 2009;158(4):644-652. doi:10.1016/j.ahj.2009.07.034.89. Albert NM, Yancy CW, Liang L, Zhao X, Hernandez AF, Peterson ED, Cannon CP, Fonarow GC. Use of aldosterone antagonists in heart failure. JAMA. 2009;302(15):1658-1665. doi:10.1001/jama.2009.1493.90. Forman DE, Cannon CP, Hernandez AF, Liang L, Yancy C, Fonarow GC. Influence of age on the management of heart failure: Findings from Get with the Guidelines-Heart Failure (GWTG-HF). Am Heart J. 2009;157(6):1010-1017. doi:10.1016/j.ahj.2009.03.010.91. Heidenreich P a., Lewis WR, LaBresh K a., Schwamm LH, Fonarow GC. Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure. Am Heart J. 2009;158(4):546-553. doi:10.1016/j.ahj.2009.07.031.92. Shah B, Hernandez AF, Liang L, Al-Khatib SM, Yancy CW, Fonarow GC, Peterson ED. Hospital Variation and Characteristics of Implantable Cardioverter-Defibrillator Use in Patients With Heart Failure. Data From the GWTG-HF (Get With The Guidelines-Heart Failure) Registry. J Am Coll Cardiol. 2009;53(5):416-422. doi:10.1016/j.jacc.2008.09.045.93. Hernandez AF, Fonarow GC, Hammill BG, Al-Khatib SM, Yancy CW, O’connor CM, Schulman K a., Peterson ED, Curtis LH. Clinical effectiveness of implantable cardioverter-defibrillators among Medicare beneficiaries with heart failure. Circ Hear Fail. 2010;3(1):7-13. doi:10.1161/CIRCHEARTFAILURE.109.884395.94. Hernandez AF, Greiner M a, Fonarow GC, Hammill BG, Heidenreich P a, Yancy CW, Peterson ED, Curtis LH. Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA. 2010;303(17):1716-1722. doi:10.1016/S0735-1097(10)61205-3.95. Whellan DJ, Zhao X, Hernandez AF, Liang L, Peterson ED, Bhatt DL, Heidenreich P a., Schwamm LH, Fonarow GC. Predictors of hospital length of stay in heart failure: Findings from get with the guidelines. J Card Fail. 2011;17(8):649-656. doi:10.1016/j.cardfail.2011.04.005.96. Kociol RD, Greiner M a., Fonarow GC, Hammill BG, Heidenreich P a., Yancy CW, Peterson ED, Curtis LH, Hernandez AF. Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure. Am J Cardiol. 2011;108(7):985-991. doi:10.1016/j.amjcard.2011.05.032.97. Krantz MJ, Ambardekar A V., Kaltenbach L, Hernandez AF, Heidenreich P a., Fonarow GC. Patterns and predictors of evidence-based medication continuation among hospitalized heart failure patients (from get with the guidelines-heart failure). Am J Cardiol. 2011;107(12):1818-1823. doi:10.1016/j.amjcard.2011.02.322.98. Thomas KL, Hernandez AF, Dai D, Heidenreich P, Fonarow GC, Peterson ED, Yancy CW. Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure. Am Heart J. 2011;161(4):746-754. doi:10.1016/j.ahj.2011.01.012.99. Hernandez AF, Fonarow GC, Liang L, Heidenreich P a., Yancy C, Peterson ED. The need for multiple measures of hospital quality: Results from the get with the guidelines-heart failure registry of the american heart association. Circulation. 2011;124(6):712-719. doi:10.1161/CIRCULATIONAHA.111.026088.100. Allen L a., Hernandez AF, Peterson ED, Curtis LH, Dai D, Masoudi F a., Bhatt DL, Heidenreich P a., Fonarow GC. Discharge to a skilled nursing facility and subsequent clinical outcomes among older patients hospitalized for heart failure. Circ Hear Fail. 2011;4(3):293-300. doi:10.1161/CIRCHEARTFAILURE.110.959171.101. Gharacholou SM, Hellkamp AS, Hernandez AF, Peterson ED, Bhatt DL, Yancy CW, Fonarow GC. Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: Insights from the get with the guidelines program. J Card Fail. 2011;17(5):431-439. doi:10.1016/j.cardfail.2010.12.005.102. Klein L, Grau-Sepulveda M V., Bonow RO, Hernandez AF, Williams M V., Bhatt DL, Fonarow GC. Quality of care and outcomes in women hospitalized for heart failure. Circ Hear Fail. 2011;4(5):589-598. doi:10.1161/CIRCHEARTFAILURE.110.960484.103. Steinberg B a., Zhao X, Heidenreich P a., Peterson ED, Bhatt DL, Cannon CP, Hernandez AF, Fonarow GC. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: Prevalence, therapies, and outcomes. Circulation. 2012;126(1):65-75. doi:10.1161/CIRCULATIONAHA.111.080770.104. Kociol RD, Peterson ED, Hammill BG, Flynn KE, Heidenreich P a., Pi?a IL, Lytle BL, Albert NM, Curtis LH, Fonarow GC, Hernandez AF. National survey of hospital strategies to reduce heart failure readmissions findings from the get with the guidelines-heart failure registry. Circ Hear Fail. 2012;5(6):680-687. doi:10.1161/CIRCHEARTFAILURE.112.967406.105. Heidenreich P a., Zhao X, Hernandez AF, Yancy CW, Fonarow GC. Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure. Am Heart J. 2012;163(2):239-245.e3. doi:10.1016/j.ahj.2011.10.008.106. Vivo RP, Krim SR, Krim NR, Zhao X, Hernandez AF, Peterson ED, Pina IL, Bhatt DL, Schwamm LH, Fonarow GC. Care and outcomes of hispanic patients admitted with heart failure with preserved or reduced ejection fraction findings from get with the guidelines-heart failure. Circ Hear Fail. 2012;5(2):167-175. doi:10.1161/CIRCHEARTFAILURE.111.963546.107. Mountantonakis SE, Grau-Sepulveda M V., Bhatt DL, Hernandez AF, Peterson ED, Fonarow GC. Presence of atrial fibrillation is independently associated with adverse outcomes in patients hospitalized with heart failure an analysis of get with the guidelines-heart failure. Circ Hear Fail. 2012;5(2):191-201. doi:10.1161/CIRCHEARTFAILURE.111.965681.108. Whellan DJ, Cox M, Hernandez AF, Heidenreich P a., Curtis LH, Peterson ED, Fonarow GC. Utilization of hospice and predicted mortality risk among older patients hospitalized with heart failure: Findings from GWTG-HF. J Card Fail. 2012;18(6):471-477. doi:10.1016/j.cardfail.2012.02.006.109. Al-Khatib SM, Hellkamp AS, Hernandez AF, Fonarow GC, Thomas KL, Al-Khalidi HR, Heidenreich P a., Hammill S, Yancy C, Peterson ED. Trends in use of implantable cardioverter-defibrillator therapy among patients hospitalized for heart failure: Have the previously observed sex and racial disparities changed over time? Circulation. 2012;125(9):1094-1101. doi:10.1161/CIRCULATIONAHA.111.066605.110. Heidenreich P a., Hernandez AF, Yancy CW, Liang L, Peterson ED, Fonarow GC. Get with the guidelines program participation, process of care, and outcome for medicare patients hospitalized with heart failure. Circ Cardiovasc Qual Outcomes. 