Geographic Differences in Patients in a Global Acute Heart Failure Clinical Trial (from the ASCEND-HF Trial).
Identifieur interne : 001E27 ( Main/Exploration ); précédent : 001E26; suivant : 001E28Geographic Differences in Patients in a Global Acute Heart Failure Clinical Trial (from the ASCEND-HF Trial).
Auteurs : Marco Metra [Italie] ; Robert J. Mentz [États-Unis] ; Adrian F. Hernandez [États-Unis] ; Gretchen M. Heizer [États-Unis] ; Paul W. Armstrong [Canada] ; Nadine Clausell [Brésil] ; Ramon Corbalan [Chili] ; Maria Rosa Costanzo [États-Unis] ; Kenneth Dickstein [Norvège] ; Mark E. Dunlap [États-Unis] ; Justin A. Ezekowitz [Canada] ; Jonathan G. Howlett [Canada] ; Michel Komajda [France] ; Henry Krum [Australie] ; Carlo Lombardi [Italie] ; Gregg C. Fonarow [États-Unis] ; John J V. Mcmurray [Royaume-Uni] ; Markku S. Nieminen [Finlande] ; Karl Swedberg [Suède] ; Adriaan A. Voors [Pays-Bas] ; Randall C. Starling [États-Unis] ; John R. Teerlink [États-Unis] ; Christopher M. O'Connor [États-Unis]Source :
- The American journal of cardiology [ 1879-1913 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- tendances : Cause de décès, Hospitalisation, Taux de survie.
- épidémiologie : Défaillance cardiaque.
- Adulte d'âge moyen, Défaillance cardiaque, Femelle, Humains, Maladie aigüe, Mâle, Santé mondiale, Sujet âgé, Évaluation des risques.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Heart Failure.
- methods : Risk Assessment.
- therapy : Heart Failure.
- trends : Cause of Death, Hospitalization, Survival Rate.
- Acute Disease, Aged, Female, Global Health, Humans, Male, Middle Aged.
Abstract
A growing number of countries and geographical regions are involved in major clinical trials. Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure is the largest trial in acutely decompensated heart failure (HF) with patients from 5 geographical regions: North America (NA), Latin America (LA), Western Europe (WE), Central Europe (CE), and Asia-Pacific (AP). Data from the 5 geographical areas were compared including baseline characteristics, medications, 30-day outcomes (mortality and mortality or HF hospitalization), and 180-day mortality. Of the 7,141 study patients, 3,243 (45.4%) were from NA (average of 15.2 patients/site), 1,762 (24.7%) from AP (28.4 patients/site), 967 (13.5%) from CE (20.2 patients/site), 665 (9.3%) from LA (17.1 patients/site), and 504 (7.1%) from WE (14.4 patients/site). There were marked differences in co-morbidities, clinical profile, medication use, length of stay, 30-day event rates, and 180-day mortality by region. Compared with NA, the adjusted risk for death or HF hospitalization at 30 days was significantly lower in CE (odds ratio [OR] 0.46, 95% CI 0.33 to 0.64), WE (OR 0.52 95% CI 0.35 to 0.75), and AP (OR 0.62 95% CI 0.48 to 0.79) and numerically lower in LA (OR 0.77, 95% CI 0.57 to 1.04) with similar results for 180-day mortality. In conclusion, in patients with acutely decompensated HF, major differences in baseline characteristics, treatments, length of the hospital stay, and 30-day HF rehospitalization rates, and 180-day mortality were found in patients enrolled from different geographical areas.
