Most hospitalized older persons do not meet the enrollment criteria for clinical trials in heart failure
American Heart JournalPublished 30 July 2003
Frederick A. Masoudi, Edward P. Havranek, Pam Wolfe, Cary P. Gross, Saif S. Rathore, John F. Steiner
Citations339
SJR quartileQ1
SJR score2.04
SNIP1.18
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
There is an urgent need for research in heart failure for typical heart failure patients, including the very old, women, and patients with preserved left ventricular systolic function.
Abstract
A minority of hospitalized older persons with heart failure fit the profile of populations of clinical trials. There is an urgent need for research in heart failure for typical heart failure patients, including the very old, women, and patients with preserved left ventricular systolic function.
Keywords
Medicine
New England Journal of MedicineThe Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure
8,985 Citations1999Bertram Pitt, Faı̈ez Zannad +6 more
Blockade of aldosterone receptors by spironolactone, in addition to standard therapy, substantially reduces the risk of both morbidity and death among patients with severe heart failure.
New England Journal of MedicineEffect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure
8,006 Citations1991The SOLVD Investigators*
The addition of enalapril to conventional therapy significantly reduced mortality and hospitalizations for heart failure in patients with chronic congestive heart failure and reduced ejection fractions.
The LancetEffect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in-Congestive Heart Failure (MERIT-HF)
5,122 Citations1999
Metoprolol controlled release/extended release (CR/XL) once daily in addition to standard therapy improved survival and the drug was well tolerated.
New England Journal of MedicineEffects of Enalapril on Mortality in Severe Congestive Heart Failure
5,077 Citations1987The Consensus Trial Study Group*
It is concluded that the addition of enalapril to conventional therapy in patients with severe congestive heart failure can reduce mortality and improve symptoms and a significant improvement in NYHA classification was observed in the enAlapril group.
The American Journal of CardiologyEffects of enalapril on mortality in severe congestive heart failure: Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS)
3,778 Citations1988Karl Swedberg, John Kjekshus
The addition of enalapril to conventional therapy in patients with severe congestive heart failure can reduce mortality and improve symptoms, and the effect seems to be due to a reduction in death from progression of heart failure.
New England Journal of MedicineThe Natural History of Congestive Heart Failure: The Framingham Study
3,478 Citations1971Patrick A. McKee, William P. Castelli +2 more
The natural history of congestive heart failure was studied over a 16-year period in 5192 persons initially free of the disease, finding that in almost every five-year age group, from 30 to 62 years, the incidence rate was greater for men than for women.
New England Journal of MedicineUnderrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials
2,177 Citations1999Laura F. Hutchins, Joseph M. Unger +3 more
There is substantial under representation of patients 65 years of age or older in studies of treatment for cancer, and the reasons should be clarified, and policies adopted to correct this underrepresentation.
Journal of the American College of CardiologyCongestive heart failure in subjects with normal versus reduced left ventricular ejection fraction
1,338 Citations1999Ramachandran S. Vasan, Martin G Larson, ScD +4 more
Although CHF cases with normal LVEF have a lower mortality risk than cases with reduced LVEF, they have a fourfold mortality risk compared with control subjects who are free of CHF.
CirculationCongestive Heart Failure in the Community
1,091 Citations1998Michele Senni, Christophe M Tribouilloy +5 more
CHF is a disease of the "very elderly," frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function.
CirculationA randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). CIBIS Investigators and Committees.
1,061 Citations1994
These results confirm previous trials evidence that a progressively increasing dose of beta-blocker in severe heart failure confers functional benefit, and suggest that benefit frombeta-blockade therapy was greater for those with nonischemic cardiomyopathy.
JAMARepresentation of Elderly Persons and Women in Published Randomized Trials of Acute Coronary Syndromes
845 Citations2001Patrick Y. Lee
Women and elderly persons remain underrepresented in published trial literature relative to their disease prevalence because safety and efficacy can vary as a function of sex and age, and these enrollment biases undermine efforts to provide evidence-based care to all cardiac patients.
Archives of Internal MedicineReadmission After Hospitalization for Congestive Heart Failure Among Medicare Beneficiaries
815 Citations1997Harlan M. Krumholz
Readmission after a hospitalization for congestive heart failure is common among Medicare beneficiaries, with almost half of the patients readmitted within 6 months, a striking rate of readmission in a common diagnosis.
JAMAImproving the Quality of Care for Medicare Patients With Acute Myocardial Infarction
500 Citations1998Thomas A. Marciniak, Edward F. Ellerbeck +8 more
The quality of care for Medicare patients with acute myocardial infarction has improved in the Cooperative Cardiovascular Project pilot states and was associated with reduced mortality.
JAMAThe Exclusion of the Elderly and Women From Clinical Trials in Acute Myocardial Infarction
499 Citations1992Jerry H. Gurwitz
To determine the extent to which the elderly have been excluded from trials of drug therapies used in the treatment of acute myocardial infarction, to identify factors associated with such exclusions, and to explore the relationship between the exclusion of elderly and the representation of women, a systematic search of the English-language literature was conducted.
New England Journal of MedicineEnrollment of Women in Cardiovascular Clinical Trials Funded by the National Heart, Lung, and Blood Institute
255 Citations2000D. James Harris, Pamela S. Douglas
Archives of Internal MedicineHeart Failure Survival Among Older Adults in the United States
240 Citations1999Janet B. Croft, Wayne H. Giles +4 more
The prognosis for older adults with heart failure underscores the importance of prevention strategies and early detection and treatment modalities that can prevent, improve, or reverse myocardial dysfunction, particularly for the growing number of adults who are at increased risk for developing heart failure because of hypertension, diabetes, ormyocardial infarction.
Archives of Internal MedicineCongestive Heart Failure in the United States
223 Citations2000David C. Goff, Dilip K. Pandey +3 more
Reliance on ICD codes results in the exclusion of one third of the patients with clinical evidence of acute CHF and the allocation of resources for relevant surveillance, research, medical care, and preventive efforts should be reevaluated.
New England Journal of MedicineThe Natural History of Congestive Heart Failure
191 Citations1971David Littmann
Heart Failure ReviewsThe Burden of Chronic Congestive Heart Failure in Older Persons: Magnitude and Implications for Policy and Research
134 Citations2002Frederick A. Masoudi, Edward P. Havranek +1 more
This review highlights the importance of heart failure in the older population and identifies the specific areas where research and policy initiatives may be instrumental in reducing the impact of the condition.
CirculationNorepinephrine Stores and Contractile Force of Papillary Muscle from the Failing Human Heart
111 Citations1966Charles A. Chidsey, Edmund H. Sonnenblick +2 more
It is concluded that norepinephrine depletion appears to be associated with defective myocardial function although no causal relationship between these two abnormalities has been established.
Proceedings of the Royal Society of MedicineThe Adrenergic Nervous System in the Control of the Normal and Failing Heart
33 Citations1965Eugene Braunwald, Charles A. Chidsey
The cardiac output was found to be normal at rest in intact, conscious dogs which had previously been subjected to total extrinsic cardiac denervation, but when the circulation was stressed acutely with the induction of severe isovolemic anemia, the cardiac output increased significantly more in the intact dogs than in the animals with denervated hearts.
