AustralieFrV1, Main, Exploration, bibRecord, 003A72

Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

Identifieur interne : 003A72 ( Main/Exploration ); précédent : 003A71; suivant : 003A73

Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

Auteurs : Kevin Damman [Pays-Bas] ; W H Wilson Tang [États-Unis] ; G Michael Felker [États-Unis] ; Johan Lassus [Finlande] ; Faiez Zannad [France] ; Henry Krum [Australie] ; John J V. Mcmurray [Royaume-Uni]

Source :

Journal of the American College of Cardiology [ 1558-3597 ] ; 2014.

RBID : pubmed:24334210

Descripteurs français

English descriptors

KwdEn :
- Angiotensin Receptor Antagonists (therapeutic use), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Cardiac Resynchronization Therapy (methods), Electrolytes, Evidence-Based Medicine, Glomerular Filtration Rate, Heart Failure, Systolic (complications), Heart Failure, Systolic (therapy), Humans, Mineralocorticoid Receptor Antagonists (therapeutic use), Randomized Controlled Trials as Topic, Renal Insufficiency (complications), Renal Insufficiency (therapy), Renin-Angiotensin System, Risk, Treatment Outcome.
MESH :
- chemical , therapeutic use : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Mineralocorticoid Receptor Antagonists.
- complications : Heart Failure, Systolic, Renal Insufficiency.
- methods : Cardiac Resynchronization Therapy.
- therapy : Heart Failure, Systolic, Renal Insufficiency.
- chemical : Electrolytes, Evidence-Based Medicine, Glomerular Filtration Rate, Humans, Randomized Controlled Trials as Topic, Renin-Angiotensin System, Risk, Treatment Outcome.

Abstract

Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients with (severe) renal dysfunction. The benefit of these evidence-based therapies in this high-risk patient group is largely unknown. This paper reviews data from randomized clinical trials in systolic heart failure and the interactions between baseline renal dysfunction and the effect of randomized treatment. It highlights that most evidence-based therapies show consistent outcome benefit in patients with moderate renal insufficiency (stage 3 CKD), whereas there are very scarce data on patients with severe (stage 4 to 5 CKD) renal insufficiency. If any, the outcome benefit might be even greater in stage 3 CKD compared with those with relatively preserved renal function. However, prescription of therapies should be individualized with consideration of possible harm and benefit, especially in those with stage 4 to 5 CKD where limited data are available.

DOI: 10.1016/j.jacc.2013.11.031
PubMed: 24334210

Affiliations:

Australie, Finlande, France, Pays-Bas, Royaume-Uni, États-Unis
Caroline du Nord, Grand Est, Groningue (province), Lorraine (région), Ohio, Écosse
Glasgow, Groningue, Nancy
Université de Glasgow

Le document en format XML

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<term>Essais contrôlés randomisés comme sujet</term>
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<term>Insuffisance rénale</term>
<term>Médecine factuelle</term>
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<front><div type="abstract" xml:lang="en">Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients with (severe) renal dysfunction. The benefit of these evidence-based therapies in this high-risk patient group is largely unknown. This paper reviews data from randomized clinical trials in systolic heart failure and the interactions between baseline renal dysfunction and the effect of randomized treatment. It highlights that most evidence-based therapies show consistent outcome benefit in patients with moderate renal insufficiency (stage 3 CKD), whereas there are very scarce data on patients with severe (stage 4 to 5 CKD) renal insufficiency. If any, the outcome benefit might be even greater in stage 3 CKD compared with those with relatively preserved renal function. However, prescription of therapies should be individualized with consideration of possible harm and benefit, especially in those with stage 4 to 5 CKD where limited data are available.</div>
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Serveur d'exploration sur les relations entre la France et l'Australie

Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki

	Serveur d'exploration sur les relations entre la France et l'Australie
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