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Baseline characteristics of patients recruited into the CARE-HF study
J G F Cleland1, J C Daubert, E Erdmann
1Department of Cardiology, Castle Hill Hospital, Castle Road, Cottingham, University of Hull, Kingston upon Hull, UK HU16 5JQ. J.G.Cleland@hull.ac.uk
Insights
Cardiac resynchronization therapy (CRT) effectively treats heart failure patients with cardiac dyssynchrony. The CARE-HF trial assessed CRT
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Device Technology
Background:
- Cardiac resynchronization therapy (CRT) is an emerging treatment for heart failure (HF) patients experiencing cardiac dyssynchrony.
- The CARE-HF study aimed to establish definitive evidence regarding CRT's impact on morbidity and mortality in moderate to severe HF.
Purpose of the Study:
- To describe the baseline characteristics of patients enrolled in the CARE-HF trial.
- To evaluate the suitability of the study population for a trial investigating CRT.
Main Methods:
- Randomized controlled trial design.
- Inclusion of 813 patients with predominantly NYHA class III heart failure across 82 centers.
Main Results:
- The study population (mean age 65 years) had severe heart failure (94% NYHA class III), significant cardiac dysfunction (mean LV ejection fraction 26%), and cardiac dyssynchrony (88% QRS ≥150 ms).
- Patients exhibited high-risk profiles despite optimal medical therapy, including loop diuretics (94%), ACE inhibitors/ARBs (95%), beta-blockers (72%), and spironolactone (56%).
Conclusions:
- The CARE-HF trial enrolled patients with moderately severe heart failure, cardiac dysfunction, and dyssynchrony.
- This high-risk population is appropriate for evaluating the benefits of CRT.
Background:
Cardiac resynchronization therapy (CRT) is a promising new treatment for patients with heart failure and cardiac dyssynchrony. The CARE-HF study is a morbidity/mortality trial designed to provide conclusive evidence of the effects of CRT in patients with moderate to severe heart failure.
Methods:
A description of the baseline characteristics of patients randomised in the CARE-HF trial.
Results:
813 Patients with predominantly NYHA class III (94%) heart failure were randomised in 82 centres. Their mean age was 65 (interquartile range [IQR] 59 to 72) years, 34% were aged >70 years and 27% were women. Thirty-eight percent of the patients had ischaemic heart disease. Mean heart rate was adequately controlled at 70 (IQR 60 to 78) bpm consistent with the use of beta-blockers. Supine systolic blood pressure was low at 117 (IQR 105 to 130) mm Hg. Eighty-eight percent of patients had a QRS > or =150 ms. Mean LV ejection fraction was 26% (IQR 22 to 29) and end-diastolic dimension was 7.2 (IQR 6.4 to 7.8) cm. Ninety-four percent of patients were receiving loop diuretics, 95% an ACE inhibitor or angiotensin receptor blocker (ARB), 72% a beta-blocker and 56% were taking spironolactone.
Conclusions:
The patients enrolled in CARE-HF had moderately severe heart failure and cardiac dysfunction with evidence of cardiac dyssynchrony. The population appears at high risk of events despite pharmacological therapy and therefore appropriate for a trial of CRT.
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