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      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 collaborati

      1 , 2 , 3 , 4 , 3 , 5 , 4 , 2 , 6 , 7 , 8 , 9 , 1 ,   10 , 11 , 12 , 13 , 5 , 14 , 4 , 15 , 16 , 4 , 14 , 17 , 3 , 14 , 3 , 10 , 17 , 1 , 18 , 17 , 19 , 14 , 3 , 1 , 20 , 18 , 1 , 17 , 13 , 21 , 3 , 5 , 16 , 16 , 17 , 4 , 1 , 3 , 7 , 22 , 23 , 10 , 7 , 1 , 1 , 1 , 8 , 10 , 1 , 17 , 24 , 4 , 2 , 9 , 5 , 2 , 16 , Authors/Task Force Members, ESC Committee for Practice Guidelines (CPG), Document Reviewers

      European Journal of Heart Failure

      Oxford University Press (OUP)

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          Guidelines on myocardial revascularization.

           W Wijns,  P Kolh,  N Danchin (2010)
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            Cardiac-resynchronization therapy for the prevention of heart-failure events.

            This trial was designed to determine whether cardiac-resynchronization therapy (CRT) with biventricular pacing would reduce the risk of death or heart-failure events in patients with mild cardiac symptoms, a reduced ejection fraction, and a wide QRS complex. During a 4.5-year period, we enrolled and followed 1820 patients with ischemic or nonischemic cardiomyopathy, an ejection fraction of 30% or less, a QRS duration of 130 msec or more, and New York Heart Association class I or II symptoms. Patients were randomly assigned in a 3:2 ratio to receive CRT plus an implantable cardioverter-defibrillator (ICD) (1089 patients) or an ICD alone (731 patients). The primary end point was death from any cause or a nonfatal heart-failure event (whichever came first). Heart-failure events were diagnosed by physicians who were aware of the treatment assignments, but they were adjudicated by a committee that was unaware of assignments. During an average follow-up of 2.4 years, the primary end point occurred in 187 of 1089 patients in the CRT-ICD group (17.2%) and 185 of 731 patients in the ICD-only group (25.3%) (hazard ratio in the CRT-ICD group, 0.66; 95% confidence interval [CI], 0.52 to 0.84; P=0.001). The benefit did not differ significantly between patients with ischemic cardiomyopathy and those with nonischemic cardiomyopathy. The superiority of CRT was driven by a 41% reduction in the risk of heart-failure events, a finding that was evident primarily in a prespecified subgroup of patients with a QRS duration of 150 msec or more. CRT was associated with a significant reduction in left ventricular volumes and improvement in the ejection fraction. There was no significant difference between the two groups in the overall risk of death, with a 3% annual mortality rate in each treatment group. Serious adverse events were infrequent in the two groups. CRT combined with ICD decreased the risk of heart-failure events in relatively asymptomatic patients with a low ejection fraction and wide QRS complex. (ClinicalTrials.gov number, NCT00180271.) 2009 Massachusetts Medical Society
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              Irbesartan in patients with heart failure and preserved ejection fraction.

              Approximately 50% of patients with heart failure have a left ventricular ejection fraction of at least 45%, but no therapies have been shown to improve the outcome of these patients. Therefore, we studied the effects of irbesartan in patients with this syndrome. We enrolled 4128 patients who were at least 60 years of age and had New York Heart Association class II, III, or IV heart failure and an ejection fraction of at least 45% and randomly assigned them to receive 300 mg of irbesartan or placebo per day. The primary composite outcome was death from any cause or hospitalization for a cardiovascular cause (heart failure, myocardial infarction, unstable angina, arrhythmia, or stroke). Secondary outcomes included death from heart failure or hospitalization for heart failure, death from any cause and from cardiovascular causes, and quality of life. During a mean follow-up of 49.5 months, the primary outcome occurred in 742 patients in the irbesartan group and 763 in the placebo group. Primary event rates in the irbesartan and placebo groups were 100.4 and 105.4 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% confidence interval [CI], 0.86 to 1.05; P=0.35). Overall rates of death were 52.6 and 52.3 per 1000 patient-years, respectively (hazard ratio, 1.00; 95% CI, 0.88 to 1.14; P=0.98). Rates of hospitalization for cardiovascular causes that contributed to the primary outcome were 70.6 and 74.3 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% CI, 0.85 to 1.08; P=0.44). There were no significant differences in the other prespecified outcomes. Irbesartan did not improve the outcomes of patients with heart failure and a preserved left ventricular ejection fraction. (ClinicalTrials.gov number, NCT00095238.) 2008 Massachusetts Medical Society
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                Author and article information

                Journal
                European Journal of Heart Failure
                European Journal of Heart Failure
                Oxford University Press (OUP)
                13889842
                August 2012
                August 2012
                February 18 2014
                : 14
                : 8
                : 803-869
                Affiliations
                [1 ]UK
                [2 ]Greece
                [3 ]Germany
                [4 ]Switzerland
                [5 ]Norway
                [6 ]Portugal
                [7 ]Spain
                [8 ]Sweden
                [9 ]Denmark
                [10 ]Italy
                [11 ]Ukraine
                [12 ]Austria
                [13 ]Romania
                [14 ]The Netherlands
                [15 ]Serbia
                [16 ]Poland
                [17 ]France
                [18 ]Belgium
                [19 ]Israel
                [20 ]Finland
                [21 ]Croatia
                [22 ]Cyprus
                [23 ]Libya
                [24 ]Hungary
                Article
                10.1093/eurjhf/hfs105
                22828712
                © 2014
                Product

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