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https://www.readbyqxmd.com/read/29664406/racial-differences-in-characteristics-and-outcomes-of-patients-with-heart-failure-and-preserved-ejection-fraction-in-the-treatment-of-preserved-cardiac-function-heart-failure-trial
#1
Eldrin F Lewis, Brian Claggett, Amil M Shah, Jiankang Liu, Sanjiv J Shah, Inder Anand, Eileen O'Meara, Nancy K Sweitzer, Jean L Rouleau, James C Fang, Akshay S Desai, Tamrat M Retta, Scott D Solomon, John F Heitner, Thomas D Stamos, Robin Boineau, Bertram Pitt, Marc A Pfeffer
BACKGROUND: Black patients have been shown to have different baseline characteristics and outcomes compared with nonblack patients in cohort studies. However, few studies have focused on heart failure (HF) with preserved ejection fraction (HFpEF) patients. We aimed to determine the difference in cardiovascular outcomes in black and nonblack patients with HFpEF and to determine the relative efficacy and safety of spironolactone in black and nonblack patients. METHODS AND RESULTS: Patients with HFpEF, randomized to spironolactone versus placebo in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) in North and South America, were grouped according to self-described black and nonblack race...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29661477/low-diastolic-blood-pressure-and-adverse-outcomes-in-heart-failure-with-preserved-ejection-fraction
#2
Tetsuro Tsujimoto, Hiroshi Kajio
BACKGROUND: It remains unknown whether a low diastolic blood pressure (DBP) increases the risks of cardiovascular events and death in patients with heart failure with preserved ejection fraction (HFpEF). METHODS: We used data from the TOPCAT trial. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure. Hazard ratios (HRs) were analyzed for DBPs of <60, 60-69, 70-79, and ≥90 mm Hg in comparison with a DBP of 80-89 mm Hg using multivariable Cox proportional hazard models...
April 9, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29572190/incident-hyperkalemia-hypokalemia-and-clinical-outcomes-during-spironolactone-treatment-of-heart-failure-with-preserved-ejection-fraction-analysis-of-the-topcat-trial
#3
Akshay S Desai, Jiankang Liu, Marc A Pfeffer, Brian Claggett, Jerome Fleg, Eldrin F Lewis, Sonja McKinlay, Eileen O'Meara, Sanjiv J Shah, Nancy K Sweitzer, Scott Solomon, Bertram Pitt
BACKGROUND: In patients with heart failure and preserved ejection fraction (HF-PEF) randomized in the Americas (but not Russia and Georgia) as part of the TOPCAT trial, treatment with spironolactone enhanced the risk of hyperkalemia but reduced the risk of hypokalemia. We examined the clinical correlates and prognostic implications of incident hypo- and hyperkalemia during study follow up. METHODS: We defined the region-specific incidence of hypokalemia (potassium [K+ ]<3...
March 20, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29501806/sudden-death-in-heart-failure-with-preserved-ejection-fraction-a-competing-risks-analysis-from-the-topcat-trial
#4
Muthiah Vaduganathan, Brian L Claggett, Neal A Chatterjee, Inder S Anand, Nancy K Sweitzer, James C Fang, Eileen O'Meara, Sanjiv J Shah, Sheila M Hegde, Akshay S Desai, Eldrin F Lewis, Jean Rouleau, Bertram Pitt, Marc A Pfeffer, Scott D Solomon
BACKGROUND: Sudden death (SD) may be an important mode of death in heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: To investigate rates and predictors of SD or aborted cardiac arrest (ACA) in HFpEF. METHODS: We studied 1,767 patients with HFpEF (EF≥45%) enrolled in the Americas region of the TOPCAT trial. We identified independent predictors of composite SD/ACA with step-wise backward selection using competing risks regression analysis accounting for non-sudden causes of death...
March 4, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29475874/diastolic-blood-pressure-and-adverse-outcomes-in-the-topcat-treatment-of-preserved-cardiac-function-heart-failure-with-an-aldosterone-antagonist-trial
#5
Pratik B Sandesara, Wesley T O'Neal, Heval M Kelli, Matthew Topel, Ayman Samman-Tahhan, Laurence S Sperling
BACKGROUND: Although diastolic blood pressure (DBP) is independently associated with an increased risk of adverse cardiovascular outcomes in the general population, it is unclear if a similar relationship exists in patients with heart failure with preserved ejection fraction. METHODS AND RESULTS: This analysis included 1703 (mean age, 72±10 years; 50% men; 78% white) patients with heart failure with preserved ejection fraction enrolled in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) Trial from the Americas who were treated for hypertension...
