Current guidelines advise against the use of NSAIDs in patients with chronic heart failure (CHF) due to the increased risk of fluid retention. However, many NSAIDS are available over the counter (OTC), and patients obtaining them in this manner may be putting themselves at increased risk of myocardial infarction or worsening heart failure. […]
Tag: Heart Failure
BNP guided therapy for heart failure
Although a number of studies have previously investigated the utility of N-terminal brain natriuretic peptide (BNP) to guide treatment for heart failure, these studies were limited by their small size and limited follow-up. The Trial of Intensified vs Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) aimed to overcome these limitations. […]
Polyunsaturated fatty acids improve outcome in heart failure
In the initial Gruppo Italiano per lo Studio della Sopravvivenza nell’infarto miocardico (GISSI) trial, patients taking n-3 polyunsaturated fatty acids (PUFA) after myocardial infarction had a lower mortality rate than those in the control group. The purpose of the GISSI-HF trial was to determine if PUFA could improve morbidity and mortality in patients with symptomatic […]
No benefit from irbesartan in patients with normal ejection fraction heart failure
The I-PRESERVE study (Irbesartan in Heart Failure with Preserved Ejection Fraction) assessed the efficacy of the angiotensin II receptor blocker (AIIRB) irebesartan on mortality and cardiovascular morbidity in patients with heart failure and a preserved LVEF. This was a multi-centre international trial which enrolled 4128 patients with a minimum age of 60 years and NYHA […]
Beta-blockers: all are equal, but some more than others
Carvedilol, Metoprolol and Bisoprolol have all been shown to improve outcomes in patients with heart failure. These evidence based beta-blockers (EBBB) are in contrast to atenolol, propranolol, and timolol, which have not been directly tested in heart failure. Therefore if a patient on one of these agents develops heart failure, is it neccesary to switch […]
VAD survival rate lower than expected in new analysis
In 2003 Medicare extended coverage of ventricular assist devices (VAD) as destination (permanent) therapy for end-stage heart failure in the USA. Hernandez et al. performed an analysis to determine the short- and long-term clinical outcomes of patients receiving VAD therapy, as well as the costs involved, since this change. […]
BEAUTIFUL – no go for go slow with ivabradine
Ivabradine is a pure heart-rate lowering agent that is a specific inhibitor of the If current in the sino-atrial node; currently it is licenced for the treatment of angina. The BEAUTIFUL (morbidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left-ventricUlar dysfunction) trial aimed to determine if heart rate lowering with […]