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Geographic Differences in Patients in a Global Acute Heart Failure Clinical Trial (from the ASCEND-HF Trial)

Författare och institution:
M. Metra (-); R. J. Mentz (-); A. F. Hernandez (-); G. M. Heizer (-); P. W. Armstrong (-); N. Clausell (-); R. Corbalan (-); M. R. Costanzo (-); K. Dickstein (-); M. E. Dunlap (-); J. A. Ezekowitz (-); J. G. Howlett (-); M. Komajda (-); H. Krum (-); C. Lombardi (-); G. C. Fonarow (-); J. J. V. McMurray (-); M. S. Nieminen (-); Karl Swedberg (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); A. A. Voors (-); R. C. Starling (-); J. R. Teerlink (-); C. M. O'Connor (-)
Publicerad i:
American Journal of Cardiology, 117 ( 11 ) s. 1771-1778
ISSN:
0002-9149
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2016
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
A growing number of countries and geographical regions are involved in major clinical trials. Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure is the largest trial in acutely decompensated heart failure (HF) with patients from 5 geographical regions: North America (NA), Latin America (LA), Western Europe (WE), Central Europe (CE), and Asia-Pacific (AP). Data from the 5 geographical, areas were compared including baseline characteristics, medications, 30-day outcomes (mortality and mortality or HF hospitalization), and 180-day mortality. Of the 7,141 study patients, 3,243 (45.4%) were from NA (average of 15.2 patients/site), 1,762 (24.7%) from AP (28.4 patients/site), 967 (13.5%) from CE (20.2 patients/site), 665 (9.3%) from LA (17.1 patients/site), and 504 (7.1%) from WE (14.4 patients/site). There were marked differences in co-morbidities, clinical profile, medication use, length of stay, 30-day event rates, and 180-day mortality by region. Compared with NA, the adjusted risk for death or HF hospitalization at 30 days was significantly lower in CE (odds ratio [OR] 0.46, 95% CI 0.33 to 0.64), WE (OR 0.52 95% CI 0.35 to 0.75), and AP (OR 0.62 95% CI 0.48 to 0:79) and numerically lower in LA (OR 0.77, 95% CI 0.57 to 1.04) with similar results for 180-day mortality. In conclusion, in patients with acutely decompensated HF, major differences in baseline characteristics, treatments, length of the hospital stay, and 30-day HF rehospitalization rates, and 180-day mortality were found in patients enrolled from different, geographical areas. (C) 2016 Elsevier Inc. All rights reserved.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Kardiologi ->
Kardiovaskulär medicin
Nyckelord:
acute myocardial-infarction, international differences, readmission, rates, outcomes, management, nesiritide, globalization, clopidogrel, ticagrelor, countries, Cardiovascular System & Cardiology
Postens nummer:
238309
Posten skapad:
2016-06-27 10:50
Posten ändrad:
2016-06-27 10:51

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