University of Leicester
Browse
DOCUMENT
Submission draft_WHF Review_13May2016.docx (3.34 MB)
DOCUMENT
In-hospital worsening heart failure: a clinically relevant endpoint?.pdf (495.36 kB)
1/0
2 files

In-hospital worsening heart failure: a clinically relevant endpoint?

journal contribution
posted on 2018-04-16, 14:51 authored by Andrew L. Clark, Myriam Cherif, Theresa A. McDonagh, Iain B. Squire
Outcome measures used for the clinical evaluation of patients with acute heart failure differ between studies and may neither adequately address the characteristic presenting symptoms and signs nor reflect the pathophysiological processes involved. In-hospital worsening of heart failure (WHF) is associated with poor outcomes and thus a potential endpoint conveying clinically meaningful prognostic information. Current definitions of WHF are based on the combination of worsening symptoms and signs and the intensification of treatment during admission. Definitions vary across studies and do not fully account for baseline therapy or circumstances in which there is failure to respond to treatment. Further, there are limited data to inform healthcare professionals as to which patients are most at risk of developing in-hospital WHF. In this opinion piece, we review the definitions for WHF used in recent and ongoing clinical trials and propose a novel definition, which captures failure to respond to treatment as well as clinical worsening (deterioration of symptoms and signs) of the patient's condition. Such a definition, applied consistently across studies, would help clarify the characteristics of patients likely to develop in-hospital WHF, allow comparative assessments of the effectiveness of interventions, and help guide appropriate patient management in order to improve outcomes.

History

Citation

ESC Heart Failure, 2018, 5 (1), pp. 9-18

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

ESC Heart Failure

Publisher

Wiley Open Access

eissn

2055-5822

Acceptance date

2017-06-20

Copyright date

2018

Available date

2018-04-16

Publisher version

https://onlinelibrary.wiley.com/doi/abs/10.1002/ehf2.12195

Language

en

Usage metrics

    University of Leicester Publications

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC