Changes in causes of death and influence of therapeutic improvement over time in patients with heart failure and reduced ejection fraction.
Identifieur interne : 000341 ( Main/Exploration ); précédent : 000340; suivant : 000342Changes in causes of death and influence of therapeutic improvement over time in patients with heart failure and reduced ejection fraction.
Auteurs : David Fernández-Vázquez [Espagne] ; Andreu Ferrero-Gregori [Espagne] ; Jesús Álvarez-García [Espagne] ; Inés G Mez-Otero [Espagne] ; Rafael Vázquez [Espagne] ; Juan Delgado Jiménez [Espagne] ; Fernando Worner Diz [Espagne] ; Alfredo Bardají [Espagne] ; Pablo García-Pavía [Espagne] ; Antoni Bayés-Genís [Espagne] ; José R. González-Juanatey [Espagne] ; Juan Cinca [Espagne] ; Domingo A. Pascual Figal [Espagne]Source :
- Revista espanola de cardiologia (English ed.) [ 1885-5857 ] ; 2020.
Abstract
INTRODUCTION AND OBJECTIVES
In patients with heart failure and reduced ejection fraction (HFrEF), several therapies have been proven to reduce mortality in clinical trials. However, there are few data on the effect of the use of evidence-based therapies on causes of death in clinical practice.
METHODS
This study included 2351 outpatients with HFrEF (< 40%) from 2 multicenter prospective registries: MUSIC (n=641, period: 2003-2004) and REDINSCOR I (n=1710, period: 2007-2011). Variables were recorded at inclusion and all patients were followed-up for 4 years. Causes of death were validated by an independent committee.
RESULTS
Patients in REDINSCOR I more frequently received beta-blockers (85% vs 71%; P <.001), mineralocorticoid antagonists (64% vs 44%; P <.001), implantable cardioverter-defibrillators (19% vs 2%; P <.001), and resynchronization therapy (7.2% vs 4.8%; P=.04). In these patients, sudden cardiac death was less frequent than in those in MUSIC (6.8% vs 11.4%; P <.001). After propensity score matching, we obtained 2 comparable populations differing only in treatments (575 vs 575 patients). In patients in REDINSCOR I, we found a lower risk of total mortality (HR, 0.70; 95%CI, 0.57-0.87; P=.001) and sudden cardiac death (sHR, 0.46; 95%CI, 0.30-0.70; P <.001), and a trend toward lower mortality due to end-stage HF (sHR, 0.73; 95%CI, 0.53-1.01; P=.059), without differences in other causes of death (sHR, 1.17; 95%CI, 0.78-1.75; P=.445), regardless of functional class.
CONCLUSIONS
In ambulatory patients with HFrEF, implementation of evidence-based therapies was associated with a lower risk of death, mainly due to a significant reduction in sudden cardiac death.
DOI: 10.1016/j.rec.2019.09.030
PubMed: 31974070
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Changes in causes of death and influence of therapeutic improvement over time in patients with heart failure and reduced ejection fraction.</title><author><name sortKey="Fernandez Vazquez, David" sort="Fernandez Vazquez, David" uniqKey="Fernandez Vazquez D" first="David" last="Fernández-Vázquez">David Fernández-Vázquez</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia</wicri:regionArea><wicri:noRegion>Murcia</wicri:noRegion></affiliation></author><author><name sortKey="Ferrero Gregori, Andreu" sort="Ferrero Gregori, Andreu" uniqKey="Ferrero Gregori A" first="Andreu" last="Ferrero-Gregori">Andreu Ferrero-Gregori</name><affiliation wicri:level="4"><nlm:affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université autonome de Barcelone</orgName></affiliation></author><author><name sortKey="Alvarez Garcia, Jesus" sort="Alvarez Garcia, Jesus" uniqKey="Alvarez Garcia J" first="Jesús" last="Álvarez-García">Jesús Álvarez-García</name><affiliation wicri:level="4"><nlm:affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université autonome de Barcelone</orgName></affiliation></author><author><name sortKey="G Mez Otero, Ines" sort="G Mez Otero, Ines" uniqKey="G Mez Otero I" first="Inés" last="G Mez-Otero">Inés G Mez-Otero</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña</wicri:regionArea><wicri:noRegion>A Coruña</wicri:noRegion></affiliation></author><author><name sortKey="Vazquez, Rafael" sort="Vazquez, Rafael" uniqKey="Vazquez R" first="Rafael" last="Vázquez">Rafael Vázquez</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz</wicri:regionArea><wicri:noRegion>Cádiz</wicri:noRegion></affiliation></author><author><name