2012;5(1):37-43. doi:10.1161/CIRCOUTCOMES.110.959122.111. Hsich EM, Grau-Sepulveda M V., Hernandez AF, Peterson ED, Schwamm LH, Bhatt DL, Fonarow GC. Sex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction. Am Heart J. 2012;163(3):430-437.e3. doi:10.1016/j.ahj.2011.12.013.112. Hsich EM, Grau-Sepulveda M V., Hernandez AF, Eapen ZJ, Xian Y, Schwamm LH, Bhatt DL, Fonarow GC. Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get with the Guideline-Heart Failure Registry. Am Heart J. 2013;166(6):1063-1071.e3. doi:10.1016/j.ahj.2013.08.029.113. Eapen ZJ, Liang L, Fonarow GC, Heidenreich P a., Curtis LH, Peterson ED, Hernandez AF. Validated, electronic health record deployable prediction models for assessing patient risk of 30-day rehospitalization and mortality in older heart failure patients. JACC Hear Fail. 2013;1(3):245-251. doi:10.1016/j.jchf.2013.01.008.114. Kociol RD, Hammill BG, Fonarow GC, Heidenreich P a., Go AS, Peterson ED, Curtis LH, Hernandez AF. Associations between use of the hospitalist model and quality of care and outcomes of older patients hospitalized for heart failure. JACC Hear Fail. 2013;1(5):445-453. doi:10.1016/j.jchf.2013.07.001.115. Bui AL, Grau-Sepulveda M V., Hernandez AF, Peterson ED, Yancy CW, Bhatt DL, Fonarow GC. Admission heart rate and in-hospital outcomes in patients hospitalized for heart failure in sinus rhythm and in atrial fibrillation. Am Heart J. 2013;165(4):567-574.e6. doi:10.1016/j.ahj.2013.01.007.116. Hess PL, Grau-Sepulveda M V., Hernandez AF, Peterson ED, Bhatt DL, Schwamm LH, Yancy CW, Fonarow GC, Al-Khatib SM. Age differences in the use of implantable cardioverter-defibrillators among older patients hospitalized with heart failure. J Cardiovasc Electrophysiol. 2013;24(6):664-671. doi:10.1111/jce.12100.117. Thomas KL, Piccini JP, Liang L, Fonarow GC, Yancy CW, Peterson ED, Hernandez AF. Racial differences in the prevalence and outcomes of atrial fibrillation among patients hospitalized with heart failure. J Am Heart Assoc. 2013;2(5):e000200. doi:10.1161/JAHA.113.000200.118. Curtis LH, Mi X, Qualls LG, Check DK, Hammill BG, Hammill SC, Heidenreich P a., Masoudi F a., Setoguchi S, Hernandez AF, Fonarow GC. Heart failure: Transitional adherence and persistence in the use of aldosterone antagonist therapy in patients with heart failure. Am Heart J. 2013;165(6):979-986.e1. doi:10.1016/j.ahj.2013.03.007.119. Kociol RD, Liang L, Hernandez AF, Curtis LH, Heidenreich P a., Yancy CW, Fonarow GC, Peterson ED. Are we targeting the right metric for heart failure? comparison of hospital 30-day readmission rates and total episode of care inpatient days. Am Heart J. 2013;165(6):987-994.e1. doi:10.1016/j.ahj.2013.02.006.120. Golwala HB, Thadani U, Liang L, Stavrakis S, Butler J, Yancy CW, Bhatt DL, Hernandez AF, Fonarow GC. Use of hydralazine-isosorbide dinitrate combination in African American and other race/ethnic group patients with heart failure and reduced left ventricular ejection fraction. J Am Heart Assoc. 2013;2(4):e000214. doi:10.1161/JAHA.113.000214.121. Krim SR, Vivo RP, Krim NR, Qian F, Cox M, Ventura H, Hernandez AF, Bhatt DL, Fonarow GC. Racial/ethnic differences in b-type natriuretic peptide levels and their association with care and outcomes among patients hospitalized with heart failure: Findings from get with the guidelines-heart failure. JACC Hear Fail. 2013;1(4):345-352. doi:10.1016/j.jchf.2013.04.008.122. Quiroz R, Doros G, Shaw P, Liang C-S, Gauthier DF, Sam F. Comparison of characteristics and outcomes of patients with heart failure preserved ejection fraction versus reduced left ventricular ejection fraction in an urban cohort. Am J Cardiol. 2014;113(4):691-696. doi:10.1016/j.amjcard.2013.11.014.123. Cheng RK, Cox M, Neely ML, Heidenreich PA. Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population. Am Heart J. 2014;168(5):721-730.e3. doi:10.1016/j.ahj.2014.07.008.124. Eapen ZJ, Grau-Sepulveda M V., Fonarow GC, Heidenreich P a., Peterson ED, Hernandez AF. Prescribing warfarin at discharge for heart failure patients: Findings from the Get with the Guidelines-Heart Failure Registry. Int J Cardiol. 2014;172(2):e322-e323. doi:10.1016/j.ijcard.2013.12.161.125. Heidenreich P a., Zhao X, Hernandez a. F, Yancy CW, Schwamm LH, Albert NM, Fonarow GC. Impact of an Expanded Hospital Recognition Program for Heart Failure Quality of Care. J Am Heart Assoc. 2014;3(5):e000950-e000950. doi:10.1161/JAHA.114.000950.126. Eapen ZJ, Mi X, Qualls LG, Hammill BG, Fonarow GC, Turakhia MP, Heidenreich P a., Peterson ED, Curtis LH, Hernandez AF, Al-Khatib SM. Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation. J Card Fail. 2014;20(1):23-30. doi:10.1016/j.cardfail.2013.11.006.127. Pokorney SD, Hellkamp a. S, Yancy CW, Curtis LH, Hammill SC, Peterson ED, Masoudi F a., Bhatt DL, Al-Khalidi HR, Heidenreich P a., Anstrom KJ, Fonarow GC, Al-Khatib SM. Primary Prevention Implantable Cardioverter-Defibrillators in Older Racial and Ethnic Minority Patients. Circ Arrhythmia Electrophysiol. 2014;8(1):145-151. doi:10.1161/CIRCEP.114.001878.128. Al-Khatib SM, Hellkamp AS, Fonarow GC, Mark DB, Curtis LH, Hernandez AF, Anstrom KJ, Peterson ED, Sanders GD, Al-Khalidi HR, Hammill BG, Heidenreich P a, Hammill SC. Association between prophylactic implantable cardioverter-defibrillators and survival in patients with left ventricular ejection fraction between 30% and 35%. JAMA. 2014;311(21):2209-2215. doi:10.1001/jama.2014.5310.129. Khazanie P, Liang L, Qualls LG, Curtis LH, Fonarow GC, Hammill BG, Hammill SC, Heidenreich P a., Masoudi F a., Hernandez AF, Piccini JP. Outcomes of Medicare Beneficiaries With Heart Failure and Atrial Fibrillation. JACC Hear Fail. 2014;2(1):41-48. doi:10.1016/j.jchf.2013.11.002.130. Vivo RP, Krim SR, Liang L, Neely M, Hernandez a. F, Eapen ZJ, Peterson ED, Bhatt DL, Heidenreich P a., Yancy CW, Fonarow GC. Short- and Long-term Rehospitalization and Mortality for Heart Failure in 4 Racial/Ethnic Populations. J Am Heart Assoc. 2014;3(5):e001134-e001134. doi:10.1161/JAHA.114.001134.131. Allen L a., Fonarow GC, Grau-Sepulveda M V., Hernandez AF, Peterson PN, Partovian C, Li SX, Heidenreich P a., Bhatt DL, Peterson ED, Krumholz HM. Hospital variation in intravenous inotrope use for patients hospitalized with heart failure insights from get with the guidelines. Circ Hear Fail. 2014;7(2):251-260. doi:10.1161/CIRCHEARTFAILURE.113.000761.132. Qian F, Fonarow GC, Krim SR, Vivo RP, Cox M, Hannan EL, Shaw B a., Hernandez AF, Eapen ZJ, Yancy CW, Bhatt DL. Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program. Int J Cardiol. 2015;189(September 2010):141-147. doi:10.1016/j.ijcard.2015.03.400.133. Zeitler EP, Hellkamp AS, Fonarow GC, Hammill SC, Curtis LH, Hernandez AF, Al-Khalidi HR, Curtis JP, Heidenreich P a., Anstrom KJ, Peterson ED, Mark DB, Hammill BG, Sanders GD, Al-Khatib SM. Primary Prevention Implantable Cardioverter-Defibrillators and Survival in Older Women. JACC Hear Fail. 2015;3(2):159-167. doi:10.1016/j.jchf.2014.09.006.134. Laskey WK, Alomari I, Cox M, Schulte PJ, Zhao X, Hernandez a. F, Heidenreich P a., Eapen ZJ, Yancy C, Bhatt DL, Fonarow GC. Heart Rate at Hospital Discharge in Patients With Heart Failure Is Associated With Mortality and Rehospitalization. J Am Heart Assoc. 2015;4(4):e001626-e001626. doi:10.1161/JAHA.114.001626.135. Kawashiro N, Kasanuki H, Ogawa H, Matsuda N, Hagiwara N. Clinical characteristics and outcome of hospitalized patients with congestive heart failure: results of the HIJC-HF registry. Circ J. 2008;72(12):2015-2020.136. Gattis WA, O’Connor CM, Gheorghiade M. Rationale and design of the initiation management predischarge: Process for assessment of carvedilol therapy for heart failure (IMPACT-HF) study: design and implications. Rev Cardiovasc Med. 2002;3(3 Suppl):S48-S54. doi:10.1159/000065939.137. Gheorghiade M, Gattis WA, Lukas MA, O’Connor CM. Rationale and design of the initiation management predischarge: Process for assessment of carvedilol therapy for heart failure (IMPACT-HF) study. Am Heart J. 2003;145(2 (Suppl)):S60-S61. doi:10.1159/000065939.138. Gattis W a., O’Connor CM, Gallup DS, Hasselblad V, Gheorghiade M. Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure: Results of the initiation management predischarge: Process for assessment of carvedilol therapy in heart failure (IMPACT-HF) trial. J Am Coll Cardiol. 2004;43(9):1534-1541. doi:10.1016/j.jacc.2003.12.040.139. Gattis W a., O’Connor CM. Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure. Am J Cardiol. 2004;93(9 SUPPL. 1):74-76. doi:10.1016/j.amjcard.2004.01.019.140. O’Connor CM, Stough WG, Gallup DS, Hasselblad V, Gheorghiade M. Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: Observations from the IMPACT-HF registry. J Card Fail. 2005;11(3):200-205. doi:10.1016/j.cardfail.2004.08.160.141. Fonarow GC, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, Mehra M, O’Connor CM, Reynolds D, Walsh MN. Improving the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting: The IMPROVE HF performance improvement registry. Am Heart J. 2007;154(1):12-38. doi:10.1016/j.ahj.2007.03.030.142. Yancy CW, Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: Findings from IMPROVE HF. Am Heart J. 2009;157(4):754-762.e2. doi:10.1016/j.ahj.2008.12.016.143. Heywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Influence of renal function on the use of guideline-recommended therapies for patients with heart failure. Am J Cardiol. 2010;105(8):1140-1146. doi:10.1016/j.amjcard.2009.12.016.144. Albert NM, Fonarow GC, Yancy CW, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride M, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: Findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Am Heart J. 2010;159(2):238-244. doi:10.1016/j.ahj.2009.11.022.145. Albert NM, Fonarow GC, Yancy CW, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride M, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Outpatient Cardiology Practices With Advanced Practice Nurses and Physician Assistants Provide Similar Delivery of Recommended Therapies (Findings from IMPROVE HF). Am J Cardiol. 2010;105(12):1773-1779. doi:10.1016/j.amjcard.2010.01.360.146. Fonarow GC, Albert NM, Curtis AB, Gattis Stough W, Gheorghiade M, Heywood JT, McBride ML, Johnson Inge P, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW. Improving evidence-based care for heart failure in outpatient cardiology practices: Primary results of the registry to improve the use of evidence-based heart failure therapies in the outpatient setting (IMPROVE HF). Circulation. 2010;122(6):585-596. doi:10.1161/CIRCULATIONAHA.109.934471.147. O’Connor CM, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, McBride ML, Inge PJ, Mehra MR, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Patient and practice factors associated with improvement in use of guideline-recommended therapies for outpatients with heart failure (from the IMPROVE HF Trial). Am J Cardiol. 2011;107(2):250-258. doi:10.1016/j.amjcard.2010.09.012.148. Gheorghiade M, Albert NM, Curtis AB, Thomas Heywood J, McBride ML, Inge PJ, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: Findings from IMPROVE HF. Congest Hear Fail. 2012;18(1):9-17. doi:10.1111/j.1751-7133.2011.00250.x.149. Walsh MN, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Liu Y, Mehra MR, O’Connor CM, Reynolds D, Yancy CW, Fonarow GC. Lack of association between electronic health record systems and improvement in use of evidence-based heart failure therapies in outpatient cardiology practices. Clin Cardiol. 2012;35(3):187-196. doi:10.1002/clc.21971.150. Ambrosy AP, Fonarow GC, Albert NM, Curtis AB, Heywood JT, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW, Gheorghiade M. B-type natriuretic peptide assessment in ambulatory heart failure patients. J Cardiovasc Med. 2012;13(6):360-367. doi:10.2459/JCM.0b013e328353128c.151. Shukla A, Curtis AB, Mehra MR, Albert NM, Gheorghiade M, Heywood JT, Liu Y, O’Connor CM, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Factors associated with improvement in utilization of cardiac resynchronization therapy in eligible heart failure patients: Findings from IMPROVE HF. PACE - Pacing Clin Electrophysiol. 2013;36(4):433-443. doi:10.1111/pace.12090.152. Ziaeian B, Zhang Y, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Clinical Effectiveness of CRT and ICD?Therapy in Heart Failure Patients by?Racial/Ethnic Classification. J Am Coll Cardiol. 