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Worse prognosis of real-world patients with acute heart failure from the Czech AHEAD registry in comparison to patients from the RELAX-AHF trial

. 2017 Feb ; 4 (1) : 8-15. [epub] 20160917

Status PubMed-not-MEDLINE Language English Country England, Great Britain Media print-electronic

Document type Journal Article

Persistent link   https://www.medvik.cz/link/pmid28217307

AIMS: The randomized clinical trial RELAX-AHF demonstrated a positive effect of vasodilator therapy with serelaxin in the treatment of AHF patients. The aim of our study was to compare clinical characteristics and outcomes of patients from the AHEAD registry who met criteria of the RELAX-AHF trial (relax-comparable group) with the same characteristics and outcomes of patients from the AHEAD registry who did not meet those criteria (relax-non-comparable group), and finally with characteristics and outcomes of patients from the RELAX-AHF trial. METHODS AND RESULTS: A total of 5856 patients from the AHEAD registry (Czech registry of AHF) were divided into two groups according to RELAX-AHF criteria: relax-comparable (n = 1361) and relax-non-comparable (n = 4495). As compared with the relax-non-comparable group, patients in the relax-comparable group were older, had higher levels of systolic and diastolic blood pressure, lower creatinine clearance, and a higher number of comorbidities. Relax-comparable patients also had significantly lower short-term as well as long-term mortality rates in comparison to relax-non-comparable patients, but a significantly higher mortality rate in comparison to the placebo group of patients from the RELAX-AHF trial. Using AHEAD score, we have identified higher-risk patients from relax-comparable group who might potentially benefit from new therapeutic approaches in the future. CONCLUSIONS: Only about one in five of all evaluated patients met criteria for the potential treatment with the new vasodilator serelaxin. AHF patients from the real clinical practice had a higher mortality when compared with patients from the randomized clinical trial.

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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 Lond Engl 2011; 15: R291. PubMed PMC

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 Failure)*. Eur J Heart Fail 2008; 10: 1215–1223. PubMed

Siirilä‐Waris K, Lassus J, Melin J, Peuhkurinen K, Nieminen MS, Harjola V‐P. Characteristics, outcomes, and predictors of 1‐year mortality in patients hospitalized for acute heart failure. Eur Heart J 2006; 27: 3011–3017. PubMed

Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola V‐P, 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: 2725–2736. PubMed

Mebazaa A, Yilmaz MB, Levy P, Ponikowski P, Peacock WF, Laribi S, Ristic AD, Lambrinou E, Masip J, Riley JP, McDonagh T, Mueller C, deFilippi C, Harjola V‐P, Thiele H, Piepoli MF, Metra M, Maggioni A, McMurray JJV, Dickstein K, Damman K, Seferovic PM, Ruschitzka F, Leite‐Moreira AF, Bellou A, Anker SD, Filippatos G. Recommendations on pre‐hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emerg…. Eur Heart J 2015; 36: 1958–1966. PubMed

Peacock WF, Emerman C, Costanzo MR, Diercks DB, Lopatin M, Fonarow GC. Early vasoactive drugs improve heart failure outcomes. Congest Heart Fail 2009; 15: 256–264. PubMed

Sharon A, Shpirer I, Kaluski E, Moshkovitz Y, Milovanov O, Polak R, Blatt A, Simovitz A, Shaham O, Faigenberg Z, Metzger M, Stav D, Yogev R, Golik A, Krakover R, Vered Z, Cotter G. High‐dose intravenous isosorbide‐dinitrate is safer and better than Bi‐PAP ventilation combined with conventional treatment for severe pulmonary edema. J Am Coll Cardiol 2000; 36: 832–837. PubMed

Teerlink JR, Cotter G, Davison BA, Felker GM, Filippatos G, Greenberg BH, Ponikowski P, Unemori E, Voors AA, Adams KF Jr, Dorobantu MI, Grinfeld LR, Jondeau G, Marmor A, Masip J, Pang PS, Werdan K, Teichman SL, Trapani A, Bush CA, Saini R, Schumacher C, Severin TM, Metra M. Serelaxin, recombinant human relaxin‐2, for treatment of acute heart failure (RELAX‐AHF): a randomised, placebo‐controlled trial. Lancet 5; 381: 29–39. PubMed

Cleland JG, Teerlink JR, Senior R, Nifontov EM, Mc Murray JJ, Lang CC, Tsyrlin VA, Greenberg BH, Mayet J, Francis DP, Shaburishvili T, Monaghan M, Saltzberg M, Neyses L, Wasserman SM, Lee JH, Saikali KG, Clarke CP, Goldman JH, Wolff AA, Malik FI. The effects of the cardiac myosin activator, omecamtiv mecarbil, on cardiac function in systolic heart failure: a double‐blind, placebo‐controlled, crossover, dose‐ranging phase 2 trial. Lancet 2011; 378: 676–683. PubMed