DOI: 10.1016/j.amjcard.2016.03.002
PubMed: 27108685
Affiliations:
- Australie, Brésil, Canada, Chili, Finlande, France, Italie, Norvège, Pays-Bas, Royaume-Uni, Suède, États-Unis
- Alberta, Californie, Caroline du Nord, Groningue (province), Illinois, Ohio, Rio Grande do Sul, Victoria (État), Écosse, Île-de-France
- Calgary, Glasgow, Groningue, Melbourne, Paris, Porto Alegre
- Université de Calgary, Université de Glasgow
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Le document en format XML
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Fonarow</name><affiliation wicri:level="2"><nlm:affiliation>Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Los Angeles, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Los Angeles</wicri:cityArea></affiliation></author><author><name sortKey="Mcmurray, John J V" sort="Mcmurray, John J V" uniqKey="Mcmurray J" first="John J V" last="Mcmurray">John J V. Mcmurray</name><affiliation wicri:level="4"><nlm:affiliation>BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>BHF Cardiovascular Research Centre, University of Glasgow, Glasgow</wicri:regionArea><orgName type="university">Université de Glasgow</orgName><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName></affiliation></author><author><name sortKey="Nieminen, Markku S" sort="Nieminen, Markku S" uniqKey="Nieminen M" first="Markku S" last="Nieminen">Markku S. Nieminen</name><affiliation wicri:level="1"><nlm:affiliation>Heart and Lung Center, Meilahti Hospital, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Heart and Lung Center, Meilahti Hospital, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Swedberg, Karl" sort="Swedberg, Karl" uniqKey="Swedberg K" first="Karl" last="Swedberg">Karl Swedberg</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg</wicri:regionArea><wicri:noRegion>University of Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Voors, Adriaan A" sort="Voors, Adriaan A" uniqKey="Voors A" first="Adriaan A" last="Voors">Adriaan A. Voors</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Cardiology, University Medical Center Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Starling, Randall C" sort="Starling, Randall C" uniqKey="Starling R" first="Randall C" last="Starling">Randall C. Starling</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Teerlink, John R" sort="Teerlink, John R" uniqKey="Teerlink J" first="John R" last="Teerlink">John R. Teerlink</name><affiliation wicri:level="2"><nlm:affiliation>Division of Cardiology, University of California, San Francisco, San Francisco, California; San Francisco Veterans Affairs Medical Center, San Francisco, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Division of Cardiology, University of California, San Francisco, San Francisco, California; San Francisco Veterans Affairs Medical Center, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="O Connor, Christopher M" sort="O Connor, Christopher M" uniqKey="O Connor C" first="Christopher M" last="O'Connor">Christopher M. 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Electronic address: metramarco@libero.it.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Division of Cardiology, Department of Medical and Surgical Specialties, University of Brescia, Brescia</wicri:regionArea><wicri:noRegion>Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Mentz, Robert J" sort="Mentz, Robert J" uniqKey="Mentz R" first="Robert J" last="Mentz">Robert J. Mentz</name><affiliation wicri:level="2"><nlm:affiliation>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Hernandez, Adrian F" sort="Hernandez, Adrian F" uniqKey="Hernandez A" first="Adrian F" last="Hernandez">Adrian F. Hernandez</name><affiliation wicri:level="2"><nlm:affiliation>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Heizer, Gretchen M" sort="Heizer, Gretchen M" uniqKey="Heizer G" first="Gretchen M" last="Heizer">Gretchen M. Heizer</name><affiliation wicri:level="2"><nlm:affiliation>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Armstrong, Paul W" sort="Armstrong, Paul W" uniqKey="Armstrong P" first="Paul W" last="Armstrong">Paul W. Armstrong</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Cardiology, University of Alberta, Edmonton, Alberta</wicri:regionArea><wicri:noRegion>Alberta</wicri:noRegion></affiliation></author><author><name sortKey="Clausell, Nadine" sort="Clausell, Nadine" uniqKey="Clausell N" first="Nadine" last="Clausell">Nadine Clausell</name><affiliation wicri:level="3"><nlm:affiliation>Serviço de Cardiologia, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Serviço de Cardiologia, Hospital de Clinicas de Porto