International Geographic Variation in Event Rates in Trials of Heart Failure With Preserved and Reduced Ejection Fraction
| العنوان: | International Geographic Variation in Event Rates in Trials of Heart Failure With Preserved and Reduced Ejection Fraction |
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| المؤلفون: | Michael R. Zile, Scott D. Solomon, Salim Yusuf, Pardeep S. Jhund, John Kjekshus, Karl Swedberg, Hans Wedel, John J.V. McMurray, Lars Køber, Marc A. Pfeffer, John Wikstrand, Peter E. Carson, Søren Lund Kristensen, Michel Komajda, Christopher B. Granger, Robert S. McKelvie |
| المصدر: | Circulation. 131:43-53 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, Canada, medicine.medical_specialty, animal structures, Ventricular Ejection Fraction, Tetrazoles, Geographic variation, Russia, Irbesartan, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, Rosuvastatin, Rosuvastatin Calcium, Intensive care medicine, Aged, Aged, 80 and over, Heart Failure, Sulfonamides, Ejection fraction, Geography, business.industry, Biphenyl Compounds, Stroke Volume, Middle Aged, medicine.disease, mortality, United States, Europe, Fluorobenzenes, Hospitalization, Clinical trial, Candesartan, Pyrimidines, Treatment Outcome, Heart failure, ventricular ejection fraction, Cardiology, Benzimidazoles, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business, Angiotensin II Type 1 Receptor Blockers, medicine.drug |
| الوصف: | Background— International geographic differences in outcomes may exist for clinical trials of heart failure and reduced ejection fraction (HF-REF), but there are few data for those with preserved ejection fraction (HF-PEF). Methods and Results— We analyzed outcomes by international geographic region in the Irbesartan in Heart Failure with Preserved systolic function trial (I-Preserve), the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM)-Preserved trial, the CHARM-Alternative and CHARM–Added HF-REF trials, and the Controlled Rosuvastatin Multinational Trial in HF-REF (CORONA). Crude rates of heart failure hospitalization varied by geographic region, and more so for HF-PEF than for HF-REF. Rates in patients with HF-PEF were highest in the United States/Canada (HF hospitalization rate 7.6 per 100 patient-years in I-Preserve; 8.8 in CHARM-Preserved), intermediate in Western Europe (4.8/100 and 4.7/100), and lowest in Eastern Europe/Russia (3.3/100 and 2.8/100). The difference between the United States/Canada versus Eastern Europe/Russia persisted after adjustment for key prognostic variables: adjusted hazard ratios 1.34 (95% confidence interval, 1.01–1.74; P =0.04) in I-Preserve and 1.85 (95% confidence interval, 1.17–2.91; P =0.01) in CHARM-Preserved. In HF-REF, rates of HF hospitalization were slightly lower in Western Europe compared with other regions. For both HF-REF and HF-PEF, there were few regional differences in rates of all-cause or cardiovascular mortality. Conclusions— The differences in event rates observed suggest there is international geographic variation in 1 or more of the definition and diagnosis of HF-PEF, the risk profile of patients enrolled, and the threshold for hospitalization, which has implications for the conduct of future global trials. |
| وصف الملف: | application/pdf |
| تدمد: | 1524-4539 0009-7322 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a78feb3ad0456bfe95d4739548b3f99c https://doi.org/10.1161/circulationaha.114.012284 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....a78feb3ad0456bfe95d4739548b3f99c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244539 00097322 |
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