Search: onr:"swepub:oai:gup.ub.gu.se/255565" >
Declining Risk of S...
Declining Risk of Sudden Death in Heart Failure
-
Shen, L. (author)
-
Jhund, P. S. (author)
-
Petrie, M. C. (author)
-
show more...
-
Claggett, B. L. (author)
-
Barlera, S. (author)
-
Cleland, J. G. F. (author)
-
Dargie, H. J. (author)
-
Granger, C. B. (author)
-
Kjekshus, J. (author)
-
Kober, L. (author)
-
Latini, R. (author)
-
Maggioni, A. P. (author)
-
Packer, M. (author)
-
Pitt, B. (author)
-
Solomon, S. D. (author)
-
- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
-
Tavazzi, L. (author)
-
- Wikstrand, John, 1938 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
-
Zannad, F. (author)
-
Zile, M. R. (author)
-
McMurray, J. J. V. (author)
-
show less...
-
(creator_code:org_t)
- 2017
- 2017
- English.
-
In: New England Journal of Medicine. - 0028-4793. ; 377:1, s. 41-51
- Related links:
-
https://gup.ub.gu.se...
-
show more...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- BACKGROUND The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, and mineralocorticoid-receptor antagonists. We sought to examine this trend in detail. We analyzed data from 40,195 patients who had heart failure with reduced ejection fraction and were enrolled in any of 12 clinical trials spanning the period from 1995 through 2014. Patients who had an implantable cardioverter-defibrillator at the time of trial enrollment were excluded. Weighted multivariable regression was used to examine trends in rates of sudden death over time. Adjusted hazard ratios for sudden death in each trial group were calculated with the use of Cox regression models. The cumulative incidence rates of sudden death were assessed at different time points after randomization and according to the length of time between the diagnosis of heart failure and randomization. Sudden death was reported in 3583 patients. Such patients were older and were more often male, with an ischemic cause of heart failure and worse cardiac function, than those in whom sudden death did not occur. There was a 44% decline in the rate of sudden death across the trials (P = 0.03). The cumulative incidence of sudden death at 90 days after randomization was 2.4% in the earliest trial and 1.0% in the most recent trial. The rate of sudden death was not higher among patients with a recent diagnosis of heart failure than among those with a longer-standing diagnosis. Rates of sudden death declined substantially over time among ambulatory patients with heart failure with reduced ejection fraction who were enrolled in clinical trials, a finding that is consistent with a cumulative benefit of evidence-based medications on this cause of death. (Funded by the China Scholarship Council and the University of Glasgow.)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- implantable cardioverter-defibrillator
- ventricular systolic
- dysfunction
- converting-enzyme inhibitors
- randomized controlled-trials
- cardiac death
- myocardial-infarction
- metaanalysis
- candesartan
- prevention
- mortality
- General & Internal Medicine
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Shen, L.
-
Jhund, P. S.
-
Petrie, M. C.
-
Claggett, B. L.
-
Barlera, S.
-
Cleland, J. G. F ...
-
show more...
-
Dargie, H. J.
-
Granger, C. B.
-
Kjekshus, J.
-
Kober, L.
-
Latini, R.
-
Maggioni, A. P.
-
Packer, M.
-
Pitt, B.
-
Solomon, S. D.
-
Swedberg, Karl, ...
-
Tavazzi, L.
-
Wikstrand, John, ...
-
Zannad, F.
-
Zile, M. R.
-
McMurray, J. J. ...
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
- Articles in the publication
-
New England Jour ...
- By the university
-
University of Gothenburg