Alegre, Porto Alegre</wicri:regionArea><placeName><settlement type="city">Porto Alegre</settlement><region type="state">Rio Grande do Sul</region></placeName></affiliation></author><author><name sortKey="Corbalan, Ramon" sort="Corbalan, Ramon" uniqKey="Corbalan R" first="Ramon" last="Corbalan">Ramon Corbalan</name><affiliation wicri:level="1"><nlm:affiliation>Cardiovascular Division, Pontificia Universidad Catolica deChile, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Cardiovascular Division, Pontificia Universidad Catolica deChile, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Costanzo, Maria Rosa" sort="Costanzo, Maria Rosa" uniqKey="Costanzo M" first="Maria Rosa" last="Costanzo">Maria Rosa Costanzo</name><affiliation wicri:level="2"><nlm:affiliation>Advocate Heart Institute, Naperville, Illinois.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Advocate Heart Institute, Naperville</wicri:cityArea></affiliation></author><author><name sortKey="Dickstein, Kenneth" sort="Dickstein, Kenneth" uniqKey="Dickstein K" first="Kenneth" last="Dickstein">Kenneth Dickstein</name><affiliation wicri:level="1"><nlm:affiliation>Cardiology Division, Stavenger University Hospital, University of Bergen, Bergen, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Cardiology Division, Stavenger University Hospital, University of Bergen, Bergen</wicri:regionArea><wicri:noRegion>Bergen</wicri:noRegion></affiliation></author><author><name sortKey="Dunlap, Mark E" sort="Dunlap, Mark E" uniqKey="Dunlap M" first="Mark E" last="Dunlap">Mark E. Dunlap</name><affiliation wicri:level="2"><nlm:affiliation>Heart and Vascular Center, Metrohealth Medical Center, Cleveland, Ohio.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Heart and Vascular Center, Metrohealth Medical Center, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Ezekowitz, Justin A" sort="Ezekowitz, Justin A" uniqKey="Ezekowitz J" first="Justin A" last="Ezekowitz">Justin A. Ezekowitz</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Cardiology, University of Alberta, Edmonton, Alberta</wicri:regionArea><wicri:noRegion>Alberta</wicri:noRegion></affiliation></author><author><name sortKey="Howlett, Jonathan G" sort="Howlett, Jonathan G" uniqKey="Howlett J" first="Jonathan G" last="Howlett">Jonathan G. Howlett</name><affiliation wicri:level="4"><nlm:affiliation>Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Komajda, Michel" sort="Komajda, Michel" uniqKey="Komajda M" first="Michel" last="Komajda">Michel Komajda</name><affiliation wicri:level="3"><nlm:affiliation>Pitie Salpetriere Hospital, University Pierre Marie Curie, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Pitie Salpetriere Hospital, University Pierre Marie Curie, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name><affiliation wicri:level="3"><nlm:affiliation>Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Lombardi, Carlo" sort="Lombardi, Carlo" uniqKey="Lombardi C" first="Carlo" last="Lombardi">Carlo Lombardi</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cardiology, Department of Medical and Surgical Specialties, University of Brescia, Brescia, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Division of Cardiology, Department of Medical and Surgical Specialties, University of Brescia, Brescia</wicri:regionArea><wicri:noRegion>Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Fonarow, Gregg C" sort="Fonarow, Gregg C" uniqKey="Fonarow G" first="Gregg C" last="Fonarow">Gregg C. Fonarow</name><affiliation wicri:level="2"><nlm:affiliation>Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Los Angeles, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Los Angeles</wicri:cityArea></affiliation></author><author><name sortKey="Mcmurray, John J V" sort="Mcmurray, John J V" uniqKey="Mcmurray J" first="John J V" last="Mcmurray">John J V. Mcmurray</name><affiliation wicri:level="4"><nlm:affiliation>BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>BHF Cardiovascular Research Centre, University of Glasgow, Glasgow</wicri:regionArea><orgName type="university">Université de Glasgow</orgName><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName></affiliation></author><author><name sortKey="Nieminen, Markku S" sort="Nieminen, Markku S" uniqKey="Nieminen M" first="Markku S" last="Nieminen">Markku S. Nieminen</name><affiliation wicri:level="1"><nlm:affiliation>Heart and Lung Center, Meilahti Hospital, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Heart and Lung Center, Meilahti Hospital, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Swedberg, Karl" sort="Swedberg, Karl" uniqKey="Swedberg