2014;64(8):797-807. doi:10.1016/j.jacc.2014.05.060.153. Wilcox JE, Fonarow GC, Zhang Y, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW. Clinical effectiveness of cardiac resynchronization and implantable cardioverter-defibrillator therapy in men and women with heart failure findings from IMPROVE HF. Circ Hear Fail. 2014;7(1):146-153. doi:10.1161/CIRCHEARTFAILURE.113.000789.154. Oliva F, Mortara A, Cacciatore G, Chinaglia A, Di Lenarda A, Gorini M, Metra M, Senni M, Maggioni AP, Tavazzi L. Acute heart failure patient profiles, management and in-hospital outcome: Results of the Italian Registry on Heart Failure Outcome. Eur J Heart Fail. 2012;14(11):1208-1217. doi:10.1093/eurjhf/hfs117.155. Cioffi G, Mortara A, Di Lenarda A, Oliva F, Lucci D, Senni M, Cacciatore G, Chinaglia A, Tarantini L, Metra M, Maggioni A Pietro, Tavazzi L. Clinical features, and in-hospital and 1-year mortalities of patients with acute heart failure and severe renal dysfunction. Data from the Italian Registry IN-HF Outcome. Int J Cardiol. 2013;168(4):3691-3697. doi:10.1016/j.ijcard.2013.06.020.156. Tavazzi L, Senni M, Metra M, Gorini M, Cacciatore G, Chinaglia A, Lenarda A Di, Mortara A, Oliva F, Maggioni AP. Multicenter prospective observational study on acute and chronic heart failure one-year follow-up results of in-hf (italian network on heart failure) outcome registry. Circ Hear Fail. 2013;6(3):473-481. doi:10.1161/CIRCHEARTFAILURE.112.000161.157. Mortara A, Oliva F, Metra M, Carbonieri E, Di Lenarda A, Gorini M, Midi P, Senni M, Urso R, Lucci D, Maggioni AP, Tavazzi L. Treatment with inotropes and related prognosis in acute heart failure: Contemporary data from the Italian Network on Heart Failure (IN-HF) Outcome registry. J Hear Lung Transplant. 2014;33(10):1056-1065. doi:10.1016/j.healun.2014.05.015.158. Senni M, Gavazzi A, Oliva F, Mortara A, Urso R, Pozzoli M, Metra M, Lucci D, Gonzini L, Cirrincione V, Montagna L, Di Lenarda A, Maggioni AP, Tavazzi L. In-hospital and 1-year outcomes of acute heart failure patients according to presentation (de novo vs. worsening) and ejection fraction. Results from IN-HF Outcome Registry. Int J Cardiol. 2014;173(2):163-169. doi:10.1016/j.ijcard.2014.02.018.159. Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S, Goto D, Takeshita A. Clinical characteristics and outcome of hospitalized patients with heart failure in Japan. Circ J. 2006;70(12):1617-1623.160. Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S, Goto D, Takeshita A. Characteristics and outcomes of patients with heart failure in general practices and hospitals. Circ J. 2007;71(4):449-454.161. Tsuchihashi-Makaya M, Hamaguchi S, Kinugawa S, Yokota T, Goto D, Yokoshiki H, Kato N, Takeshita A, Tsutsui H. Characteristics and outcomes of hospitalized patients with heart failure and reduced vs preserved ejection fraction. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J. 2009;73(10):1893-1900. doi:JST.JSTAGE/circj/CJ-09-0254 [pii].162. Hamaguchi S, Tsuchihashi-Makaya M, Kinugawa S, Yokota T, Takeshita A, Yokoshiki H, Tsutsui H. Anemia is an independent predictor of long-term adverse outcomes in patients hospitalized with heart failure in Japan. A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J. 2009;73(10):1901-1908. doi:10.1253/circj.CJ-09-0184.163. Hamaguchi S, Tsuchihashi-Makaya M, Kinugawa S, Yokota T, Ide T, Takeshita A, Tsutsui H. Chronic kidney disease as an independent risk for long-term adverse outcomes in patients hospitalized with heart failure in Japan. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J. 2009;73(8):1442-1447. doi:10.1253/circj.CJ-09-0062.164. Hamaguchi S, Yokoshiki H, Kinugawa S, Tsuchihashi-Makaya M, Yokota T, Takeshita A, Tsutsui H. Effects of atrial fibrillation on long-term outcomes in patients hospitalized for heart failure in Japan: a report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J. 2009;73(11):2084-2090. doi:. Tsuchihashi-Makaya M, Furumoto T, Kinugawa S, Hamaguchi S, Goto K, Goto D, Yamada S, Yokoshiki H, Takeshita A, Tsutsui H. Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure. Hypertens Res. 2010;33(3):197-202. doi:10.1038/hr.2009.199.166. Hamaguchi S, Tsuchihashi-Makaya M, Kinugawa S, Goto D, Yokota T, Goto K, Yamada S, Yokoshiki H, Takeshita A, Tsutsui H. Body mass index is an independent predictor of long-term outcomes in patients hospitalized with heart failure in Japan. Circ J. 2010;74(12):2605-2611. doi:10.1253/circj.CJ-10-0599.167. Tsuchihashi-Makaya M, Kinugawa S, Yokoshiki H, Hamaguchi S, Yokota T, Goto D, Goto K, Takeshita A, Tsutsui H. Beta-blocker use at discharge in patients hospitalized for heart failure is associated with improved survival. Circ J. 2010;74(7):1364-1371. doi:10.1253/circj.CJ-09-0993.168. Hamaguchi S, Kinugawa S, Goto D, Tsuchihashi-Makaya M, Yokota T, Yamada S, Yokoshiki H, Takeshita A, Tsutsui H. Predictors of long-term adverse outcomes in elderly patients over 80 years hospitalized with heart failure. - A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)-. Circ J. 2011;75(10):2403-2410. doi:10.1253/circj.CJ-11-0267.169. Hamaguchi S, Furumoto T, Tsuchihashi-Makaya M, Goto K, Goto D, Yokota T, Kinugawa S, Yokoshiki H, Takeshita A, Tsutsui H. Hyperuricemia predicts adverse outcomes in patients with heart failure. Int J Cardiol. 2011;151(2):143-147. doi:10.1016/j.ijcard.2010.05.002.170. Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Goto D, Yamada S, Yokoshiki H, Takeshita A, Tsutsui H. Loop diuretic use at discharge is associated with adverse outcomes in hospitalized patients with heart failure: a report from the Japanese cardiac registry of heart failure in cardiology (JCARE-CARD). Circ J. 2012;76(8):1920-1927. doi:10.1253/circj.CJ-11-1196.171. Hamaguchi S, Kinugawa S, Sobirin MA, Goto D, Tsuchihashi-Makaya M, Yamada S, Yokoshiki H, Tsutsui H, Investigators J-C. Mode of death in patients with heart failure and reduced vs. preserved ejection fraction: report from the registry of hospitalized heart failure patients. Circ J. 2012;76(7):1662-1669. doi:. Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Goto D, Yamada S, Yokoshiki H, Tsutsui H. Characteristics, management, and outcomes for patients during hospitalization due to worsening heart failure-A report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). J Cardiol. 