sortKey="Delgado Jimenez, Juan" sort="Delgado Jimenez, Juan" uniqKey="Delgado Jimenez J" first="Juan" last="Delgado Jiménez">Juan Delgado Jiménez</name><affiliation wicri:level="3"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Facultad de Medicina UCM, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Facultad de Medicina UCM, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Worner Diz, Fernando" sort="Worner Diz, Fernando" uniqKey="Worner Diz F" first="Fernando" last="Worner Diz">Fernando Worner Diz</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida</wicri:regionArea><wicri:noRegion>Lleida</wicri:noRegion></affiliation></author><author><name sortKey="Bardaji, Alfredo" sort="Bardaji, Alfredo" uniqKey="Bardaji A" first="Alfredo" last="Bardají">Alfredo Bardají</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona</wicri:regionArea><wicri:noRegion>Tarragona</wicri:noRegion></affiliation></author><author><name sortKey="Garcia Pavia, Pablo" sort="Garcia Pavia, Pablo" uniqKey="Garcia Pavia P" first="Pablo" last="García-Pavía">Pablo García-Pavía</name><affiliation wicri:level="3"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Bayes Genis, Antoni" sort="Bayes Genis, Antoni" uniqKey="Bayes Genis A" first="Antoni" last="Bayés-Genís">Antoni Bayés-Genís</name><affiliation wicri:level="3"><nlm:affiliation>Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Gonzalez Juanatey, Jose R" sort="Gonzalez Juanatey, Jose R" uniqKey="Gonzalez Juanatey J" first="José R" last="González-Juanatey">José R. González-Juanatey</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña</wicri:regionArea><wicri:noRegion>A Coruña</wicri:noRegion></affiliation></author><author><name sortKey="Cinca, Juan" sort="Cinca, Juan" uniqKey="Cinca J" first="Juan" last="Cinca">Juan Cinca</name><affiliation wicri:level="4"><nlm:affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université autonome de Barcelone</orgName></affiliation></author><author><name sortKey="Pascual Figal, Domingo A" sort="Pascual Figal, Domingo A" uniqKey="Pascual Figal D" first="Domingo A" last="Pascual Figal">Domingo A. Pascual Figal</name><affiliation wicri:level="3"><nlm:affiliation>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. Electronic address: dpascual@um.es.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:31974070</idno><idno type="pmid">31974070</idno><idno type="doi">10.1016/j.rec.2019.09.030</idno><idno type="wicri:Area/Main/Corpus">000341</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000341</idno><idno type="wicri:Area/Main/Curation">000341</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000341</idno><idno type="wicri:Area/Main/Exploration">000341</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Changes in causes of death and influence of therapeutic improvement over time in patients with heart failure and reduced ejection fraction.</title><author><name sortKey="Fernandez Vazquez, David" sort="Fernandez Vazquez, David" uniqKey="Fernandez Vazquez D" first="David" last="Fernández-Vázquez">David Fernández-Vázquez</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia</wicri:regionArea><wicri:noRegion>Murcia</wicri:noRegion></affiliation></author><author><name sortKey="Ferrero Gregori, Andreu" sort="Ferrero Gregori, Andreu" uniqKey="Ferrero Gregori A" first="Andreu" last="Ferrero-Gregori">Andreu Ferrero-Gregori</name><affiliation wicri:level="4"><nlm:affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université autonome de Barcelone</orgName></affiliation></author><author><name sortKey="Alvarez Garcia, Jesus" sort="Alvarez Garcia, Jesus" uniqKey="Alvarez Garcia J" first="Jesús" last="Álvarez-García">Jesús Álvarez-García</name><affiliation wicri:level="4"><nlm:affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université autonome de Barcelone</orgName></affiliation></author><author><name sortKey="G Mez Otero, Ines" sort="G Mez Otero, Ines" uniqKey="G Mez Otero I" first="Inés" last="G Mez-Otero">Inés G Mez-Otero</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña</wicri:regionArea><wicri:noRegion>A Coruña</wicri:noRegion></affiliation></author><author><name sortKey="Vazquez, Rafael" sort="Vazquez, Rafael" uniqKey="Vazquez R" first="Rafael" last="Vázquez">Rafael