Contemporary outpatient management of patients with worsening heart failure with reduced ejection fraction: Clinical outcome results from the CHART-HF study.

Clinical outcomes Heart failure with reduced ejection fraction Real-world evidence Worsening heart failure event

Journal

International journal of cardiology. Cardiovascular risk and prevention
ISSN: 2772-4875
Titre abrégé: Int J Cardiol Cardiovasc Risk Prev
Pays: Netherlands
ID NLM: 9918282077306676

Informations de publication

Date de publication:
Jun 2024
Historique:
received: 10 11 2023
revised: 15 03 2024
accepted: 02 05 2024
medline: 20 5 2024
pubmed: 20 5 2024
entrez: 20 5 2024
Statut: epublish

Résumé

Based on available data from randomized clinical trials, patients with heart failure with reduced ejection fraction (HFrEF) and worsening HF events (WHFE) have substantial disease burden and poor outcomes. WHFE clinical outcome data in non-clinical trial patients, more representative of the US clinical practice, has not been demonstrated. CHART-HF collected data from two complementary, non-clinical trial cohort with HFrEF (LVEF <45 %): 1) 1,000 patients from an integrated delivery network and 2) 458 patients from a nationwide physician panel. CHART-HF included patients with WHFE between 2017 and 2019 followed by an index outpatient cardiology visit ≤6 months, and patients without WHFE in a given year between 2017 and 2019, with the last outpatient cardiology visit in the same year as the index visit. Compared to patients without WHFE (after covariate adjustment, all p < 0.05), patients with WHFE had a greater risk of HF-related hospitalization (hazard ratio [HR]: 1.53-2.40) and next WHFE event (HR: 1.67-2.41) following index visits in both cohorts. HFrEF patients with recent WHFE consistently had worse clinical outcomes in these non-clinical trial cohorts. Despite advances in therapies, unmet need to improve clinical outcomes in HFrEF patients with WHFE remains.

Sections du résumé

Background UNASSIGNED
Based on available data from randomized clinical trials, patients with heart failure with reduced ejection fraction (HFrEF) and worsening HF events (WHFE) have substantial disease burden and poor outcomes. WHFE clinical outcome data in non-clinical trial patients, more representative of the US clinical practice, has not been demonstrated.
Methods and results UNASSIGNED
CHART-HF collected data from two complementary, non-clinical trial cohort with HFrEF (LVEF <45 %): 1) 1,000 patients from an integrated delivery network and 2) 458 patients from a nationwide physician panel. CHART-HF included patients with WHFE between 2017 and 2019 followed by an index outpatient cardiology visit ≤6 months, and patients without WHFE in a given year between 2017 and 2019, with the last outpatient cardiology visit in the same year as the index visit. Compared to patients without WHFE (after covariate adjustment, all p < 0.05), patients with WHFE had a greater risk of HF-related hospitalization (hazard ratio [HR]: 1.53-2.40) and next WHFE event (HR: 1.67-2.41) following index visits in both cohorts.
Conclusion UNASSIGNED
HFrEF patients with recent WHFE consistently had worse clinical outcomes in these non-clinical trial cohorts. Despite advances in therapies, unmet need to improve clinical outcomes in HFrEF patients with WHFE remains.

Identifiants

pubmed: 38766664
doi: 10.1016/j.ijcrp.2024.200278
pii: S2772-4875(24)00043-6
pmc: PMC11101901
doi:

Types de publication

Journal Article

Langues

eng

Pagination

200278

Informations de copyright

© 2024 Published by Elsevier B.V.

Auteurs

Hanna K Gaggin (HK)

Harvard Medical School, Boston, MA, USA.
Cardiology Division, Massachusetts General Hospital, Boston, MA, USA.

Stephen J Greene (SJ)

Duke Clinical Research Institute, Durham, NC, USA.
Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.

Mo Zhou (M)

Analysis Group, Inc., Boston, MA, USA.

Dominik Lautsch (D)

Merck & Co., Inc., Rahway, NJ, USA.

Lori D Bash (LD)

Merck & Co., Inc., Rahway, NJ, USA.

Laurence Djatche (L)

Merck & Co., Inc., Rahway, NJ, USA.

Yan Song (Y)

Analysis Group, Inc., Boston, MA, USA.

James Signorovitch (J)

Analysis Group, Inc., Boston, MA, USA.

Andra S Stevenson (AS)

Merck & Co., Inc., Rahway, NJ, USA.

Robert O Blaustein (RO)

Merck & Co., Inc., Rahway, NJ, USA.

Javed Butler (J)

Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
Baylor Scott and White Research Institute, Dallas, TX, USA.

Classifications MeSH