Peacock WF, Chandra A, Char D, Collins S, Der Sahakian G, Ding L, Dunbar L, Fermann G, Fonarow GC, Garrison N, Hu M, Jourdain P, Laribi S, Levy P, Möckel M, Mueller C, Ray P, Singer A, Ventura H, Weiss M, Mebazaa A. Clevidipine in acute heart failure: results of the A Study of Blood Pressure Control in Acute Heart Failure—A Pilot Study (PRONTO). Am Heart J 2014; 167: 529–536. PubMed

Anker SD, Ponikowski P, Mitrovic V, Peacock WF, Filippatos G. Ularitide for the treatment of acute decompensated heart failure: from preclinical to clinical studies. Eur Heart J 2015; 36: 715–723. PubMed PMC

Pitt B, Anker SD, Böhm M, Gheorghiade M, Køber L, Krum H, Maggioni AP, Ponikowski P, Voors AA, Zannad F, Nowack C, Kim S‐Y, Pieper A, Kimmeskamp‐Kirschbaum N, Filippatos G. Rationale and design of MinerAlocorticoid Receptor antagonist Tolerability Study‐Heart Failure (ARTS‐HF): a randomized study of finerenone vs. eplerenone in patients who have worsening chronic heart failure with diabetes and/or chronic kidney disease. Eur J Heart Fail 2015; 17: 224–232. PubMed

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, Dušek 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: 151–160. PubMed

Spinar J, Jarkovsky J, Spinarova L, Mebazaa A, Gayat E, Vitovec J, Linhart A, Widimsky P, Miklik R, Zeman K, Belohlavek J, Malek F, Felsoci M, Kettner J, Ostadal P, Cihalik C, Vaclavik J, Taborsky M, Dusek L, Littnerova S, Parenica J. AHEAD score–Long‐term risk classification in acute heart failure. Int J Cardiol 2016; 202: 21–26. PubMed

Nieminen MS, Böhm M, Cowie MR, Drexler H, Filippatos GS, Jondeau G, Hasin Y, Lopez‐Sendon J, Mebazaa A, Metra M, Rhodes A, Swedberg K, Priori SG, Garcia MA, Blanc JJ, Budaj A, Dean V, Deckers J, Burgos EF, Lekakis J, Lindahl B, Mazzotta G, Morais J, Oto A, Smiseth OA, Dickstein K, Albuquerque A, Conthe P, Crespo‐Leiro M, Ferrari R, Follath F, Gavazzi A, Janssens U, Komajda M, Moreno R, Singer M, Singh S, Tendera M, Thygesen K; ESC Committe for Practice Guideline (CPG) . Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J 2005; 26: 384–416. PubMed

Mebazaa A, Parissis J, Porcher R, Gayat E, Nikolaou M, Boas F, 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: 290–301. PubMed

O'Connor CM, Starling RC, Hernandez AF, Armstrong PW, Dickstein K, Hasselblad V, Heizer GM, Komajda M, Massie BM, McMurray JJ, Nieminen MS, Reist CJ, Rouleau JL, Swedberg K, Adams KF Jr, Anker SD, Atar D, Battler A, Botero R, Bohidar NR, Butler J, Clausell N, Corbalán R, Costanzo MR, Dahlstrom U, Deckelbaum LI, Diaz R, Dunlap ME, Ezekowitz JA, Feldman D, Felker GM, Fonarow GC, Gennevois D, Gottlieb SS, Hill JA, Hollander JE, Howlett JG, Hudson MP, Kociol RD, Krum H, Laucevicius A, Levy WC, Méndez GF, Metra M, Mittal S, Oh BH, Pereira NL, Ponikowski P, Tang WH, Tanomsup S, Teerlink JR, Triposkiadis F, Troughton RW, Voors AA, Whellan DJ, Zannad F, Califf RM. Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med 2011; 365: 32–43. PubMed

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: 347–356. DOI:10.1016/j.jacc.2008.04.028. PubMed DOI

Miró Ò, Gil V, Müller C, Mebazaa A, Bueno H, Martín‐Sánchez F, Herrero P, Jacob J, Llorens P. How does a clinical trial fit into the real world? The RELAX‐AHF study population into the EAHFE registry. Clin Res Cardiol 2015; 104: 850–860. PubMed

Wang TS, Hellkamp AS, Patel CB, Ezekowitz JA, Fonarow GC, Hernandez AF. Representativeness of RELAX‐AHF Clinical Trial Population in Acute Heart Failure. Circ Cardiovasc Qual Outcomes 2014; 7: 259–268. PubMed

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