Circulation. Heart failure
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Randomized Controlled Trial Multicenter Study Comparative Study
Efficacy and cost of an exercise program for functionally impaired older patients with heart failure: a randomized controlled trial.
Little is known about the optimum way to deliver exercise to older, functionally impaired patients with heart failure. We tested whether an exercise program tailored to the needs of these patients could improve exercise capacity and quality of life or reduce costs to the National Health Service. ⋯ This exercise intervention did not improve exercise capacity or quality of life in older patients with heart failure and was not cost saving to the National Health Service. Clinical Trial Registration- URL: http://www.controlled-trials.com. Unique identifier: ISRCTN51615566.
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Multicenter Study Comparative Study
Risk prediction for early in-hospital mortality following heart transplantation in the United States.
Risk factors for early mortality after heart transplant (HT) have not been used for quantitative risk prediction. We sought to develop and validate a risk prediction model for posttransplant in-hospital mortality in HT recipients. ⋯ The proposed model allows risk stratification of HT candidates for early posttransplant mortality and may be useful in counseling patients with regard to their posttransplant prognosis. The model with additional donor-related variables may be useful during donor selection.
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Multicenter Study Comparative Study
Multiple biomarkers for risk prediction in chronic heart failure.
Prior studies have suggested using a panel of biomarkers that measure diverse biological processes as a prognostic tool in chronic heart failure. Whether this approach improves risk prediction beyond clinical evaluation is unknown. ⋯ In ambulatory chronic heart failure patients, a score derived from multiple biomarkers integrating diverse biological pathways substantially improves prediction of adverse events beyond current metrics.
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Multicenter Study Comparative Study
Presence of atrial fibrillation is independently associated with adverse outcomes in patients hospitalized with heart failure: an analysis of get with the guidelines-heart failure.
It is unclear if the presence of atrial fibrillation (AF) on admission is associated with worse in-hospital outcomes in patients hospitalized with heart failure (HF). This study evaluated the clinical characteristics, management, length of stay, and mortality of HF patients with and without AF. ⋯ In patients hospitalized with HF, AF is present in one-third and is independently associated with adverse hospital outcomes and longer length of stay. Whether prompt restoration of sinus rhythm would improve outcomes in patients hospitalized with HF and new-onset or paroxysmal AF is unclear and requires further study.
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Multicenter Study Comparative Study
Decline in heart transplant wait list mortality in the United States following broader regional sharing of donor hearts.
A change in allocation algorithm in July 2006 allowed broader regional sharing of donor hearts in the United States (US). We assessed if the allocation change has been associated with a decline in wait list mortality in the US. ⋯ The risk of death on the wait list or becoming too sick to transplant has decreased by 17% in the US since the allocation algorithm allowing broader regional sharing was implemented in 2006. The shift in hearts to sicker candidates has not resulted in higher in-hospital or first year post-transplant mortality.