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Prognosis and mechanism of death in treated heart failure: data from the placebo arm of Val-HeFT.

Publication ,  Journal Article
Cohn, JN; Carson, PE; O'Connor, C; Opasich, C; Piña, IL; Scherillo, M; Sinagra, G; Warner-Stevenson, L; Tristani, FE; Volpi, A
Published in: Congest Heart Fail
2006

The magnitude of benefit on mortality of combined angiotensin-converting enzyme inhibitor (ACEI) and beta-blocker (BB) therapy for heart failure cannot be reliably assessed from prospective randomized trials of individual drugs with intent-to-treat analysis. The placebo arm of the Valsartan Heart Failure Trial (Val-HeFT) included patients who remained on background therapy with ACEIs, BBs, neither, or both. The outcomes in these four subgroups should provide a better guide to mortality benefit. Overall mortality (mean follow-up, 23 months) was 31.6% in those receiving neither neurohormonal blocker, 29% and 39% lower in those on ACEIs or BBs, respectively, and 62% lower (11.9% mortality) in those receiving both drugs. In the neither neurohormonal inhibitor group, 48% of the heart failure-related deaths were adjudicated as sudden, whereas in the group receiving ACEIs and BBs, 79% of the deaths were sudden, and pump failure mortality was only 1% per year. The combination of ACEIs and BBs exerts a greater mortality reduction than suggested from clinical trials and reduces pump failure mortality to 1% per year.

Duke Scholars

Published In

Congest Heart Fail

DOI

ISSN

1527-5299

Publication Date

2006

Volume

12

Issue

3

Start / End Page

127 / 131

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Treatment Failure
  • Survival Analysis
  • Prospective Studies
  • Prognosis
  • Placebos
  • Patient Dropouts
  • Middle Aged
  • Male
  • Humans
 

Citation

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Cohn, J. N., Carson, P. E., O’Connor, C., Opasich, C., Piña, I. L., Scherillo, M., … Volpi, A. (2006). Prognosis and mechanism of death in treated heart failure: data from the placebo arm of Val-HeFT. Congest Heart Fail, 12(3), 127–131. https://doi.org/10.1111/j.1527-5299.2006.05441.x
Cohn, Jay N., Peter E. Carson, Christopher O’Connor, Cristina Opasich, Ileana L. Piña, Marino Scherillo, Gianfranco Sinagra, Lynne Warner-Stevenson, Felix E. Tristani, and Alberto Volpi. “Prognosis and mechanism of death in treated heart failure: data from the placebo arm of Val-HeFT.Congest Heart Fail 12, no. 3 (2006): 127–31. https://doi.org/10.1111/j.1527-5299.2006.05441.x.
Cohn JN, Carson PE, O’Connor C, Opasich C, Piña IL, Scherillo M, et al. Prognosis and mechanism of death in treated heart failure: data from the placebo arm of Val-HeFT. Congest Heart Fail. 2006;12(3):127–31.
Cohn, Jay N., et al. “Prognosis and mechanism of death in treated heart failure: data from the placebo arm of Val-HeFT.Congest Heart Fail, vol. 12, no. 3, 2006, pp. 127–31. Pubmed, doi:10.1111/j.1527-5299.2006.05441.x.
Cohn JN, Carson PE, O’Connor C, Opasich C, Piña IL, Scherillo M, Sinagra G, Warner-Stevenson L, Tristani FE, Volpi A. Prognosis and mechanism of death in treated heart failure: data from the placebo arm of Val-HeFT. Congest Heart Fail. 2006;12(3):127–131.

Published In

Congest Heart Fail

DOI

ISSN

1527-5299

Publication Date

2006

Volume

12

Issue

3

Start / End Page

127 / 131

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Treatment Failure
  • Survival Analysis
  • Prospective Studies
  • Prognosis
  • Placebos
  • Patient Dropouts
  • Middle Aged
  • Male
  • Humans