2013;62(2):95-101. doi:10.1016/j.jjcc.2013.03.009.173. Goto D, Kinugawa S, Hamaguchi S, Sakakibara M, Tsuchihashi-Makaya M, Yokota T, Yamada S, Yokoshiki H, Tsutsui H. Clinical characteristics and outcomes of dilated phase of hypertrophic cardiomyopathy: Report from the registry data in Japan. J Cardiol. 2013;61(1):65-70. doi:10.1016/j.jjcc.2012.08.010.174. Hamaguchi S, Kinugawa S, Matsushima S, Fukushima A, Yokota T, Sakakibara M, Yokoshiki H, Tsuchihashi-Makaya M, Tsutsui H. Clinical characteristics and CHADS2 score in patients with heart failure and atrial fibrillation: Insights from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Int J Cardiol. 2014;176(1):239-242. doi:10.1016/j.ijcard.2014.06.068.175. Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Goto D, Tsutsui H. Weekend versus weekday hospital admission and outcomes during hospitalization for patients due to worsening heart failure: A report from Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Heart Vessels. 2014;29(3):328-335. doi:10.1007/s00380-013-0359-5.176. Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Matsushima S, Sakakibara M, Ishimori N, Goto D, Tsutsui H. Hyponatremia is an independent predictor of adverse clinical outcomes in hospitalized patients due to worsening heart failure. J Cardiol. 2014;63(3):182-188. doi:10.1016/j.jjcc.2013.07.012.177. Choi D-J, Han S, Jeon E-S, Cho M-C, Kim J-J, Yoo B-S, Shin M-S, Seong I-W, Ahn Y, Kang S-M, Kim Y-J, Kim HS, Chae SC, Oh B-H, Lee M-M, Ryu K-H. Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry. Korean Circ J. 2011;41(7):363. doi:10.4070/kcj.2011.41.7.363.178. Hong S-J, Oh J, Kang S-M, Youn JC, Han S, Jeon E-S, Cho M-C, Kim J-J, Yoo B-S, Chae SC, Oh B-H, Choi D-J, Lee M-M, Ryu K-H. Clinical implication of right bundle branch block in hospitalized patients with acute heart failure: Data from the Korean Heart Failure (KorHF) Registry. Int J Cardiol. 2012;157(3):416-418. doi:10.1016/j.ijcard.2012.03.155.179. Lee SE, Choi D-J, Yoon C-H, Oh I-Y, Jeon E-S, Kim J-J, Cho M-C, Chae SC, Ryu K-H, Oh B-H. Improvement of hyponatraemia during hospitalisation for acute heart failure is not associated with improvement of prognosis: an analysis from the Korean Heart Failure (KorHF) registry. Heart. 2012;98(24):1798-1804. doi:10.1136/heartjnl-2012-302334.180. Yoon C-H, Youn T-J, Ahn S, Choi D-J, Cho G-Y, Chae I-H, Choi J, Cho H, Han S, Cho M-C, Jeon E-S, Chae SC, Kim J-J, Ryu K-H, Oh B-H. Low Serum Total Cholesterol Level is a Surrogate Marker, But Not a Risk Factor, for Poor Outcome in Patients Hospitalized With Acute Heart Failure: A Report From the Korean Heart Failure Registry. J Card Fail. 2012;18(3):194-201. doi:10.1016/j.cardfail.2011.12.006.181. Youn YJ, Yoo B-S, Lee J-W, Kim J-Y, Han SW, Jeon E-S, Cho M-C, Kim J-J, Kang S-M, Chae SC, Oh B-H, Choi D-J, Lee MM, Ryu K-H, on behalf of the KorHF Registry. Treatment Performance Measures Affect Clinical Outcomes in Patients With Acute Systolic Heart Failure. Circ J. 2012;76(5):1151-1158. doi:10.1253/circj.CJ-11-1093.182. Park SJ, On YK, Byeon K, Kim JS, Choi JO, Choi DJ, Ryu KH, Jeon ES. Short- and long-term outcomes depending on electrical dyssynchrony markers in patients presenting with acute heart failure: Clinical implication of the first-degree atrioventricular block and QRS prolongation from the Korean Heart Failure registry. Am Heart J. 2013;165(1):57-64.e2. doi:10.1016/j.ahj.2012.10.009.183. Oh J, Kang SM, Hong N, Youn JC, Han S, Jeon ES, Cho MC, Kim JJ, Yoo BS, Chae SC, Oh BH, Choi DJ, Lee MM, Ryu KH. Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure: Data from the Korean Heart Failure (KorHF) Registry. Int J Cardiol. 2013;168(5):4739-4743. doi:10.1016/j.ijcard.2013.07.241.184. Oh J, Kang SM, Hong N, Youn JC, Han S, Jeon ES, Cho MC, Kim JJ, Yoo BS, Chae SC, Oh BH, Choi DJ, Lee MM, Ryu KH. The CKD-EPI is more accurate in clinical outcome prediction than MDRD equation in acute heart failure: Data from the Korean Heart Failure (KorHF) Registry. Int J Cardiol. 2013;167(3):1084-1087. doi:10.1016/j.ijcard.2012.10.054.185. Park JJ, Choi DJ, Yoon CH, Oh IY, Jeon ES, Kim JJ, Cho MC, Chae SC, Ryu KH, Yoo BS, Kang SM, Oh BH. Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry). Am J Cardiol. 2014;113(3):511-517. doi:10.1016/j.amjcard.2013.10.022.186. Oh J, Kang S-M, Song MK, Hong N, Youn J-C, Han S, Jeon E-S, Cho M-C, Kim J-J, Yoo B-S, Chae SC, Oh B-H, Choi D-J, Lee M-M, Ryu K-H. Clinical benefit of spironolactone in patients with acute decompensated heart failure and severe renal dysfunction: Data from the Korean Heart Failure (KorHF) Registry. Am Heart J. 2015;169(5):713-720.e3. doi:10.1016/j.ahj.2015.01.014.187. National Heart Failure Audit. National Institute for Cardiovascular Outcomes Research. . Fonarow GC, Abraham WT, Albert NM, Gattis W a., Gheorghiade M, Greenberg B, O’Connor CM, Yancy CW, Young J. Organized program to initiate lifesaving treatment in hospitalized patients with heart failure (OPTIMIZE-HF): Rationale and design. Am Heart J. 2004;148(1):43-51. doi:10.1016/j.ahj.2004.03.004.189. Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA. 2006;296(18):2217-2226. doi:10.1001/jama.296.18.2217.190. Albert NM, Fonarow GC, Abraham WT, Chiswell K, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Predictors of Delivery of Hospital-Based Heart Failure Patient Education: A Report from OPTIMIZE-HF. J Card Fail. 2007;13(3):189-198. doi:10.1016/j.cardfail.2006.11.008.191. Fonarow GC, Abraham WT, Albert NM, Gattis Stough W, Gheorghiade M, Greenberg BH, O’Connor CM, Pieper K, Sun JL, Yancy CW, Young JB. Influence of a performance-improvement initiative on quality of care for patients hospitalized with heart failure: results of the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). Arch Intern Med. 2007;167(14):1493-1502. doi:10.1001/archinte.167.14.1493.192. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy C, Young JB. Carvedilol use at discharge in patients hospitalized for heart failure is associated with improved survival: An analysis from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). Am Heart J. 2007;153(1):1-11. doi:10.1016/j.ahj.2006.10.008.193. