Abstract:
AIMS:Our objective was to create a simple prognostic risk score for patients with systolic heart failure and mild symptoms. We then assessed the efficacy of eplerenone across different categories of risk. METHODS AND RESULTS:The Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure trial (EMPHASIS-HF) was an international randomized trial, comparing eplerenone with placebo in 2737 patients with systolic heart failure and mild symptoms. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure, over a median 2.1 years follow-up. Using multivariable Cox modelling age, sex, systolic blood pressure, estimated glomerular filtration rate, diabetes, BMI, haemoglobin, prior heart failure (HF) hospitalization, prior myocardial infarction/coronary artery bypass surgery (CABG), and heart rate were identified as strong independent risk factors. Estimates from the model were converted into a simple integer risk score which was categorized into three groups of low-, medium-, and high risk. In placebo patients, the rates (per 100 patient-years) for the primary outcome were 7.6, 19.0, and 39.4 in the low-, medium-, and high-risk groups, respectively. On eplerenone, these rates were reduced to 5.6, 12.2, and 24.2, respectively. Eplerenone was beneficial across all risk categories and the hazard ratios were similar. The absolute treatment benefit was greatest among those at highest risk. Similar patterns emerged for all-cause mortality and for all HF hospitalizations. CONCLUSION:This easy-to-use integer risk score should be of value in quantifying individual patient risk in patients with systolic HF and mild symptoms. The relative benefits of eplerenone appeared consistent across the whole spectrum of risk, including those at lower risk.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Collier TJ,Pocock SJ,McMurray JJ,Zannad F,Krum H,van Veldhuisen DJ,Swedberg K,Shi H,Vincent J,Pitt Bdoi
10.1093/eurheartj/eht247subject
Has Abstractpub_date
2013-09-01 00:00:00pages
2823-9issue
36eissn
0195-668Xissn
1522-9645pii
eht247journal_volume
34pub_type
杂志文章,多中心研究,随机对照试验abstract::We have evaluated overall and cardiac sympathetic activity in 47 patients undergoing coronary angiography, 27 with stable angina of at least 3 months duration, and 20 with unstable ischaemic symptoms within this period. Cardiac and overall sympathetic activity were assessed using radiotracer noradrenaline kinetic tech...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.6.751
更新日期:1993-06-01 00:00:00
abstract:AIMS:The risk of gastrointestinal (GI) bleeding limits the use of antiplatelet and anticoagulant drugs. Risk factors for GI bleeding in post- myocardial infarction (MI) patients have not been well defined. We sought to identify risk factors for GI bleeding in patients following MI. METHODS AND RESULTS:The VALsartan In...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehp256
更新日期:2009-09-01 00:00:00
abstract::During the long-term follow-up of patients with hypertrophic cardiomyopathy (HCM), some patients develop left ventricular (LV) wall motion abnormalities in the absence of fixed coronary artery disease. The purpose of this study is to clarify which clinical features in patients with HCM seem to influence gradual develo...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.12.1629
更新日期:1993-12-01 00:00:00
abstract::Oxygen consumption was measured during 30 min of work in 16 patients, after a myocardial infarction (anterior or posterior), and compared with 16 normal subjects, of the same age, involved in the same activities, in a steel factory. The VO2 at work of the patients was a little lower than in normals. The mean heart rat...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_l.54
更新日期:1988-11-01 00:00:00
abstract:AIMS:Although cerebral blood flow (CBF) is known to be low in patients with advanced systolic heart failure (HF), little is known of the prognostic significance of this observation. We investigated whether CBF might be associated with the development of adverse outcomes in systolic HF, and whether it might provide prog...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehr345
更新日期:2012-02-01 00:00:00
abstract:AIMS:To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. METHODS AND RESULTS:We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm338
更新日期:2008-05-01 00:00:00
abstract::This study was undertaken to assess the effects of hypothermia and chemical cardioplegia on the functional recovery of hypertrophied non-failing rat hearts subjected to an extended period of global ischaemia. Left ventricular hypertrophy was produced by constriction of the abdominal aorta. Hearts were studied an avera...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_f.347
更新日期:1984-12-01 00:00:00
abstract:AIMS:Aortic stenosis causes cardiac hypertrophy and fibrosis, which often persists despite pressure unloading after aortic valve replacement. The persistence of myocardial fibrosis in particular leads to impaired cardiac function and increased mortality. We investigated whether granulocyte colony-stimulating factor (G-...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehr434
更新日期:2012-03-01 00:00:00
abstract:UNLABELLED:Peripheral vessels provide a useful in vivo haemodynamic model allowing evaluation of local intravascular fluid dynamics. Velocity measurements using a 0.018 inch Doppler-tipped angioplasty guidewire, quantitative angiography and laboratory data were gathered from 45 patients with a total of 48 percutaneous ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.suppl_j.60
更新日期:1995-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/eurheartj/4.suppl_g.1
更新日期:1983-11-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1688
更新日期:1999-12-01 00:00:00
abstract::Hypokalaemia commonly occurs in acute myocardial infarction (AMI) and may be caused by elevated serum levels of adrenaline, allegedly by beta 2-adrenergic mediated influx of potassium (K) into cells. We investigated the effect on serum K of intravenous acebutolol (a relatively beta 1-selective agent) in 50 patients wi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062036
更新日期:1986-02-01 00:00:00
abstract:AIMS:The combined use of cardiac computed tomography (CT) coronary angiography (CTCA) and myocardial perfusion imaging allows the non-invasive evaluation of coronary morphology and function. Cardiovascular magnetic resonance (CMR) imaging has several advantages: it can simultaneously assess myocardial perfusion, ventri...
