Clinical trials update from the European Society of Cardiology Heart Failure meeting 2011: TEHAF, WHICH, CARVIVA, and atrial fibrillation in GISSI‐HF and EMPHASIS‐HF

This article provides information and a commentary on key trials relevant to the pathophysiology, prevention, and treatment of heart failure (HF) presented at the European Society of Cardiology Heart Failure meeting held in Gothenburg, Sweden in May 2011. Unpublished reports should be considered as preliminary, since analyses may change in the final publication. In the TEHAF study, use of the Health Buddy® monitoring system failed to reduce the number of HF admissions compared with usual care but a subgroup of patients with more recently diagnosed HF may have benefited. In the WHICH study, some reductions in the rate of hospital stay were observed in patients who underwent a nurse‐led home‐based intervention programme following a hospital admission for an acute HF exacerbation, compared with patients who were followed in a specialized outpatient clinic. Results from CARVIVA‐HF suggest that ivabradine alone or in combination with carvedilol is safe and effective for improving exercise capacity and quality of life in HF patients on optimized angiotensin‐converting enzyme inhibitor therapy. In the GISSI‐HF study there was no difference in atrial fibrillation (AF) occurrence between the n‐3 polyunsaturated fatty acids and placebo groups. In EMPHASIS‐HF the incidence of new onset AF or flutter was reduced in patients with mild HF randomized to eplerenone compared with placebo.

[1]  Michael Böhm,et al.  Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study , 2010, The Lancet.

[2]  M. Mamas,et al.  A meta‐analysis of the prognostic significance of atrial fibrillation in chronic heart failure , 2009, European journal of heart failure.

[3]  A. Goette The vanishing story of angiotensin II receptor blockers in the treatment of atrial fibrillation. , 2011, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[4]  T. Jaarsma,et al.  Home care in heart failure: towards an integrated care model , 2011, European journal of heart failure.

[5]  Nick Freemantle,et al.  Clinical trials update from the American Heart Association Meeting 2010: EMPHASIS‐HF, RAFT, TIM‐HF, Tele‐HF, ASCEND‐HF, ROCKET‐AF, and PROTECT , 2011, European journal of heart failure.

[6]  M. Böhm,et al.  Prevention of Atrial Fibrillation by Renin-Angiotensin System Inhibition , 2010 .

[7]  Nick Freemantle,et al.  Effect of Cardiac Resynchronization on the Incidence of Atrial Fibrillation in Patients With Severe Heart Failure , 2006, Circulation.

[8]  Gianni Tognoni,et al.  Valsartan reduces the incidence of atrial fibrillation in patients with heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT). , 2005, American heart journal.

[9]  Karl Swedberg,et al.  Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with beta-blockers: results from COMET. , 2005, European heart journal.

[10]  J. Le Heuzey,et al.  Prevention of atrial fibrillation onset by beta-blocker treatment in heart failure: a meta-analysis. , 2007, European heart journal.

[11]  Anna Strömberg,et al.  Self‐care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology , 2011, European journal of heart failure.

[12]  Ankur Gupta,et al.  Ivabradine and outcomes in chronic heart failure , 2010, The Lancet.

[13]  J. Cleland,et al.  It makes SENSE to take a safer road. , 2011, European heart journal.

[14]  J. Daubert,et al.  Cardiac resynchronization therapy: are modern myths preventing appropriate use? , 2009, Journal of the American College of Cardiology.

[15]  M. Cheitlin Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study , 2012 .

[16]  J. McMurray,et al.  Eplerenone in patients with systolic heart failure and mild symptoms. , 2011, The New England journal of medicine.

[17]  J. Cleland,et al.  The atrial fibrillation paradox of heart failure. , 2010, Congestive heart failure.

[18]  Michael Böhm,et al.  Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study , 2011, Circulation.

[19]  L. Køber,et al.  Trandolapril reduces the incidence of atrial fibrillation after acute myocardial infarction in patients with left ventricular dysfunction. , 1999, Circulation.

[20]  J. Cleland,et al.  Which components of heart failure programmes are effective? A systematic review and meta‐analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review , 2011, European journal of heart failure.

[21]  M. Pfeffer,et al.  Prevention of atrial fibrillation in patients with symptomatic chronic heart failure by candesartan in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) program. , 2006, American heart journal.

[22]  M. Volterrani,et al.  Effect of Carvedilol, Ivabradine or their combination on exercise capacity in patients with Heart Failure (the CARVIVA HF trial). , 2011, International journal of cardiology.

[23]  W. W. Tang,et al.  Revisiting the cardio‐renal hypothesis: the pivotal role of the kidney in congestive heart failure , 2011, European journal of heart failure.

[24]  A. Strömberg,et al.  European Society of Cardiology Heart Failure Association Standards for delivering heart failure care , 2011, European journal of heart failure.

[25]  A. Rigby,et al.  Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. , 2005, Journal of the American College of Cardiology.

[26]  L. Tavazzi,et al.  ect of n-3 polyunsaturated fatty acids in patients with chronic heart failure ( the GISSI-HF trial ) : a randomised , double-blind , placebo-controlled trial , 1980 .

[27]  A. Ducharme,et al.  Enalapril Decreases the Incidence of Atrial Fibrillation in Patients With Left Ventricular Dysfunction Insight From the Studies Of Left Ventricular Dysfunction (SOLVD) Trials , 2003, Circulation.

[28]  D. J. Veldhuisen,et al.  Presence and development of atrial fibrillation in chronic heart failure , 2006, European journal of heart failure.

[29]  P. Scuffham,et al.  The WHICH? trial: rationale and design of a pragmatic randomized, multicentre comparison of home‐ vs. clinic‐based management of chronic heart failure patients , 2011, European journal of heart failure.

[30]  K. Swedberg,et al.  Rationale and design of a randomized, double‐blind, placebo‐controlled outcome trial of ivabradine in chronic heart failure: the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT) , 2010, European journal of heart failure.