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Relationship betwee...
Relationship between duration of heart failure, patient characteristics, outcomes, and effect of therapy in PARADIGM-HF
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Yeoh, S. E. (författare)
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Dewan, P. (författare)
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Desai, A. S. (författare)
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Solomon, S. D. (författare)
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Rouleau, J. L. (författare)
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Lefkowitz, M. (författare)
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Rizkala, A. (författare)
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- Swedberg, Karl, 1944 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Zile, M. R. (författare)
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Jhund, P. S. (författare)
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Packer, M. (författare)
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McMurray, J. J. V. (författare)
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(creator_code:org_t)
- 2020-10-19
- 2020
- Engelska.
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Ingår i: Esc Heart Failure. - : Wiley. - 2055-5822.
- Relaterad länk:
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https://onlinelibrar...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Aims Little is known about patient characteristics, outcomes, and the effect of treatment in relation to duration of heart failure (HF). We have investigated these questions in PARADIGM-HF. The aim of the study was to compare patient characteristics, outcomes, and the effect of sacubitril/valsartan, compared with enalapril, in relation to time from HF diagnosis in PARADIGM-HF. Methods and results HF duration was categorized as 0-1, >1-2, >2-5, and >5 years. Outcomes were adjusted for prognostic variables, including N-terminal pro-brain natriuretic peptide (NT-proBNP). The primary endpoint was the composite of HF hospitalization or cardiovascular death. The number of patients in each group was as follows: 0-1 year, 2523 (30%); >1-2 years, 1178 (14%); >2-5 years, 2054 (24.5%); and >5 years, 2644 (31.5%). Patients with longer-duration HF were older, more often male, and had worse New York Heart Association class and quality of life, more co-morbidity, and higher troponin-T but similar NT-proBNP levels. The primary outcome rate (per 100 person-years) increased with HF duration: 0-1 year, 8.4 [95% confidence interval (CI) 7.6-9.2]; >1-2 years, 11.2 (10.0-12.7); >2-5 years, 13.4 (12.4-14.6); and >5 years, 14.2 (13.2-15.2);P < 0.001. The hazard ratio was 1.26 (95% CI 1.07-1.48), 1.52 (1.33-1.74), and 1.53 (1.33-1.75), respectively, for >1-2, >2-5, and >5 years, compared with 0-1 year. The benefit of sacubitril/valsartan was consistent across HF duration for all outcomes, with the primary endpoint hazard ratio 0.80 (95% CI 0.67-0.97) for 0-1 year and 0.73 (0.63-0.84) in the >5 year group. For the primary outcome, the number needed to treat for >5 years was 18, compared with 29 for 0-1 year. Conclusions Patients with longer-duration HF had more co-morbidity, worse quality of life, and higher rates of HF hospitalization and death. The benefit of a neprilysin inhibitor was consistent, irrespective of HF duration. Switching to sacubitril/valsartan had substantial benefits, even in patients with long-standing HF.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Heart failure
- Duration
- Sacubitril
- valsartan
- Outcomes
- natriuretic-peptide
- risk
- sacubitril/valsartan
- enalapril
- mortality
- health
- Cardiovascular System & Cardiology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Yeoh, S. E.
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Dewan, P.
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Desai, A. S.
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Solomon, S. D.
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Rouleau, J. L.
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Lefkowitz, M.
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visa fler...
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Rizkala, A.
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Swedberg, Karl, ...
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Zile, M. R.
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Jhund, P. S.
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Packer, M.
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McMurray, J. J. ...
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visa färre...
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- MEDICIN OCH HÄLSOVETENSKAP
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Göteborgs universitet