Tens of thousands of lives could potentially be saved by key heart failure therapies
A national study has found that nearly 68,000 deaths potentially could be prevented each year by optimally implementing key national guidelinerecommended therapies, including critical medications and cardiac devices, for all eligible heart failure patients.
Although heart failure is a major cause of death, morbidity and health care expenditures in the U.S., the routine clinical use of scientifically proven treatments that reduce mortality and improve quality of life has been slow and inconsistent.
"This is one of the first studies to quantify the potential survival benefits that could result if these guideline-recommended therapies were universally applied to all eligible heart failure patients in the United States," said the study's first author, Dr. Gregg C. Fonarow, UCLA's Elliot Corday Professor of Cardiovascular Medicine and Science and director of the AhmansonUCLA Cardiomyopathy Center at the David Geffen School of Medicine at UCLA.
Published in the June edition of the American Heart Journal, the findings help further the understanding of the possible health benefits of more consistent use of these heart failure therapies. The study also provides strong motivation for clinicians to improve implementation of these evidence-based treatments through performance-improvement initiatives and programs.
Heart failure occurs when the heart can no longer pump enough blood to the body's other organs. Often, patients with heart failure have reduced left-ventricle ejection fraction, which indicates a lowered volume of blood being pumped out of this heart chamber with each beat of the heart.
The study examined six evidence-based therapies for heart failure patients with reduced left-ventricle ejection fraction. The six therapies are highly recommended in the national guidelines of the American College of Cardiology and the American Heart Association for heart failure patients.
In conducting the study, investigators used a number of published sources, including clinical trials results, in-patient and out-patient patient registries for heart failure patients, and heart failure quality-of-care studies in cardiology and general clinical practice settings.
For each heart failure therapy, the study authors determined patient eligibility criteria, estimated the frequency of use, identified fatality rates and calculated mortality riskreduction statistics due to treatment.
They found that out of 2,644,800 heart failure patients with reduced left-ventricular ejection fraction in the U.S., many were eligible for the evidence-based therapies but did not receive them. The number of potential deaths that could be prevented each year with optimal implementation of all six therapies totaled 67,996, they said.
Potential lives saved by individual therapies alone are as follows:
Four heart failure medications
Aldosterone antagonists: 21,407 potential lives saved; beta blockers: 12,922; angiotensin-converting enzyme inhibitors or angiotensin receptor blockers: 6,516; hydralazine/isosorbide dinitrate: 6,655
Cardiac resynchronization therapy
Potential lives saved with this device, which helps coordinate heart contractions: 8,317
Potential lives saved with this device, which delivers electrical shocks if potentially fatal heart rhythm abnormalities occur: 12,179
According to the researchers, the greatest potential gains were seen with those therapies for which the treatment gaps (number of patients who did not receive the therapy for which they were eligible) and the magnitude of benefits were the largest. Improved use of aldosterone antagonist therapy, followed by beta blocker and implantable cardioverter-defibrillator therapies, would provide the greatest benefit in possible lives saved, they said.
Mortality riskreduction due to treatment ranged from 17 percent with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers to 43 percent with hydralazine/isosorbide.
The number of heart failure patients who were eligible but not currently being treated ranged from 139,749 for hydrlazine/isorbide dinitrate to 852,512 for implantable cardioverter-defibrillators.
"With tens of thousands of lives potentially saved with optimal application of these therapies, the findings have significant clinical and public health implications," Fonarow said. "Determining the impact of each evidence-based therapy is helpful in prioritizing performance-improvement initiative efforts and planning future strategies to improve adherence."
Fonarow noted that the research estimated only reduction in deaths by optimal application of these therapies. Further study may evaluate hospitalization reductions, improvements in symptoms, functional status and other important clinical outcomes related to broader application of these therapies.
Provided by University of California - Los Angeles
- Key guideline-recommended therapies improve survival for heart failure patients Apr 04, 2011 | not rated yet | 0
- Heart failure care improved by performance intervention at outpatient cardiology practices Jul 26, 2010 | not rated yet | 0
- Most eligible patients miss out on cardiac resynchronization therapy for heart failure Dec 11, 2009 | not rated yet | 0
- Older patients with 1 type of heart failure may receive little or no benefit from drugs Mar 12, 2009 | not rated yet | 0
- Deaths reduced with cardiac resynchronization therapy Jan 31, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
latitude & longitude & air pressure
33 minutes ago Hi there, I have a peculiar question. Imagine that you are in a earth position, obtained by google, that gives you the latitude and longitude....
Differences of Classical Mechanics when learned with Calc vs algebra?
3 hours ago what are the differences? Every example I find usually has a derivative or integral or some kind of calculus defined concept that seems to make it...
what is the distance traveled
7 hours ago Hi. I have newly started to study mechanical physics. based on study, I conduct a simple experiment. But unfortunately i am unable apply the laws in...
Image of a Convex Lens Cut in Half Horizontally
11 hours ago Hello everyone, A friend of mine came up with this question in class and I really do not have a good answer. Suppose you have a convex lens...
Ray tracing throught optical system of thick lenses
11 hours ago Can you advise me a free software that allow to draw rays passed throught system of thick lenses (preferable in 3D)?
Faraday's law on circular wire
12 hours ago In my examples on Faraday's law in my book, they use a drawing of a magnet approaching a circular wire. The changing magnetic flux then induces an...
- More from Physics Forums - Classical Physics
More news stories
Costs to treat stroke are projected to more than double and the number of people having strokes may increase 20 percent by 2030, according to the American Heart Association/American Stroke Association.
Cardiology 8 hours ago | not rated yet | 0
Blood thinners are the preferred treatment option to prevent heart attacks, blood clots and stroke, but they are not without risk, and not just because of their side effects. These high-risk drugs, known as anticoagulants, ...
Cardiology 10 hours ago | not rated yet | 0
Results from a large observational study reported at EuroPCR 2013 today question whether bivalirudin is superior to heparin in the absence of GPIIb/IIIa blockade, showing similar 30-day mortality in patients with non-ST segment ...
Cardiology 11 hours ago | not rated yet | 0
The DESolve bioresorbable coronary scaffold system achieves good efficacy and safety with low rates of late lumen loss and major coronary adverse events at six months, show first results from the pivotal DESolve Nx trial ...
Cardiology 11 hours ago | not rated yet | 0
The Orsiro stent, which is a novel stent platform eluting sirolimus from a biodegradable polymer, demonstrated non-inferiority to the Xience Prime everolimus-eluting stent for the primary angiographic endpoint of in-stent ...
Cardiology May 21, 2013 | 5 / 5 (1) | 0
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
7 hours ago | 4.5 / 5 (2) | 0 |
Calorie information in fast food restaurants used by 40 percent of 9-18 year olds when making food choices
A new study published online today (Thursday) in the Journal of Public Health has found that of young people who visited fast food or chain restaurants in the U.S. in 2010, girls and youth who were obese were more likely ...
1 hour ago | not rated yet | 0
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
3 hours ago | 5 / 5 (1) | 0 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
4 hours ago | 5 / 5 (1) | 2 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
7 hours ago | not rated yet | 0 |
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
4 hours ago | not rated yet | 0 |