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Prospective Evaluation of Beta-Blocker Use at the Time of Hospital Discharge as a Heart Failure Performance Measure: Results From OPTIMIZE-HF. J Card Fail. 2007;13(9):722-731. doi:10.1016/j.cardfail.2007.06.727.194. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Pieper K, Sun JL, Yancy C, Young JB. Association between performance measures and clinical outcomes for patients hospitalized with heart failure. JAMA. 2007;297(1):61-70. doi:10.1001/jama.297.1.61.195. Fonarow GC, Stough WG, Abraham WT, Albert NM, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Characteristics, Treatments, and Outcomes of Patients With Preserved Systolic Function Hospitalized for Heart Failure. A Report From the OPTIMIZE-HF Registry. J Am Coll Cardiol. 2007;50(8):768-777. doi:10.1016/j.jacc.2007.04.064.196. Young JB, Abraham WT, Albert NM, Gattis Stough W, Gheorghiade M, Greenberg BH, O’Connor CM, She L, Sun JL, Yancy CW, Fonarow GC. Relation of Low Hemoglobin and Anemia to Morbidity and Mortality in Patients Hospitalized With Heart Failure (Insight from the OPTIMIZE-HF Registry). Am J Cardiol. 2008;101(2):223-230. doi:10.1016/j.amjcard.2007.07.067.197. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Nunez E, Yancy CW, Young JB. Day of admission and clinical outcomes for patients hospitalized for heart failure: findings from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). Circ Heart Fail. 2008;1(1):50-57. doi:10.1161/CIRCHEARTFAILURE.107.748376.198. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Nunez E, Yancy CW, Young JB. A smoker’s paradox in patients hospitalized for heart failure: Findings from OPTIMIZE-HF. Eur Heart J. 2008;29(16):1983-1991. doi:10.1093/eurheartj/ehn210.199. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Dosing of Beta-Blocker Therapy Before, During, and After Hospitalization for Heart Failure (from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure). Am J Cardiol. 2008;102(11):1524-1529. doi:10.1016/j.amjcard.2008.07.045.200. O’Connor CM, Abraham WT, Albert NM, Clare R, Gattis Stough W, Gheorghiade M, Greenberg BH, Yancy CW, Young JB, Fonarow GC. Predictors of mortality after discharge in patients hospitalized with heart failure: An analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). Am Heart J. 2008;156(4):662-673. doi:10.1016/j.ahj.2008.04.030.201. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Influence of Beta-Blocker Continuation or Withdrawal on Outcomes in Patients Hospitalized With Heart Failure. Findings From the OPTIMIZE-HF Program. J Am Coll Cardiol. 2008;52(3):190-199. doi:10.1016/j.jacc.2008.03.048.202. Rossi JS, Flaherty JD, Fonarow GC, Nunez E, Gattis Stough W, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, Yancy CW, Young JB, Davidson CJ, Gheorghiade M. Influence of coronary artery disease and coronary revascularization status on outcomes in patients with acute heart failure syndromes: A report from OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failur. Eur J Heart Fail. 2008;10(12):1215-1223. doi:10.1016/j.ejheart.2008.09.009.203. Yancy CW, Abraham WT, Albert NM, Clare R, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, She L, Sun JL, Young JB, Fonarow GC. Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure. Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry. J Am Coll Cardiol. 2008;51(17):1675-1684. doi:10.1016/j.jacc.2008.01.028.204. Abraham WT, Fonarow GC, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure. Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). J Am Coll Cardiol. 2008;52(5):347-356. doi:10.1016/j.jacc.2008.04.028.205. Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy C, Young JB. Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF). Am J Cardiol. 2009;104(1):107-115. doi:10.1016/j.amjcard.2009.02.057.206. Hernandez AF, Hammill BG, O’Connor CM, Schulman K a., Curtis LH, Fonarow GC. Clinical Effectiveness of Beta-Blockers in Heart Failure. Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry. J Am Coll Cardiol. 2009;53(2):184-192. doi:10.1016/j.jacc.2008.09.031.207. Albert NM, Fonarow GC, Abraham WT, Gheorghiade M, Greenberg BH, Nunez E, O’Connor CM, Stough WG, Yancy CW, Young JB. Depression and Clinical Outcomes in Heart Failure: An OPTIMIZE-HF Analysis. Am J Med. 2009;122(4):366-373. doi:10.1016/j.amjmed.2008.09.046.208. Curtis LH, Greiner M a., Hammill BG, DiMartino LD, Shea AM, Hernandez AF, Fonarow GC. Representativeness of a national heart failure quality-of-care registry:Comparison of OPTIMIZE-HF and Non-OPTIMIZE-HF medicare patients. Circ Cardiovasc Qual Outcomes. 2009;2(4):377-384. doi:10.1161/CIRCOUTCOMES.108.822692.209. Flaherty JD, Rossi JS, Fonarow GC, Nunez E, Stough WG, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, Yancy CW, Young JB, Davidson CJ, Gheorghiade M. Influence of coronary angiography on the utilization of therapies in patients with acute heart failure syndromes: Findings from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). Am Heart J. 2009;157(6):1018-1025. doi:10.1016/j.ahj.2009.03.011.210. Patterson ME, Hernandez AF, Hammill BG, Fonarow GC, Peterson ED, Schulman KA, Curtis LH. Process of care performance measures and long-term outcomes in patients hospitalized with heart failure. Med Care. 2010;48(3):210-216. doi:10.1097/MLR.0b013e3181ca3eb4.211. Kociol RD, Horton JR, Fonarow GC, Reyes EM, Shaw LK, O’Connor CM, Felker GM, Hernandez AF. Admission, discharge, or change in B-type natriuretic peptide and long-term outcomes: Data from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) linked to Medicare claims. Circ Hear Fail. 2011;4(5):628-636. doi:10.1161/CIRCHEARTFAILURE.111.962290.212. Mentz RJ, Fiuzat M, Wojdyla DM, Chiswell K, Gheorghiade M, Fonarow GC, Oconnor CM. Clinical characteristics and outcomes of hospitalized heart failure patients with systolic dysfunction and chronic obstructive pulmonary disease: Findings from OPTIMIZE-HF. Eur J Heart Fail. 2012;14(4):395-403. doi:10.1093/eurjhf/hfs009.213. Patel K, Fonarow GC, Kitzman DW, Aban IB, Love TE, Allman RM, Gheorghiade M, Ahmed A. Aldosterone antagonists and outcomes in real-world older patients with heart failure and preserved ejection fraction. JACC Hear Fail. 2013;1(1):40-47. doi:10.1016/j.jchf.2012.08.001.214. Mentz RJ, Wojdyla D, Fiuzat M, Chiswell K, Fonarow GC, O’Connor CM. Association of beta-blocker use and selectivity with outcomes in patients with heart failure and chronic obstructive pulmonary disease (from OPTIMIZE-HF). Am J Cardiol. 