February 23, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29460366/ejection-fraction-as-a-statistical-index-of-left-ventricular-systolic-function-the-first-full-allometric-scrutiny-of-its-appropriateness-and-accuracy
#6
Lorenzo Lolli, Alan M Batterham, Greg Atkinson
Left ventricular ejection fraction (EF) is a ratio that is deemed to accurately normalize stroke volume (SV) to end-diastolic volume (EDV). Ratios are now well-recognized for not normalizing the numerator, in this case SV, consistently for the denominator, EDV. We aimed to provide the first allometric-based scrutiny of the conventional assumptions that underpin the EF ratio. We allometrically modelled untransformed SV and EDV measurements from 112 preclinical heart failure patients in the Multi-Ethnic Study of Atherosclerosis (MESA), and 864 chronic heart failure patients in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study...
February 20, 2018: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29324539/trial-of-optimal-personalised-care-after-treatment-gynaecological-cancer-topcat-g-a-randomized-feasibility-trial
#7
Val Morrison, Llinos H Spencer, Nikki Totton, Kirstie Pye, Seow Tien Yeo, Caryl Butterworth, Liz Hall, Rhiannon Whitaker, Rhiannon Tudor Edwards, Laura J Timmis, Zoe Hoare, Richard D Neal, Clare Wilkinson, Simon Leeson
OBJECTIVE: This study aimed to evaluate the feasibility of completing a parallel-group randomized controlled trial to compare usual follow-up care for women who have completed treatment of gynecological cancer against a nurse-led telephone intervention, known as Optimal Personalised Care After Treatment-Gynaecological. METHODS: The unblinded trial aimed to recruit patients who had completed treatment of cervical, endometrial, epithelial ovarian, or vulval cancer within the previous 3 months at 3 North Wales hospitals...
February 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29228101/spironolactone-and-resistant-hypertension-in-heart-failure-with-preserved-ejection-fraction
#8
Patrick Rossignol, Brian Lee Claggett, Jiankang Liu, Orly Vardeny, Bertram Pitt, Faiez Zannad, Scott Solomon
BACKGROUND: Recent evidence suggests that the mineralocorticoid receptor antagonist spironolactone should be the preferred fourth-line antihypertensive treatment in resistant hypertension (RHTN). Whether spironolactone improves blood pressure (BP) control in heart failure with preserved ejection fraction (HFpEF) and RHTN is unknown. METHODS: We identified patients with RHTN, defined as baseline systolic blood pressure (SBP) between 140 and 160 mm Hg on 3 or more medications, in the Americas cohort of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial, in which patients with HFpEF were randomized to spironolactone vs...
March 10, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29191321/abdominal-obesity-is-associated-with-an-increased-risk-of-all-cause-mortality-in-patients-with-hfpef
#9
RANDOMIZED CONTROLLED TRIAL
Tetsuro Tsujimoto, Hiroshi Kajio
BACKGROUND: There is a lack of studies that evaluate the association between abdominal obesity and subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: The present study aimed to assess the association between abdominal obesity and risk of all-cause mortality in patients with HFpEF. METHODS: The present study used data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial...
December 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#10
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29094152/association-of-serial-kansas-city-cardiomyopathy-questionnaire-assessments-with-death-and-hospitalization-in-patients-with-heart-failure-with-preserved-and-reduced-ejection-fraction-a-secondary-analysis-of-2-randomized-clinical-trials
#11
Yashashwi Pokharel, Yevgeniy Khariton, Yuanyuan Tang, Michael E Nassif, Paul S Chan, Suzanne V Arnold, Philip G Jones, John A Spertus
Importance: While there is increasing emphasis on incorporating patient-reported outcome measures in routine care for patients with heart failure (HF), how best to interpret longitudinally collected patient-reported outcome measures is unknown. Objective: To examine the strength of association between prior, current, or a change in Kansas City Cardiomyopathy Questionnaire (KCCQ) scores with death and hospitalization in patients with HF with preserved (HFpEF) and reduced (HFrEF) ejection fractions...
December 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29051160/the-prognostic-significance-of-diabetes-and-microvascular-complications-in-patients-with-heart-failure-with-preserved-ejection-fraction
#12
Pratik B Sandesara, Wesley T O'Neal, Heval M Kelli, Ayman Samman-Tahhan, Muhammad Hammadah, Arshed A Quyyumi, Laurence S Sperling
OBJECTIVE: This study examined the prognostic significance of diabetes and microvascular complications in patients with heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS: This analysis included 3,385 patients (mean age 69 ± 9.6 years; 49% male; 89% white) with HFpEF from the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial (TOPCAT). Diabetes and microvascular complications were ascertained by self-reported history and medical record review...
January 2018: Diabetes Care
https://www.readbyqxmd.com/read/29041892/-randomized-controlled-trials-in-patients-with-heart-failure-in-russia-following-the-study-topcat-what-awaits-us-in-the-future
#13
M Y Lopatin
No abstract text is available yet for this article.