K" first="Karl" last="Swedberg">Karl Swedberg</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg</wicri:regionArea><wicri:noRegion>University of Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Voors, Adriaan A" sort="Voors, Adriaan A" uniqKey="Voors A" first="Adriaan A" last="Voors">Adriaan A. Voors</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Cardiology, University Medical Center Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Starling, Randall C" sort="Starling, Randall C" uniqKey="Starling R" first="Randall C" last="Starling">Randall C. Starling</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Teerlink, John R" sort="Teerlink, John R" uniqKey="Teerlink J" first="John R" last="Teerlink">John R. Teerlink</name><affiliation wicri:level="2"><nlm:affiliation>Division of Cardiology, University of California, San Francisco, San Francisco, California; San Francisco Veterans Affairs Medical Center, San Francisco, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Division of Cardiology, University of California, San Francisco, San Francisco, California; San Francisco Veterans Affairs Medical Center, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="O Connor, Christopher M" sort="O Connor, Christopher M" uniqKey="O Connor C" first="Christopher M" last="O'Connor">Christopher M. O'Connor</name><affiliation wicri:level="2"><nlm:affiliation>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke Clinical Research Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham</wicri:cityArea></affiliation></author></analytic><series><title level="j">The American journal of cardiology</title><idno type="eISSN">1879-1913</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute Disease</term><term>Aged</term><term>Cause of Death (trends)</term><term>Female</term><term>Global Health</term><term>Heart Failure (epidemiology)</term><term>Heart Failure (therapy)</term><term>Hospitalization (trends)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Risk Assessment (methods)</term><term>Survival Rate (trends)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Cause de décès (tendances)</term><term>Défaillance cardiaque ()</term><term>Défaillance cardiaque (épidémiologie)</term><term>Femelle</term><term>Hospitalisation (tendances)</term><term>Humains</term><term>Maladie aigüe</term><term>Mâle</term><term>Santé mondiale</term><term>Sujet âgé</term><term>Taux de survie (tendances)</term><term>Évaluation des risques ()</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Risk Assessment</term></keywords><keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Cause de décès</term><term>Hospitalisation</term><term>Taux de survie</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Cause of Death</term><term>Hospitalization</term><term>Survival Rate</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Défaillance cardiaque</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Acute Disease</term><term>Aged</term><term>Female</term><term>Global Health</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Défaillance cardiaque</term><term>Femelle</term><term>Humains</term><term>Maladie aigüe</term><term>Mâle</term><term>Santé mondiale</term><term>Sujet âgé</term><term>Évaluation des risques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A growing number of countries and geographical regions are involved in major clinical trials. Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure is the largest trial in acutely decompensated heart failure (HF) with patients from 5 geographical regions: North America (NA), Latin America (LA), Western Europe (WE), Central Europe (CE), and Asia-Pacific (AP). Data from the 5 geographical areas were compared including baseline characteristics, medications, 30-day outcomes (mortality and mortality or HF hospitalization), and 180-day mortality. Of the 7,141 study patients, 3,243 (45.4%) were from NA (average of 15.2 patients/site), 1,762 (24.7%) from AP (28.4 patients/site), 967 (13.5%) from CE (20.2 patients/site), 665 (9.3%) from LA (17.1 patients/site), and 504 (7.1%) from WE (14.4 patients/site). There were marked differences in co-morbidities, clinical profile, medication use, length of stay, 30-day event rates, and 180-day mortality by region. Compared with NA, the adjusted risk for death or HF hospitalization at 30 days was significantly lower in CE (odds ratio [OR] 0.46, 95% CI 0.33 to 0.64), WE (OR 0.52 95% CI 0.35 to 0.75), and AP (OR 0.62 95% CI 0.48 to 0.79) and numerically lower in LA (OR 0.77, 95% CI 0.57 to 1.04) with similar results for 180-day mortality. In conclusion, in patients with acutely decompensated HF, major differences in baseline characteristics, treatments, length of the hospital stay, and 30-day HF rehospitalization rates, and 180-day mortality were found in patients enrolled from different geographical areas.