2013;111(4):582-587. doi:10.1016/j.amjcard.2012.10.041.215. Mujib M, Patel K, Fonarow GC, Kitzman DW, Zhang Y, Aban IB, Ekundayo OJ, Love TE, Kilgore ML, Allman RM, Gheorghiade M, Ahmed A. Angiotensin-converting enzyme inhibitors and outcomes in heart failure and preserved ejection fraction. Am J Med. 2013;126(5):401-410. doi:10.1016/j.amjmed.2013.01.004.216. Patel K, Fonarow GC, Ahmed M, Morgan C, Kilgore M, Love TE, Deedwania P, Aronow WS, Anker SD, Ahmed a. Calcium Channel Blockers and Outcomes in Older Patients With Heart Failure and Preserved Ejection Fraction. Circ Hear Fail. 2014;7(6):945-952. doi:10.1161/CIRCHEARTFAILURE.114.001301.217. Chioncel O, Vinereanu D, Datcu M, Ionescu DD, Capalneanu R, Brukner I, Dorobantu M, Ambrosy A, MacArie C, Gheorghiade M. The Romanian Acute Heart Failure Syndromes (RO-AHFS) registry. Am Heart J. 2011;162(1):142-153.e1. doi:10.1016/j.ahj.2011.03.033.218. Ambrosy AP, Gheorghiade M, Bubenek S, Vinereanu D, Vaduganathan M, Macarie C, Chioncel O. The predictive value of transaminases at admission in patients hospitalized for heart failure: findings from the RO-AHFS registry. Eur Hear journal Acute Cardiovasc care. 2013;2(2):99-108. doi:10.1177/2048872612474906.219. Chioncel O, Ambrosy AP, Bubenek S, Filipescu D, Vinereanu D, Petris A, Christodorescu R, Macarie C, Gheorghiade M, Collins SP. Epidemiology, pathophysiology, and in-hospital management of pulmonary edema. J Cardiovasc Med. 2014:1. doi:10.2459/JCM.0000000000000192.220. Chioncel O, Ambrosy AP, Filipescu D, Bubenek S, Vinereanu D, Petris A, Collins SP, Macarie C, Gheorghiade M. Patterns of intensive care unit admissions in patients hospitalized for heart failure. J Cardiovasc Med. 2015;16(5):331-340. doi:10.2459/JCM.0000000000000030.221. Jonsson A, Edner M, Alehagen U, Dahlstr?m U. Heart failure registry: a valuable tool for improving the management of patients with heart failure. Eur J Heart Fail. 2010;12(1):25-31. doi:10.1093/eurjhf/hfp175.222. Eklind-Cervenka M, Benson L, Dahlstr?m U, Edner M, Rosenqvist M, Lund LH. Association of candesartan vs losartan with all-cause mortality in patients with heart failure. JAMA. 2011;305(2):175-182. doi:10.1001/jama.2010.1949.223. Lund LH, Benson L, Dahlstr?m U, Edner M. Association between use of renin-angiotensin system antagonists and mortality in patients with heart failure and preserved ejection fraction. JAMA. 2012;308(20):2108-2117. doi:10.1001/jama.2012.14785.224. Holmstr?m A, Sigurjonsdottir R, Edner M, Jonsson ?, Dahlstr?m U, Fu MLX. Increased comorbidities in heart failure patients ≥ 85 years but declined from > 90 years: Data from the Swedish Heart Failure Registry. Int J Cardiol. 2013;167(6):2747-2752. doi:10.1016/j.ijcard.2012.06.095.225. Lund LH, Svennblad B, Melhus H, Hallberg P, Dahlstr?m U, Edner M. Association of spironolactone use with all-cause mortality in heart failure a propensity scored cohort study. Circ Hear Fail. 2013;6(2):174-183. doi:10.1161/CIRCHEARTFAILURE.112.000115.226. Lund LH, Jurga J, Edner M, Benson L, Dahlstr?m U, Linde C, Alehagen U. Prevalence, correlates, and prognostic significance of QRS prolongation in heart failure with reduced and preserved ejection fraction. Eur Heart J. 2013;34(7):529-539. doi:10.1093/eurheartj/ehs305.227. Thorvaldsen T, Benson L, Hagerman I, Dahlstr?m U, Edner M, Lund LH. Planned repetitive use of levosimendan for heart failure in cardiology and internal medicine in Sweden. Int J Cardiol. 2014;175(1):55-61. doi:10.1016/j.ijcard.2014.04.243.228. Johansson I, Edner M, Dahlstrom U, Nasman P, Ryden L, Norhammar A. Is the prognosis in patients with diabetes and heart failure a matter of unsatisfactory management? An observational study from the Swedish Heart Failure Registry. Eur J Hear Fail. 2014;16(4):409-418. doi:10.1002/ejhf.44.229. Linde C, St?hlberg M, Benson L, Braunschweig F, Edner M, Dahlstr?m U, Alehagen U, Lund LH. Gender, underutilization of cardiac resynchronization therapy, and prognostic impact of QRS prolongation and left bundle branch block in heart failure. Europace. 2014;17(3):424-431. doi:10.1093/europace/euu205.230. Thorvaldsen T, Benson L, St?hlberg M, Dahlstr?m U, Edner M, Lund LH. Triage of patients with moderate to severe heart failure: Who should be referred to a heart failure center? J Am Coll Cardiol. 2014;63(7):661-671. doi:10.1016/j.jacc.2013.10.017.231. Lund LH, Benson L, St?hlberg M, Braunschweig F, Edner M, Dahlstr?m U, Linde C. Age, prognostic impact of QRS prolongation and left bundle branch block, and utilization of cardiac resynchronization therapy: findings from 14,713 patients in the Swedish Heart Failure Registry. Eur J Heart Fail. 2014;16(10):1073-1081. doi:10.1002/ejhf.162.232. Lund LH, Benson L, Dahlstr?m U, Edner M, Friberg L. Association Between Use of β-Blockers and Outcomes in Patients With Heart Failure and Preserved Ejection Fraction. JAMA. 2014;312(19):2008-2018. doi:10.1001/jama.2014.15241.233. Alehagen U, Benson L, Edner M, Dahlstr?m U, Lund LH. Association Between Use of Statins and Outcomes in Heart Failure With Reduced Ejection Fraction: A Prospective Propensity Score Matched Cohort Study of 21,864 Patients in the Swedish Heart Failure Registry. Circ Heart Fail. 2015. doi:10.1161/CIRCHEARTFAILURE.114.001730.234. Cermakova P, Lund LH, Fereshtehnejad S-M, Johnell K, Winblad B, Dahlstr?m U, Eriksdotter M, Religa D. Heart failure and dementia: survival in relation to types of heart failure and different dementia disorders. Eur J Heart Fail. 2015:1-8. doi:10.1002/ejhf.222.235. Laothavorn P, Hengrussamee K, Kanjanavanit R, Moleerergpoom W, Laorakpongse D, Pachirat O, Boonyaratavej S, Sritara P. Thai acute decompensated heart failure registry (Thai ADHERE). CVD Prev Control. 