RELAX-AHF and PROTECT studies find targeting WHF may reduce readmissions and save lives

May 17, 2014, European Society of Cardiology

Worsening symptoms and signs of heart failure (WHF) in patients admitted to a hospital is a common sign of treatment failure and can lead to long-term consequences for the patient, including longer length of hospitalization and a higher risk for readmission and death, according to a late-breaking study (RELAX-AHF, PROTECT) presented in Athens at the ESC's Heart Failure Congress 2014

Heart failure is the most common reason for admission to hospital in people over 65 years old and affects millions of people each year. Research has shown that the outcomes of patients admitted with Acute Heart Failure (AHF) are dire with significant time spent in the hospital and high rates of readmissions or death within 6 months. Currently available therapies such as i.v. diuretics and vasodilators, may relieve some of the symptoms of AHF including dyspnoea, but most probably do not affect short term outcomes.

"Worsening heart failure is a clinical event occurring during an admission for defined as worsening of the symptoms and signs that brought the patient to the hospital requiring additional intravenous or mechanical therapy," said Beth Davison, lead author on the RELAX-AHF study and vice president of Momentum Research Inc. "It prolongs the hospital stay and is associated with increased risk for readmission within 2 months and death within 6 months. Preventing this early event would not only reduce the patient's suffering during the admission but possibly also reduce its longer-term consequences."

In data pooled from the PROTECT Pilot, PROTECT, Pre-RELAX-AHF, and RELAX-AHF studies the association of WHF with length of stay, mortality and HF re-hospitalization were examined. In 3691 patients, death or WHF occurred in 12.4%. WHF was associated with a mean increase in the length of stay of 5.2 days (95% confidence intervals [CI] 4.6-5.8 days); a hazard ratio (HR) for 60-day HF readmission or CV death of 1.64 (CI 1.34-2.01) and a HR for 180-day mortality of 1.93 (1.55-2.41) – all P< 0.001. WHF was also associated with larger increases in markers of renal and hepatic dysfunction during the first days of admission.

The association of WHF with these outcomes remained robust after adjustment for changes in these markers at day 2 on top of adjustment for baseline characteristics. The association of WHF with mortality was significant regardless of what therapy was given for WHF, although patients who needed IV inotropes or mechanical support had higher mortality.

"Because WHF is associated with more adverse outcome physicians should monitor closely who develop WHF during admission," said Dr. Davison. "As suggested by the results of the RELAX-AHF study, future therapy may reduce the occurrence of WHF and some of its downstream effects."

Explore further: RELAX-AHF shows first positive findings in HFpEF patients

Related Stories

RELAX-AHF shows first positive findings in HFpEF patients

May 26, 2013
Serelaxin may be more effective for relieving dyspnea in heart failure with preserved ejection fraction (HFpEF) than reduced (HFrEF) during the first 24 hours, according to results from RELAX-AHF presented in today's late ...

Two drugs do not improve kidney function in acute heart failure patients

November 18, 2013
Two drugs tested in a larger trial did not improve kidney function in acute heart failure patients, contrary to results of smaller studies. The results were presented today at the American Heart Association's Scientific Sessions ...

Sleeping pills increase CV events in heart failure patients

May 17, 2014
Sleeping pills increase the risk of cardiovascular events in heart failure patients by 8-fold, according to research from Japan. The study was presented today at the Heart Failure Congress 2014, held 17-20 May in Athens, ...

Death highest in heart failure patients admitted in January, on Friday, and overnight

May 25, 2013
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...

Women with acute heart failure have similar in-hospital mortality to men but are less treated

August 27, 2012
Women with acute heart failure have similar in-hospital mortality to men but are less treated in the real world, according to results from the global ALARM-HF registry presented today at the ESC Congress 2012. The findings ...

Eplerenone reduces primary endpoint in acute myocardial infarction patients

April 29, 2014
A drug known to reduce mortality rate in patients with heart failure has now been found significantly effective when administered early in patients following an acute (ST elevated) myocardial infarction. This effect,say the ...

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.