Vázquez</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz</wicri:regionArea><wicri:noRegion>Cádiz</wicri:noRegion></affiliation></author><author><name sortKey="Delgado Jimenez, Juan" sort="Delgado Jimenez, Juan" uniqKey="Delgado Jimenez J" first="Juan" last="Delgado Jiménez">Juan Delgado Jiménez</name><affiliation wicri:level="3"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Facultad de Medicina UCM, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Facultad de Medicina UCM, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Worner Diz, Fernando" sort="Worner Diz, Fernando" uniqKey="Worner Diz F" first="Fernando" last="Worner Diz">Fernando Worner Diz</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida</wicri:regionArea><wicri:noRegion>Lleida</wicri:noRegion></affiliation></author><author><name sortKey="Bardaji, Alfredo" sort="Bardaji, Alfredo" uniqKey="Bardaji A" first="Alfredo" last="Bardají">Alfredo Bardají</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona</wicri:regionArea><wicri:noRegion>Tarragona</wicri:noRegion></affiliation></author><author><name sortKey="Garcia Pavia, Pablo" sort="Garcia Pavia, Pablo" uniqKey="Garcia Pavia P" first="Pablo" last="García-Pavía">Pablo García-Pavía</name><affiliation wicri:level="3"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Bayes Genis, Antoni" sort="Bayes Genis, Antoni" uniqKey="Bayes Genis A" first="Antoni" last="Bayés-Genís">Antoni Bayés-Genís</name><affiliation wicri:level="3"><nlm:affiliation>Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Gonzalez Juanatey, Jose R" sort="Gonzalez Juanatey, Jose R" uniqKey="Gonzalez Juanatey J" first="José R" last="González-Juanatey">José R. González-Juanatey</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña</wicri:regionArea><wicri:noRegion>A Coruña</wicri:noRegion></affiliation></author><author><name sortKey="Cinca, Juan" sort="Cinca, Juan" uniqKey="Cinca J" first="Juan" last="Cinca">Juan Cinca</name><affiliation wicri:level="4"><nlm:affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université autonome de Barcelone</orgName></affiliation></author><author><name sortKey="Pascual Figal, Domingo A" sort="Pascual Figal, Domingo A" uniqKey="Pascual Figal D" first="Domingo A" last="Pascual Figal">Domingo A. Pascual Figal</name><affiliation wicri:level="3"><nlm:affiliation>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. Electronic address: dpascual@um.es.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author></analytic><series><title level="j">Revista espanola de cardiologia (English ed.)</title><idno type="eISSN">1885-5857</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION AND OBJECTIVES</b></p><p>In patients with heart failure and reduced ejection fraction (HFrEF), several therapies have been proven to reduce mortality in clinical trials. However, there are few data on the effect of the use of evidence-based therapies on causes of death in clinical practice.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This study included 2351 outpatients with HFrEF (< 40%) from 2 multicenter prospective registries: MUSIC (n=641, period: 2003-2004) and REDINSCOR I (n=1710, period: 2007-2011). Variables were recorded at inclusion and all patients were followed-up for 4 years. Causes of death were validated by an independent committee.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Patients in REDINSCOR I more frequently received beta-blockers (85% vs 71%; P <.001), mineralocorticoid antagonists (64% vs 44%; P <.001), implantable cardioverter-defibrillators (19% vs 2%; P <.001), and resynchronization therapy (7.2% vs 4.8%; P=.04). In these patients, sudden cardiac death was less frequent than in those in MUSIC (6.8% vs 11.4%; P <.001). After propensity score matching, we obtained 2 comparable populations differing only in treatments (575 vs 575 patients). In patients in REDINSCOR I, we found a lower risk of total mortality (HR, 0.70; 95%CI, 0.57-0.87; P=.001) and sudden cardiac death (sHR, 0.46; 95%CI, 0.30-0.70; P <.001), and a trend toward lower mortality due to end-stage HF (sHR, 0.73; 95%CI, 0.53-1.01; P=.059), without differences in other causes of death (sHR, 1.17; 95%CI, 0.78-1.75; P=.445), regardless of functional class.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>In ambulatory patients with HFrEF, implementation of evidence-based therapies was associated with a lower risk of death, mainly due to a significant reduction in sudden cardiac death.