2010;5(3):89-95. doi:10.1016/j.cvdpc.2010.06.001.236. Moleerergpoom W, Hengrussamee K, Piyayotai D, Jintapakorn W, Sukhum P, Kunjara-Na-Ayudhya R, Suwanjutah T, Laothavorn P. Predictors of in-hospital mortality in acute decompensated heart failure (Thai ADHERE). J Med Assoc Thai. 2013;96(2):157-164.237. Damasceno A, Mayosi BM, Sani M, Ogah OS, Mondo C, Ojji D, Dzudie A, Kouam CK, Suliman A, Schrueder N, Yonga G, Ba SA, Maru F, Alemayehu B, Edwards C, Davison B a, Cotter G, Sliwa K. The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries. Arch Intern Med. 2012;172(18):1386-1394. doi:10.1001/archinternmed.2012.3310.238. Sliwa K, Davison B a., Mayosi BM, Damasceno A, Sani M, Ogah OS, Mondo C, Ojji D, Dzudie A, Kouam CK, Suliman A, Schrueder N, Yonga G, Ba SA, Maru F, Alemayehu B, Edwards C, Cotter G. Readmission and death after an acute heart failure event: Predictors and outcomes in sub-Saharan Africa: Results fromthe THESUS-HF registry. Eur Heart J. 2013;34(40):3151-3159. doi:10.1093/eurheartj/eht393.239. Sani MU, Davison BA, Cotter G, Sliwa K, Edwards C, Liu L, Damasceno A, Mayosi BM, Ogah OS, Mondo C, Dzudie A, Ojji DB, Voors AA. Renal dysfunction in African patients with acute heart failure. Eur J Heart Fail. 2014;16(7):718-728. doi:10.1002/ejhf.103.240. Dzudie A, Milo O, Edwards C, Cotter G, Davison B a., Damasceno A, Mayosi BM, Mondo C, Ogah O, Ojji D, Sani MU, Sliwa K. Prognostic significance of ECG abnormalities for mortality risk in acute heart failure: Insight from the Sub-Saharan Africa survey of heart failure (THESUS-HF). J Card Fail. 2014;20(1):45-52. doi:10.1016/j.cardfail.2013.11.005.241. Ogah OS, Davison B a., Sliwa K, Mayosi BM, Damasceno A, Sani MU, Mondo C, Dzudie A, Ojji DB, Kouam C, Suliman A, Schrueder N, Yonga G, Ba SA, Maru F, Alemayehu B, Edwards C, Cotter G. Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study. Clin Res Cardiol. 2015. doi:10.1007/s00392-015-0810-y.242. Green CP, Porter CB, Bresnahan DR, Spertus J a. Development and evaluation of the Kansas City cardiomyopathy questionnaire: A new health status measure for heart failure. J Am Coll Cardiol. 2000;35(5):1245-1255. doi:10.1016/S0735-1097(00)00531-3.243. Patient-Reported Outcomes Measurement Information System (PROMIS). . Patient Health Questionnaire-2 (PHQ-2). . Al-Khatib SM, Hellkamp A, Curtis J, Mark D, Peterson E, Sanders GD, Heidenreich P a, Hernandez AF, Curtis LH, Hammill S. Non-evidence-based ICD implantations in the United States. JAMA. 2011;305(1):43-49. doi:10.1001/jama.2010.1915.246. Rodriguez Y, Garisto JD, Carrillo RG. Laser lead extraction in the octogenarian patient. Circ Arrhythmia Electrophysiol. 2011;4(5):719-723. doi:10.1161/CIRCEP.111.964270.247. Tompkins C, McLean R, Cheng A, Brinker J a., Marine JE, Nazarian S, Spragg DD, Sinha S, Halperin H, Tomaselli GF, Berger RD, Calkins H, Henrikson C a. End-stage renal disease predicts complications in pacemaker and ICD implants. J Cardiovasc Electrophysiol. 2011;22(10):1099-1104. doi:10.1111/j.1540-8167.2011.02066.x.248. Bogale N, Priori S, Cleland JGF, Brugada J, Linde C, Auricchio A, Van Veldhuisen DJ, Limbourg T, Gitt A, Gras D, Stellbrink C, Gasparini M, Metra M, Derumeaux G, Gadler F, Buga L, Dickstein K. The European CRT Survey: 1 year (915 months) follow-up results. Eur J Heart Fail. 2012;14(1):61-73. doi:10.1093/eurjhf/hfr158.249. Peterson PN, Greiner MA, Qualls LG, Al-Khatib SM, Curtis JP, Fonarow GC, Hammill SC, Heidenreich PA, Hammill BG, Piccini JP, Hernandez AF, Curtis LH, Masoudi FA. QRS duration, bundle-branch block morphology, and outcomes among older patients with heart failure receiving cardiac resynchronization therapy. JAMA. 2013;310(6):617-626. doi:10.1001/jama.2013.8641.250. Alter P, Waldhans S, Plachta E, Moosdorf R, Grimm W. Complications of implantable cardioverter defibrillator therapy in 440 consecutive patients. PACE - Pacing Clin Electrophysiol. 2005;28(9):926-932. doi:10.1111/j.1540-8159.2005.00195.x.251. van Rees JB, de Bie MK, Thijssen J, Borleffs CJW, Schalij MJ, van Erven L. Implantation-related complications of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices a systematic review of randomized clinical trials. J Am Coll Cardiol. 2011;58(10):995-1000. doi:10.1016/j.jacc.2011.06.007.252. Organization WH. A Global Brief on Hypertension.; 2013.253. Organization WH. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. Geneva; 2000.254. Organization WH. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. IDF Consult. 2006.255. Organization WH. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. 2011:1-25. doi:WHO/NMH/CHP/CPM/11.1.256. Organization WH. Global Surveillance, Prevention and Control of Chronic Respiratory Diseases: A Comprehensive Approach.; 2006. doi:10.1177/1479972306070070.257. Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67(6):2089-2100. doi:10.1111/j.1523-1755.2005.00365.x.258. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci S a., Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi F a., McBride PE, McMurray JJ V, Mitchell JE, Peterson PN, Riegel B, et al. 2013 ACCF/AHA guideline for the management of heart failure: A report of the american college of cardiology foundation/american heart association task force on practice guidelines. Circulation. 2013;128(16):240-327. doi:10.1161/CIR.0b013e31829e8776.259. McMurray JJ V, Adamopoulos S, Anker SD, Auricchio A, B?hm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, K?ber L, Lip GYH, Maggioni A Pietro, Parkhomenko A, Pieske BM, Popescu B a, R?nnevik PK, Rutten FH, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart. Eur Heart J. 2012;33(14):1787-1847. doi:10.1093/eurheartj/ehs104.260. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC, Watson K, Wilson PWF. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S1-S45. doi:10.1161/01.cir.0000437738.63853.7a.261. Subramanian U, Weiner M, Gradus-Pizlo I, Wu J, Tu W, Murray MD. Patient perception and provider assessment of severity of heart failure as predictors of hospitalization. Hear Lung J Acute Crit Care. 2005;34(2):89-98. doi:10.1016/j.hrtlng.2004.05.002.262. Koifman E, Grossman E, Elis A, Dicker D, Koifman B, Mosseri M, Kuperstein R, Goldenberg I, Kamerman T, Levine-Tiefenbrun N, Klempfner R. Multidisciplinary rehabilitation program in recently hospitalized patients with heart failure and preserved ejection fraction: rationale and design of a randomized controlled trial. Am Heart J. 2014;168(6):830-7.e1. doi:10.1016/j.ahj.2014.08.010. ................
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