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Clinical outcomes according to QRS duration and morphology in the Eplerenone in Mild Patients: Hospitalization and SurvIval Study in Heart Failure (EMPHASIS-HF)
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Cannon, J. A. (author)
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Collier, T. J. (author)
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Shen, L. (author)
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- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
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Krum, H. (author)
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van Veldhuisen, D. J. (author)
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Vincent, J. (author)
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Pocock, S. J. (author)
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Pitt, B. (author)
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Zannad, F. (author)
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McMurray, J. J. V. (author)
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(creator_code:org_t)
- 2015-07-03
- 2015
- English.
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In: European Journal of Heart Failure. - : Wiley. - 1388-9842. ; 17:7, s. 707-716
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Abstract
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- AimsWe examined the relationship between different degrees of QRS prolongation and different QRS morphologies and clinical outcomes in patients with heart failure, reduced ejection fraction (HF-REF), and mild symptoms in the Eplerenone in Mild Patients Hospitalization and SurvIval Study in Heart Failure trial (EMPHASIS-HF). We also evaluated the effect of eplerenone in these patients according to QRS duration/morphology. Methods and resultsPatients were categorized as: QRS duration (ms) (i) <120 (n = 1375); (ii) 120-149 (n = 517); and (iii) 150 (n = 383), and QRS morphology (i) normal (n = 1252); (ii) left bundle branch block (BBB) (n = 608); and (iii) right BBB/intraventricular conduction defect (IVCD) (n = 415). The outcomes examined were the composite of cardiovascular death or heart failure hospitalization and all-cause mortality. Both abnormal QRS duration and QRS morphology were associated with higher risk, e.g. the rates of the composite outcome were: 10.2, 17.6, and 15.5 per 100 patient-years in the <120, 120-149, and 150ms groups, respectively. Eplerenone reduced the risk of the primary outcome and mortality, compared with placebo, consistently across the QRS duration/morphology subgroups. ConclusionWe found that even moderate prolongation of QRS duration and right BBB/IVCD were associated with a high risk of adverse outcomes in HF-REF. Eplerenone was similarly effective, irrespective of QRS duration/morphology.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Systolic heart failure
- Clinical trial
- Eplerenone
- CARDIAC-RESYNCHRONIZATION-THERAPY
- BUNDLE-BRANCH BLOCK
- TASK-FORCE
- MORTALITY
- IMPACT
- METAANALYSIS
- PREVALENCE
- GUIDELINES
- MORBIDITY
- BENEFIT
- Cardiac & Cardiovascular Systems
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Cannon, J. A.
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Collier, T. J.
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Shen, L.
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Swedberg, Karl, ...
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Krum, H.
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van Veldhuisen, ...
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show more...
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Vincent, J.
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Pocock, S. J.
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Pitt, B.
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Zannad, F.
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McMurray, J. J. ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Journal ...
- By the university
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University of Gothenburg