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Brésil</li><li>Canada</li><li>Chili</li><li>Finlande</li><li>France</li><li>Italie</li><li>Norvège</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suède</li><li>États-Unis</li></country><region><li>Alberta</li><li>Californie</li><li>Caroline du Nord</li><li>Groningue (province)</li><li>Illinois</li><li>Ohio</li><li>Rio Grande do Sul</li><li>Victoria (État)</li><li>Écosse</li><li>Île-de-France</li></region><settlement><li>Calgary</li><li>Glasgow</li><li>Groningue</li><li>Melbourne</li><li>Paris</li><li>Porto Alegre</li></settlement><orgName><li>Université de Calgary</li><li>Université de Glasgow</li></orgName></list><tree><country name="Italie"><noRegion><name sortKey="Metra, Marco" sort="Metra, Marco" uniqKey="Metra M" first="Marco" last="Metra">Marco Metra</name></noRegion><name sortKey="Lombardi, Carlo" sort="Lombardi, Carlo" uniqKey="Lombardi C" first="Carlo" last="Lombardi">Carlo Lombardi</name></country><country name="États-Unis"><region name="Caroline du Nord"><name sortKey="Mentz, Robert J" sort="Mentz, Robert J" uniqKey="Mentz R" first="Robert J" last="Mentz">Robert J. Mentz</name></region><name sortKey="Costanzo, Maria Rosa" sort="Costanzo, Maria Rosa" uniqKey="Costanzo M" first="Maria Rosa" last="Costanzo">Maria Rosa Costanzo</name><name sortKey="Dunlap, Mark E" sort="Dunlap, Mark E" uniqKey="Dunlap M" first="Mark E" last="Dunlap">Mark E. Dunlap</name><name sortKey="Fonarow, Gregg C" sort="Fonarow, Gregg C" uniqKey="Fonarow G" first="Gregg C" last="Fonarow">Gregg C. Fonarow</name><name sortKey="Heizer, Gretchen M" sort="Heizer, Gretchen M" uniqKey="Heizer G" first="Gretchen M" last="Heizer">Gretchen M. Heizer</name><name sortKey="Hernandez, Adrian F" sort="Hernandez, Adrian F" uniqKey="Hernandez A" first="Adrian F" last="Hernandez">Adrian F. Hernandez</name><name sortKey="O Connor, Christopher M" sort="O Connor, Christopher M" uniqKey="O Connor C" first="Christopher M" last="O'Connor">Christopher M. O'Connor</name><name sortKey="Starling, Randall C" sort="Starling, Randall C" uniqKey="Starling R" first="Randall C" last="Starling">Randall C. Starling</name><name sortKey="Teerlink, John R" sort="Teerlink, John R" uniqKey="Teerlink J" first="John R" last="Teerlink">John R. Teerlink</name></country><country name="Canada"><noRegion><name sortKey="Armstrong, Paul W" sort="Armstrong, Paul W" uniqKey="Armstrong P" first="Paul W" last="Armstrong">Paul W. Armstrong</name></noRegion><name sortKey="Ezekowitz, Justin A" sort="Ezekowitz, Justin A" uniqKey="Ezekowitz J" first="Justin A" last="Ezekowitz">Justin A. Ezekowitz</name><name sortKey="Howlett, Jonathan G" sort="Howlett, Jonathan G" uniqKey="Howlett J" first="Jonathan G" last="Howlett">Jonathan G. Howlett</name></country><country name="Brésil"><region name="Rio Grande do Sul"><name sortKey="Clausell, Nadine" sort="Clausell, Nadine" uniqKey="Clausell N" first="Nadine" last="Clausell">Nadine Clausell</name></region></country><country name="Chili"><noRegion><name sortKey="Corbalan, Ramon" sort="Corbalan, Ramon" uniqKey="Corbalan R" first="Ramon" last="Corbalan">Ramon Corbalan</name></noRegion></country><country name="Norvège"><noRegion><name sortKey="Dickstein, Kenneth" sort="Dickstein, Kenneth" uniqKey="Dickstein K" first="Kenneth" last="Dickstein">Kenneth Dickstein</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Komajda, Michel" sort="Komajda, Michel" uniqKey="Komajda M" first="Michel" last="Komajda">Michel Komajda</name></region></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name></region></country><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Mcmurray, John J V" sort="Mcmurray, John J V" uniqKey="Mcmurray J" first="John J V" last="Mcmurray">John J V. Mcmurray</name></region></country><country name="Finlande"><noRegion><name sortKey="Nieminen, Markku S" sort="Nieminen, Markku S" uniqKey="Nieminen M" first="Markku S" last="Nieminen">Markku S. Nieminen</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Swedberg, Karl" sort="Swedberg, Karl" uniqKey="Swedberg K" first="Karl" last="Swedberg">Karl Swedberg</name></noRegion></country><country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Voors, Adriaan A" sort="Voors, Adriaan A" uniqKey="Voors A" first="Adriaan A" last="Voors">Adriaan A. Voors</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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