دورية أكاديمية

Geographic variations in the PARADIGM-HF heart failure trial

التفاصيل البيبلوغرافية
العنوان: Geographic variations in the PARADIGM-HF heart failure trial
المؤلفون: Kristensen SL, Martiez F, Jhund PS, Arango JL, Bĕlohlávek J, Boytsov S, Cabrera W, Gomez E, Hagège AA, Huang J, Kiatchoosakun S, Kim KS, Mendoza I, Senni M, Squire IB, Vinereanu D, Wong RC, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Solomon SD, Swedberg K, Zile MR, Packer M, McMurray JJ
المساهمون: Kristensen, S, Martiez, F, Jhund, P, Arango, J, Bĕlohlávek, J, Boytsov, S, Cabrera, W, Gomez, E, Hagège, A, Huang, J, Kiatchoosakun, S, Kim, K, Mendoza, I, Senni, M, Squire, I, Vinereanu, D, Wong, R, Gong, J, Lefkowitz, M, Rizkala, A, Rouleau, J, Shi, V, Solomon, S, Swedberg, K, Zile, M, Packer, M, Mcmurray, J
بيانات النشر: GB
Oxford University Press
سنة النشر: 2016
المجموعة: Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive)
مصطلحات موضوعية: Clinical trial, Geographical variation, Heart failure, Prognosi, Treatment outcome
الوصف: Aims The globalization of clinical trials has highlighted geographic variations in patient characteristics, event rates, and treatment effects. We investigated these further in PARADIGM-HF, the largest and most globally representative trial in heart failure (HF) to date. Methods and results We looked at five regions: North America (NA) 602 (8%), Western Europe (WE) 1680 (20%), Central/Eastern Europe/ Russia (CEER) 2762 (33%), Latin America (LA) 1433 (17%), and Asia-Pacific (AP) 1487 (18%). Notable differences included: WE patients (mean age 68 years) and NA (65 years) were older than AP (58 years) and LA (63 years) and had more coronary disease; NA and CEER patients had the worst signs, symptoms, and functional status. North American patients were the most likely to have a defibrillating-device (54 vs. 2% AP) and least likely prescribed a mineralocorticoid receptor antagonist (36 vs. 65% LA). Other evidence-based therapies were used most frequently in NA and WE. Rates of the primary composite outcome of cardiovascular (CV) death or HF hospitalization (per 100 patient-years) varied among regions: NA 13.6 (95% CI 11.7-15.7) WE 9.6 (8.6-10.6), CEER 12.3 (11.4-13.2), LA 11.2 (10.0-12.5), and AP 12.5 (11.3-13.8). After adjustment for prognostic variables, relative to NA, the risk of CV death was higher in LA and AP and the risk of HF hospitalization lower in WE. The benefit of sacubitril/valsartan was consistent across regions. Conclusion There were many regional differences in PARADIGM-HF, including in age, symptoms, comorbidity, background therapy, and event-rates, although these did not modify the benefit of sacubitril/valsartan. Clinical trial registration URL http://www.clinicaltrials.govTest. Unique identifier: NCT01035255.
نوع الوثيقة: article in journal/newspaper
وصف الملف: STAMPA
اللغة: English
العلاقة: info:eu-repo/semantics/altIdentifier/pmid/27354044; info:eu-repo/semantics/altIdentifier/wos/WOS:000390303700013; volume:37; issue:41; firstpage:3167; lastpage:3174; numberofpages:8; journal:EUROPEAN HEART JOURNAL; http://hdl.handle.net/10281/372356Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85015912024
DOI: 10.1093/eurheartj/ehw226
الإتاحة: https://doi.org/10.1093/eurheartj/ehw226Test
http://hdl.handle.net/10281/372356Test
رقم الانضمام: edsbas.40351BE3
قاعدة البيانات: BASE