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">31974070</PMID><DateRevised><Year>2020</Year><Month>07</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1885-5857</ISSN><JournalIssue CitedMedium="Internet"><Volume>73</Volume><Issue>7</Issue><PubDate><Year>2020</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Revista espanola de cardiologia (English ed.)</Title><ISOAbbreviation>Rev Esp Cardiol (Engl Ed)</ISOAbbreviation></Journal><ArticleTitle>Changes in causes of death and influence of therapeutic improvement over time in patients with heart failure and reduced ejection fraction.</ArticleTitle><Pagination><MedlinePgn>561-568</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1885-5857(19)30420-7</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.rec.2019.09.030</ELocationID><Abstract><AbstractText Label="INTRODUCTION AND OBJECTIVES" NlmCategory="OBJECTIVE">In patients with heart failure and reduced ejection fraction (HFrEF), several therapies have been proven to reduce mortality in clinical trials. However, there are few data on the effect of the use of evidence-based therapies on causes of death in clinical practice.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This study included 2351 outpatients with HFrEF (< 40%) from 2 multicenter prospective registries: MUSIC (n=641, period: 2003-2004) and REDINSCOR I (n=1710, period: 2007-2011). Variables were recorded at inclusion and all patients were followed-up for 4 years. Causes of death were validated by an independent committee.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Patients in REDINSCOR I more frequently received beta-blockers (85% vs 71%; P <.001), mineralocorticoid antagonists (64% vs 44%; P <.001), implantable cardioverter-defibrillators (19% vs 2%; P <.001), and resynchronization therapy (7.2% vs 4.8%; P=.04). In these patients, sudden cardiac death was less frequent than in those in MUSIC (6.8% vs 11.4%; P <.001). After propensity score matching, we obtained 2 comparable populations differing only in treatments (575 vs 575 patients). In patients in REDINSCOR I, we found a lower risk of total mortality (HR, 0.70; 95%CI, 0.57-0.87; P=.001) and sudden cardiac death (sHR, 0.46; 95%CI, 0.30-0.70; P <.001), and a trend toward lower mortality due to end-stage HF (sHR, 0.73; 95%CI, 0.53-1.01; P=.059), without differences in other causes of death (sHR, 1.17; 95%CI, 0.78-1.75; P=.445), regardless of functional class.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In ambulatory patients with HFrEF, implementation of evidence-based therapies was associated with a lower risk of death, mainly due to a significant reduction in sudden cardiac death.</AbstractText><CopyrightInformation>Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fernández-Vázquez</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferrero-Gregori</LastName><ForeName>Andreu</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Álvarez-García</LastName><ForeName>Jesús</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gómez-Otero</LastName><ForeName>Inés</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vázquez</LastName><ForeName>Rafael</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Delgado Jiménez</LastName><ForeName>Juan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Facultad de Medicina UCM, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Worner Diz</LastName><ForeName>Fernando</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bardají</LastName><ForeName>Alfredo</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>García-Pavía</LastName><ForeName>Pablo</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bayés-Genís</LastName><ForeName>Antoni</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>González-Juanatey</LastName><ForeName>José R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, IDIS, Santiago de Compostela, A Coruña, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cinca</LastName><ForeName>Juan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pascual Figal</LastName><ForeName>Domingo A</ForeName><Initials>DA</Initials><AffiliationInfo><Affiliation>Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. Electronic address: dpascual@um.es.