Department of Internal Medicine, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia.
Department of Internal Medicine, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia.
Curr Probl Cardiol. 2024 Feb;49(2):102193. doi: 10.1016/j.cpcardiol.2023.102193. Epub 2023 Nov 11.
The evidence supporting pharmacological heart failure treatment relies on randomized clinical trials with stringent inclusion and exclusion criteria.
Assess the eligibility of outpatients with chronic heart failure for the trials DAPA-HF, EMPEROR-reduced, and PARADIGM-HF, while exploring potential differences among study populations.
By reviewing medical records, we determined the eligibility rate for each study and evaluated the incidence of heart failure hospitalizations and all-cause mortality during this period.
A total of 446 patients were included in the cohort. Approximately 75% would be ineligible for the trials, mainly because of their comorbidities. Ineligible patients had a higher all-cause mortality, but a similar incidence of hospitalization.
Approximately 1 in 4 patients from a heart failure clinic in Medellin, Colombia would meet the eligibility criteria for the DAPA-HF, EMPEROR-reduced, and PARADIGM-HF trials. These findings highlight the need to complement randomized clinical trials with real-world data.
支持心力衰竭药物治疗的证据主要来自于纳入和排除标准严格的随机临床试验。
评估慢性心力衰竭门诊患者参加 DAPA-HF、EMPEROR-reduced 和 PARADIGM-HF 试验的资格,并探讨研究人群之间的潜在差异。
通过审查病历,我们确定了每个研究的入选率,并评估了在此期间心力衰竭住院和全因死亡率的发生率。
共纳入了 446 名患者。大约 75%的患者不符合试验标准,主要是因为他们的合并症。不符合条件的患者全因死亡率较高,但住院率相似。
来自哥伦比亚麦德林心力衰竭诊所的大约 1/4 的患者符合 DAPA-HF、EMPEROR-reduced 和 PARADIGM-HF 试验的入选标准。这些发现强调了需要用真实世界的数据来补充随机临床试验。