Worse prognosis of real-world patients with acute heart failure from the Czech AHEAD registry in comparison to patients from the RELAX-AHF trial
2017
The randomized clinical trial RELAX-AHF demonstrated a positive
effect of vasodilator therapy with serelaxin in the treatment
of AHF patients. The aim of our study was to compare clinical
characteristics and outcomes of patients from the AHEAD
registry who met criteria of the RELAX-AHF trial
(relax-comparable group) with the same characteristics and
outcomes of patients from the AHEAD registry who did not meet
those criteria (relax-non-comparable group), and finally with
characteristics and outcomes of patients from the RELAX-AHF
trial. Methods and results A total of 5856 patients from the
AHEAD registry (Czech registry of AHF) were divided into two
groups according to RELAX-AHF criteria: relax-comparable (n =
1361) and relax-non-comparable (n = 4495). As compared with the
relax-non-comparable group, patients in the relax-comparable
group were older, had higher levels of systolic and diastolic
blood pressure, lower creatinine clearance, and a higher number
of comorbidities. Relax-comparable patients also had
significantly lower short-term as well as long-term mortality
rates in comparison to relax-non-comparable patients, but a
significantly higher mortality rate in comparison to the
placebo group of patients from the RELAX-AHF trial. Using AHEAD
score, we have identified higher-risk patients from
relax-comparable group who might potentially benefit from new
therapeutic approaches in the future. Conclusions Only about
one in five of all evaluated patients met criteria for the
potential treatment with the new vasodilator serelaxin. AHF
patients from the real clinical practice had a higher mortality
when compared with patients from the randomized clinical trial.
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