August 2017: Kardiologiia
https://www.readbyqxmd.com/read/29034087/spironolactone-in-cardiovascular-disease-an-expanding-universe
#14
REVIEW
John W Funder
Spironolactone has been marketed for over half a century as a 'potassium-sparing diuretic', used primarily in patients with ascites. With the realization that primary aldosteronism is the most common (5-13%) form of secondary hypertension, it has become widely used as a mineralocorticoid receptor antagonist. More recently, in the wake of the RALES trial, spironolactone in addition to standard therapy has been shown to be very beneficial in heart failure with a reduced ejection fraction. Despite the failure of the TOPCAT trial, spironolactone is being increasingly used in diastolic heart failure (i...
2017: F1000Research
https://www.readbyqxmd.com/read/29032132/prognostic-importance-of-temporal-changes-in-resting-heart-rate-in-heart-failure-and-preserved-ejection-fraction-from-the-topcat-study
#15
Ali Vazir, Brian Claggett, Bertram Pitt, Inder Anand, Nancy Sweitzer, James Fang, Jerome Fleg, Jean Rouleau, Sanjiv Shah, Marc A Pfeffer, Scott D Solomon
OBJECTIVES: The aim of this study was to examine the relationship between baseline heart rate (HR), change in HR from a preceding visit, and time-updated HR with subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF) in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial. BACKGROUND: Higher resting HR and increase in HR over time in patients with heart failure are associated with adverse outcomes...
October 4, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28647918/designing-future-clinical-trials-in-heart-failure-with-preserved-ejection-fraction-lessons-from-topcat
#16
REVIEW
Ravi B Patel, Sanjiv J Shah, Gregg C Fonarow, Javed Butler, Muthiah Vaduganathan
PURPOSE OF REVIEW: Spironolactone did not demonstrate benefit with respect to the primary composite endpoint in the global TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial in patients with chronic heart failure with preserved ejection fraction (HFpEF). We identify key lessons from the TOPCAT experience that can be applied to future HFpEF trials. RECENT FINDINGS: Subsequent analyses of TOPCAT have revealed marked regional heterogeneity in patient profiles, event rates, drug adherence, and treatment effects...
August 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28637881/physical-activity-and-prognosis-in-the-topcat-trial-treatment-of-preserved-cardiac-function-heart-failure-with-an-aldosterone-antagonist
#17
RANDOMIZED CONTROLLED TRIAL
Sheila M Hegde, Brian Claggett, Amil M Shah, Eldrin F Lewis, Inder Anand, Sanjiv J Shah, Nancy K Sweitzer, James C Fang, Bertram Pitt, Marc A Pfeffer, Scott D Solomon
BACKGROUND: Physical activity (PA) is inversely associated with adverse cardiovascular outcomes in healthy populations, but the impact of physical activity in patients with heart failure (HF) with preserved ejection fraction is less well characterized. METHODS: The baseline self-reported PA of 1751 subjects enrolled in the Americas region of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) was categorized as poor, intermediate, or ideal PA with American Heart Association criteria...
September 12, 2017: Circulation
https://www.readbyqxmd.com/read/28482692/heart-rate-and-the-risk-of-adverse-outcomes-in-patients-with-heart-failure-with-preserved-ejection-fraction
#18
Wesley T O'Neal, Pratik B Sandesara, Ayman Samman-Tahhan, Heval M Kelli, Muhammad Hammadah, Elsayed Z Soliman
Background Although high resting heart rates are associated with adverse outcomes in heart failure with reduced ejection, the reports for heart failure with preserved ejection fraction (HFpEF) are conflicting. Design A secondary analysis was conducted in order to examine the relationship between resting heart rate and adverse outcomes in 2705 patients (mean age = 68 ± 10 years; 47% men; 88% white) with HFpEF who were in sinus rhythm from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT)...
July 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28445660/spironolactone-metabolites-in-topcat-new-insights-into-regional-variation
#19
COMPARATIVE STUDY
Simon de Denus, Eileen O'Meara, Akshay S Desai, Brian Claggett, Eldrin F Lewis, Grégoire Leclair, Martin Jutras, Joël Lavoie, Scott D Solomon, Bertram Pitt, Marc A Pfeffer, Jean L Rouleau
No abstract text is available yet for this article.
April 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28444995/peripheral-artery-disease-and-risk-of-adverse-outcomes-in-heart-failure-with-preserved-ejection-fraction
#20
Pratik B Sandesara, Muhammad Hammadah, Ayman Samman-Tahhan, Heval M Kelli, Wesley T O'Neal
BACKGROUND: Peripheral artery disease (PAD) in heart failure with preserved ejection fraction (HFpEF) is associated with an increased mortality risk, but the risk of individual outcomes associated with PAD in this patient group is less clear. HYPOTHESIS: PAD is associated with adverse outcomes in HFpEF, including hospitalization and specific cardiovascular outcomes. METHODS: We examined the association between PAD and adverse outcomes in 3385 patients with HFpEF (mean age, 69 ± 9...
September 2017: Clinical Cardiology
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