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><Language>spa</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>01</Month><Day>20</Day></ArticleDate></Article><MedlineJournalInfo><Country>Spain</Country><MedlineTA>Rev Esp Cardiol (Engl Ed)</MedlineTA><NlmUniqueID>101587954</NlmUniqueID><ISSNLinking>1885-5857</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Rev Esp Cardiol (Engl Ed). 2020 Sep;73(9):783-784</RefSource><PMID Version="1">32631798</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Fracción de eyección reducida</Keyword><Keyword MajorTopicYN="N">Heart failure</Keyword><Keyword MajorTopicYN="N">Insuficiencia cardiaca</Keyword><Keyword MajorTopicYN="N">Mortalidad</Keyword><Keyword MajorTopicYN="N">Mortality</Keyword><Keyword MajorTopicYN="N">Muerte súbita</Keyword><Keyword MajorTopicYN="N">Reduced ejection fraction</Keyword><Keyword MajorTopicYN="N">Sudden cardiac death</Keyword><Keyword MajorTopicYN="N">Tratamientos</Keyword><Keyword MajorTopicYN="N">Treatments</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>02</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>09</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>1</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>1</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>1</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31974070</ArticleId><ArticleId IdType="pii">S1885-5857(19)30420-7</ArticleId><ArticleId IdType="doi">10.1016/j.rec.2019.09.030</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li><li>Communauté de Madrid</li></region><settlement><li>Barcelone</li><li>Madrid</li></settlement><orgName><li>Université autonome de Barcelone</li></orgName></list><tree><country name="Espagne"><noRegion><name sortKey="Fernandez Vazquez, David" sort="Fernandez Vazquez, David" uniqKey="Fernandez Vazquez D" first="David" last="Fernández-Vázquez">David Fernández-Vázquez</name></noRegion><name sortKey="Alvarez Garcia, Jesus" sort="Alvarez Garcia, Jesus" uniqKey="Alvarez Garcia J" first="Jesús" last="Álvarez-García">Jesús Álvarez-García</name><name sortKey="Bardaji, Alfredo" sort="Bardaji, Alfredo" uniqKey="Bardaji A" first="Alfredo" last="Bardají">Alfredo Bardají</name><name sortKey="Bayes Genis, Antoni" sort="Bayes Genis, Antoni" uniqKey="Bayes Genis A" first="Antoni" last="Bayés-Genís">Antoni Bayés-Genís</name><name sortKey="Cinca, Juan" sort="Cinca, Juan" uniqKey="Cinca J" first="Juan" last="Cinca">Juan Cinca</name><name sortKey="Delgado Jimenez, Juan" sort="Delgado Jimenez, Juan" uniqKey="Delgado Jimenez J" first="Juan" last="Delgado Jiménez">Juan Delgado Jiménez</name><name sortKey="Ferrero Gregori, Andreu" sort="Ferrero Gregori, Andreu" uniqKey="Ferrero Gregori A" first="Andreu" last="Ferrero-Gregori">Andreu Ferrero-Gregori</name><name sortKey="G Mez Otero, Ines" sort="G Mez Otero, Ines" uniqKey="G Mez Otero I" first="Inés" last="G Mez-Otero">Inés G Mez-Otero</name><name sortKey="Garcia Pavia, Pablo" sort="Garcia Pavia, Pablo" uniqKey="Garcia Pavia P" first="Pablo" last="García-Pavía">Pablo García-Pavía</name><name sortKey="Gonzalez Juanatey, Jose R" sort="Gonzalez Juanatey, Jose R" uniqKey="Gonzalez Juanatey J" first="José R" last="González-Juanatey">José R. González-Juanatey</name><name sortKey="Pascual Figal, Domingo A" sort="Pascual Figal, Domingo A" uniqKey="Pascual Figal D" first="Domingo A" last="Pascual Figal">Domingo A. Pascual Figal</name><name sortKey="Vazquez, Rafael" sort="Vazquez, Rafael" uniqKey="Vazquez R" first="Rafael" last="Vázquez">Rafael Vázquez</name><name sortKey="Worner Diz, Fernando" sort="Worner Diz, Fernando" uniqKey="Worner Diz F" first="Fernando" last="Worner Diz">Fernando Worner Diz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SanteMusiqueV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000341 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000341 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SanteMusiqueV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:31974070
|texte= Changes in causes of death and influence of therapeutic improvement over time in patients with heart failure and reduced ejection fraction.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:31974070" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SanteMusiqueV1
| This area was generated with Dilib version V0.6.38. |  |