TY - JOUR
T1 - Causes of death and rehospitalization in patients hospitalized with worsening heart failure and reduced left ventricular ejection fraction
T2 - Results from efficacy of vasopressin antagonism in heart failure outcome study with tolvaptan (EVEREST) program
AU - O'Connor, Christopher M.
AU - Miller, Alan B.
AU - Blair, John E.A.
AU - Konstam, Marvin A.
AU - Wedge, Patricia
AU - Bahit, Maria C.
AU - Carson, Peter
AU - Haass, Markus
AU - Hauptman, Paul J.
AU - Metra, Marco
AU - Oren, Ron M.
AU - Patten, Richard
AU - Piña, Ileana
AU - Roth, Sherryn
AU - Sackner-Bernstein, Jonathan D.
AU - Traver, Brian
AU - Cook, Thomas
AU - Gheorghiade, Mihai
N1 - Funding Information:
Dr O'Connor reports having received funding from the National Heart Lung and Blood Institute (NHLBI), Amgen, Astra, Bristol-Meyers Squibb, GlaxoSmithKline, Guidant, Medtronic, Merck, Nitrox LLC, Novartis, Otsuka, Pfizer, ArcaBioPharma, Sanofi-Sythelabo, and MedPace; Dr Miller Reports having received research grants from Otsuka and Pfizer and honoraria from Medtronic, Nitromed, Novartis, Pfizer, Sanofi, and Scios Inc; Dr Blair reports having been a consultant for SigmaTau; Dr Konstam reports the following companies, involved in development of drugs or devices for HF, for which he consulted, performed research, or have had other financial relationships: Otsuka, Merck, Cardiokine, Biogen, Orqis Medical, Boston Scientific, Sanofi, Cytokinetics, and Novartis; Ms Wedge reports having received funding from Otsuka; Dr Hauptman reports having been a consultant for Otsuka, BioControl Medical, Merck, Cardiokine, and ArcaBioPharma and having been on the speakers bureau of GlaxoSmithKline; Dr Metra reports having received consulting fees from Corthera, Duke Clinical Research Institute, Merck, Nile therapeutics, and Servier; Dr Piña reports having received grant support through Case Western Reserve University and the NHLBI, Office of Women's Health (Health and Human Services); having been on the speakers bureau for AstraZeneca, Merck, Solvay, Novartis, and Innovia; and having been a consultant for the Food and Drug Administration and Sanofi-Aventis; Mr Traver and Dr Cook report having received compensation through a contract between the University of Wisconsin and Otsuka; Dr Gheorghiade reports having been a consultant for Otsuka, Solvay Pharma, Novartis, Bayer, Sigma Tau, Debiopharm, Medtronic, Merck, Astellas, Cytokinetics, CorThera Inc, Pericor Therapeutics, GlaxoSmithKline, Johnson & Johnson, Abbott, Errekappa Terapeutici, Protein Design Laboratories, AstraZeneca, Protein Design Laboratories, and Sanofi-Aventis. No other disclosures were reported.
Funding Information:
Funding sources: This study was supported by Otsuka Pharmaceuticals under the guidance of the EVEREST steering committee.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2010/5
Y1 - 2010/5
N2 - Background: The postdischarge rehospitalization and death rates are high in patients with acute heart failure (HF) syndromes despite optimization of standard therapy for chronic HF. To the best of our knowledge, there has been no systematic analysis of the causes of death and rehospitalization in this patient population. Methods: This was a prespecified analysis of adjudicated cause-specific all-cause mortality and cardiovascular (CV) hospitalization in the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial, a randomized, double-blind, placebo-controlled study in patients hospitalized with worsening HF and left ventricular ejection fraction ≤40% comparing tolvaptan, an oral vasopressin receptor antagonist to placebo, in addition to standard care. Results: Of the 4,133 randomized, there were 5,239 rehospitalizations and 1,080 deaths during a median of 9.9 months. Of all deaths, 41.0% were due to HF, 26.0% due to sudden cardiac death (SCD), 2.6% due to acute myocardial infarction (MI), 2.2% due to stroke, and 13.2% due to non-CV causes. Of all hospitalizations, 39.2% were non-CV, whereas 46.3% were for HF, and a minority of hospitalizations was due to stroke, MI, arrhythmia, or other CV causes. Conclusions: Despite close follow-up and evidence-based therapy within a clinical trial, rehospitalization and death remain high. Although most deaths were from HF, one quarter of patients had SCD. In addition, there were almost as many non-CV hospitalizations as HF hospitalizations. Knowledge of the causes of death and rehospitalization may be essential for proper management and early initiation of therapy.
AB - Background: The postdischarge rehospitalization and death rates are high in patients with acute heart failure (HF) syndromes despite optimization of standard therapy for chronic HF. To the best of our knowledge, there has been no systematic analysis of the causes of death and rehospitalization in this patient population. Methods: This was a prespecified analysis of adjudicated cause-specific all-cause mortality and cardiovascular (CV) hospitalization in the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial, a randomized, double-blind, placebo-controlled study in patients hospitalized with worsening HF and left ventricular ejection fraction ≤40% comparing tolvaptan, an oral vasopressin receptor antagonist to placebo, in addition to standard care. Results: Of the 4,133 randomized, there were 5,239 rehospitalizations and 1,080 deaths during a median of 9.9 months. Of all deaths, 41.0% were due to HF, 26.0% due to sudden cardiac death (SCD), 2.6% due to acute myocardial infarction (MI), 2.2% due to stroke, and 13.2% due to non-CV causes. Of all hospitalizations, 39.2% were non-CV, whereas 46.3% were for HF, and a minority of hospitalizations was due to stroke, MI, arrhythmia, or other CV causes. Conclusions: Despite close follow-up and evidence-based therapy within a clinical trial, rehospitalization and death remain high. Although most deaths were from HF, one quarter of patients had SCD. In addition, there were almost as many non-CV hospitalizations as HF hospitalizations. Knowledge of the causes of death and rehospitalization may be essential for proper management and early initiation of therapy.
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U2 - 10.1016/j.ahj.2010.02.023
DO - 10.1016/j.ahj.2010.02.023
M3 - Article
C2 - 20435194
AN - SCOPUS:77951653633
VL - 159
SP - 841-849.e1
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 5
ER -