Implantable Hemodynamic Monitors Improve Survival in Patients With Heart Failure and Reduced Ejection Fraction
Copyright © 2024. Published by Elsevier Inc..
BACKGROUND: Trials evaluating implantable hemodynamic monitors to manage patients with heart failure (HF) have shown reductions in HF hospitalizations but not mortality. Prior meta-analyses assessing mortality have been limited in construct because of an absence of patient-level data, short-term follow-up duration, and evaluation across the combined spectrum of ejection fractions.
OBJECTIVES: The purpose of this meta-analysis was to determine whether management with implantable hemodynamic monitors reduces mortality in patients with heart failure and reduced ejection fraction (HFrEF) and to confirm the effect of hemodynamic-monitoring guided management on HF hospitalization reduction reported in previous studies.
METHODS: The patient-level pooled meta-analysis used 3 randomized studies (GUIDE-HF [Hemodynamic-Guided Management of Heart Failure], CHAMPION [CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients], and LAPTOP-HF [Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy]) of implantable hemodynamic monitors (2 measuring pulmonary artery pressures and 1 measuring left atrial pressure) to assess the effect on all-cause mortality and HF hospitalizations.
RESULTS: A total of 1,350 patients with HFrEF were included. Hemodynamic-monitoring guided management significantly reduced overall mortality with an HR of 0.75 (95% CI: 0.57-0.99); P = 0.043. HF hospitalizations were significantly reduced with an HR of 0.64 (95% CI: 0.55-0.76); P < 0.0001.
CONCLUSIONS: Management of patients with HFrEF using an implantable hemodynamic monitor significantly reduces both mortality and HF hospitalizations. The reduction in HF hospitalizations is seen early in the first year of monitoring and mortality benefits occur after the first year.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:83 |
|---|---|
| Enthalten in: |
Journal of the American College of Cardiology - 83(2024), 6 vom: 13. Feb., Seite 682-694 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Lindenfeld, JoAnn [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Diuretics |
|---|
| Anmerkungen: |
Date Completed 09.02.2024 Date Revised 09.02.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jacc.2023.11.030 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36815226X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36815226X | ||
| 003 | DE-627 | ||
| 005 | 20240209232127.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240208s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jacc.2023.11.030 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1285.xml |
| 035 | |a (DE-627)NLM36815226X | ||
| 035 | |a (NLM)38325994 | ||
| 035 | |a (PII)S0735-1097(23)08205-0 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Lindenfeld, JoAnn |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Implantable Hemodynamic Monitors Improve Survival in Patients With Heart Failure and Reduced Ejection Fraction |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 09.02.2024 | ||
| 500 | |a Date Revised 09.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024. Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: Trials evaluating implantable hemodynamic monitors to manage patients with heart failure (HF) have shown reductions in HF hospitalizations but not mortality. Prior meta-analyses assessing mortality have been limited in construct because of an absence of patient-level data, short-term follow-up duration, and evaluation across the combined spectrum of ejection fractions | ||
| 520 | |a OBJECTIVES: The purpose of this meta-analysis was to determine whether management with implantable hemodynamic monitors reduces mortality in patients with heart failure and reduced ejection fraction (HFrEF) and to confirm the effect of hemodynamic-monitoring guided management on HF hospitalization reduction reported in previous studies | ||
| 520 | |a METHODS: The patient-level pooled meta-analysis used 3 randomized studies (GUIDE-HF [Hemodynamic-Guided Management of Heart Failure], CHAMPION [CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients], and LAPTOP-HF [Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy]) of implantable hemodynamic monitors (2 measuring pulmonary artery pressures and 1 measuring left atrial pressure) to assess the effect on all-cause mortality and HF hospitalizations | ||
| 520 | |a RESULTS: A total of 1,350 patients with HFrEF were included. Hemodynamic-monitoring guided management significantly reduced overall mortality with an HR of 0.75 (95% CI: 0.57-0.99); P = 0.043. HF hospitalizations were significantly reduced with an HR of 0.64 (95% CI: 0.55-0.76); P < 0.0001 | ||
| 520 | |a CONCLUSIONS: Management of patients with HFrEF using an implantable hemodynamic monitor significantly reduces both mortality and HF hospitalizations. The reduction in HF hospitalizations is seen early in the first year of monitoring and mortality benefits occur after the first year | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a heart failure hospitalizations | |
| 650 | 4 | |a heart failure with reduced ejection fraction | |
| 650 | 4 | |a implantable hemodynamic monitoring | |
| 650 | 4 | |a implantable hemodynamic monitors | |
| 650 | 4 | |a mortality | |
| 650 | 7 | |a Diuretics |2 NLM | |
| 700 | 1 | |a Costanzo, Maria Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Zile, Michael R |e verfasserin |4 aut | |
| 700 | 1 | |a Ducharme, Anique |e verfasserin |4 aut | |
| 700 | 1 | |a Troughton, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Maisel, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Mehra, Mandeep R |e verfasserin |4 aut | |
| 700 | 1 | |a Paul, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Sears, Samuel F |e verfasserin |4 aut | |
| 700 | 1 | |a Smart, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Johnson, Nessa |e verfasserin |4 aut | |
| 700 | 1 | |a Henderson, John |e verfasserin |4 aut | |
| 700 | 1 | |a Adamson, Philip B |e verfasserin |4 aut | |
| 700 | 1 | |a Desai, Akshay S |e verfasserin |4 aut | |
| 700 | 1 | |a Abraham, William T |e verfasserin |4 aut | |
| 700 | 0 | |a GUIDE-HF, CHAMPION, and LAPTOP-HF Investigators |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of the American College of Cardiology |d 1987 |g 83(2024), 6 vom: 13. Feb., Seite 682-694 |w (DE-627)NLM012608602 |x 1558-3597 |7 nnns |
| 773 | 1 | 8 | |g volume:83 |g year:2024 |g number:6 |g day:13 |g month:02 |g pages:682-694 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jacc.2023.11.030 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 83 |j 2024 |e 6 |b 13 |c 02 |h 682-694 | ||