The Rationale for an Acute Heart Failure Syndromes Clinical Trials Network

Sean P. Collins, Phillip D. Levy, Christopher J. Lindsell, Peter Pang, Alan B. Storrow, Chadwick D. Miller, Allen J. Naftilan, Vinay Thohan, William T. Abraham, Brian Hiestand, Gerasimos Filippatos, Deborah B. Diercks, Judd Hollander, Richard Nowak, W. Frank Peacock, Mihai Gheorghiade

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Clinical trials involving novel therapies treating acute heart failure syndromes (AHFS) have shown limited success with regard to both efficacy and safety. As a direct result, outcomes have changed little over time and AHFS remains a disease process associated with largely no change in hospitalization rates (80%), hospital length of stay (median 4.5 days), and in-hospital (4-7%) and 60-day mortality (10%). Despite extensive emergency department (ED) involvement during the initial phase of AHFS management, clinical trials have enrolled patients after the ED phase of management, up to 48 hours after initial therapy, long after many patients have experienced significant beneficial effects of standard therapy. As standard therapy has provided symptomatic improvement in up to 70% of patients in these trials, it is not surprising that investigational agents started after 24 to 48 hours of standard therapy have shown limited clinical efficacy when compared with standard therapy. Methods and Results: The ability to screen, enroll, and randomize in the emergency setting is fundamental. The unique environment, the ethical complexities of enrollment in emergency-based research, and the need for rapid and standardized study-compliant care represent key challenges to active recruitment in AHFS studies. Specifically, the ability to identify and enroll a large cohort of AHFS patients early (

Original languageEnglish (US)
Pages (from-to)467-474
Number of pages8
JournalJournal of Cardiac Failure
Volume15
Issue number6
DOIs
StatePublished - Aug 2009
Externally publishedYes

Fingerprint

Heart Failure
Clinical Trials
Hospital Emergency Service
Length of Stay
Emergencies
Therapeutics
Hospitalization
Safety
Mortality
Research

Keywords

  • Acute heart failure syndromes
  • cardiology
  • clinical trials network
  • emergency department

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Collins, S. P., Levy, P. D., Lindsell, C. J., Pang, P., Storrow, A. B., Miller, C. D., ... Gheorghiade, M. (2009). The Rationale for an Acute Heart Failure Syndromes Clinical Trials Network. Journal of Cardiac Failure, 15(6), 467-474. https://doi.org/10.1016/j.cardfail.2008.12.013

The Rationale for an Acute Heart Failure Syndromes Clinical Trials Network. / Collins, Sean P.; Levy, Phillip D.; Lindsell, Christopher J.; Pang, Peter; Storrow, Alan B.; Miller, Chadwick D.; Naftilan, Allen J.; Thohan, Vinay; Abraham, William T.; Hiestand, Brian; Filippatos, Gerasimos; Diercks, Deborah B.; Hollander, Judd; Nowak, Richard; Peacock, W. Frank; Gheorghiade, Mihai.

In: Journal of Cardiac Failure, Vol. 15, No. 6, 08.2009, p. 467-474.

Research output: Contribution to journalArticle

Collins, SP, Levy, PD, Lindsell, CJ, Pang, P, Storrow, AB, Miller, CD, Naftilan, AJ, Thohan, V, Abraham, WT, Hiestand, B, Filippatos, G, Diercks, DB, Hollander, J, Nowak, R, Peacock, WF & Gheorghiade, M 2009, 'The Rationale for an Acute Heart Failure Syndromes Clinical Trials Network', Journal of Cardiac Failure, vol. 15, no. 6, pp. 467-474. https://doi.org/10.1016/j.cardfail.2008.12.013
Collins, Sean P. ; Levy, Phillip D. ; Lindsell, Christopher J. ; Pang, Peter ; Storrow, Alan B. ; Miller, Chadwick D. ; Naftilan, Allen J. ; Thohan, Vinay ; Abraham, William T. ; Hiestand, Brian ; Filippatos, Gerasimos ; Diercks, Deborah B. ; Hollander, Judd ; Nowak, Richard ; Peacock, W. Frank ; Gheorghiade, Mihai. / The Rationale for an Acute Heart Failure Syndromes Clinical Trials Network. In: Journal of Cardiac Failure. 2009 ; Vol. 15, No. 6. pp. 467-474.
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