journal_title:European heart journal
pub_type: 杂志文章
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更新日期:2013-07-01 00:00:00
abstract:Aims:The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome. Methods and results:A total of 104 centres in 27 European countries participated and wer...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
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更新日期:2017-05-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015273
更新日期:1997-03-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(03)00235-5
更新日期:2003-07-01 00:00:00
abstract:AIMS:Recent data suggest that the administration of bone marrow-derived stem cells (BMSC) might improve myocardial perfusion and left ventricular (LV) function after acute myocardial infarction (AMI). The aim of this study was to assess spontaneous mobilization of BMSC expressing the haematopoietic and endothelial prog...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi164
更新日期:2005-06-01 00:00:00
abstract::Eleven patients with an atrioventricular accessory pathway were studied by programmed electrical stimulation to determine if reentrant tachycardia could be prevented by delivery of either a single atrial extrastimulus, applied at a critical time after the tachycardia-initiating stimulus (or stimuli), or a train of sti...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061756
更新日期:1985-01-01 00:00:00
abstract:AIMS:To evaluate the association between occupational and leisure-time physical activity (PA), ownership of goods promoting sedentary behaviour, and the risk of myocardial infarction (MI) in different socio-economic populations of the world. Studies in developed countries have found low PA as a risk factor for cardiova...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehr432
更新日期:2012-02-01 00:00:00
abstract::The understanding of atrial fibrillation (AF) evolved from a sole rhythm disturbance towards the complex concept of a cardiomyopathy based on arrhythmia substrates. There is evidence that atrial fibrosis can be visualized using late gadolinium enhancement cardiac magnetic resonance imaging and that it is a powerful pr...
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doi:10.1093/eurheartj/ehz786
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abstract::Angiotensin II (AII) has been implicated as an important factor in the pathophysiology of heart diseases. Following the recent identification of two subtypes of the AII receptor in cardiac tissue of animals, we investigated the possible occurrence of these, or similar, subtypes in human atrial tissue. In right-atrial ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015008
更新日期:1996-07-01 00:00:00
abstract::The effects of dexamethasone on cultured rat beating heart cells experimentally infected with coxsackievirus B2 were investigated at an early stage (1-3 days) post challenge. Changes in the release of the cardiac enzyme, aspartate amino-transferase (AST), beating %, cytopathic effect (CPE), virus titre, ultrastructure...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.suppl_d.39
更新日期:1991-08-01 00:00:00
abstract:AIMS:Very few data exist on the occurrence of acute kidney injury (AKI) associated with transcatheter aortic valve implantation (TAVI). The objectives of the present study were (i) to determine the incidence, predictive factors, and prognostic value of AKI following TAVI, and (ii) to compare the occurrence of AKI in TA...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
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更新日期:2010-04-01 00:00:00
abstract:AIM:A genetic variant (rs20417) of the PTGS2 gene, encoding for COX-2, has been associated with decreased COX-2 activity and a decreased risk of cardiovascular disease (CVD). However, this genetic association and the role of COX-2 in CVD remain controversial. METHODS AND RESULTS:The association of rs20417 with CVD was...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu168
更新日期:2014-09-01 00:00:00
abstract:AIMS:Elevated blood pressure (EBP) is the most prevalent and potentially modifiable risk factor for AF, yet little is known of its atrial effects. We aimed to characterize the atrial electrical and structural changes in a chronic ovine model of EBP after prenatal corticosteroid exposure. METHODS AND RESULTS:Twelve she...
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pub_type: 杂志文章
doi:10.1093/eurheartj/ehl360
更新日期:2006-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究
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更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Percutaneous mitral valvuloplasty with the Inoue balloon is conventionally performed with double vascular access: arterial and venous. However, in patients with a good echogenic window it may be performed with venous access only and the procedure monitored by 2D-echocardiography and colour flow mapping. This...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0803
更新日期:1998-04-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:1998-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(02)00426-8
更新日期:2003-02-01 00:00:00