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Our mission: To promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our goal is to reduce the burden in cardiovascular disease in Europe through percutaneous cardiovascular interventions.
Our Mission is "to improve the quality of life of the population by reducing the impact of cardiac rhythm disturbances and reduce sudden cardiac death"
To improve quality of life and logevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
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OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Dr. Brunner La Rocca
Presenter report:Brunner-La Rocca, Hans Peter (Switzerland)
Background: It is uncertain whether intensified, NT-BNP-guided therapy of heart failure (HF) improves outcome compared to standard, symptom-guided therapy, and whether there is a difference in the response in patients ≥ versus <75 years of age.
Methods: Therefore, 499 patients with systolic HF (ejection fraction 45%) were randomised to an NT-BNP-guided or a symptom-guided strategy and stratified into patients aged ≥75 versus 60-74years. Included were patients with dyspnea NYHA≥II, HF hospitalizations within one year and NT-BNP levels >400pg/ml (60-74years) or 800pg/ml (≥75years). Therapy was uptitrated according to guidelines aiming to reduce symptoms to NYHA£II or additionally NT-BNP-levels below levels mentioned above. The primary endpoint was survival free of all-cause hospitalisations up to 18 months and quality of life. Secondary endpoints were survival and HF hospitalization-free survival.
Results: Compared to standard therapy, intensified treatment did not improve primary endpoint (hazard ratio (HR)=0.92, p=0.46), but did improve the more disease-specific endpoint of survival free of HF hospitalisations (HR=0.66, p=0.008). Intensified therapy reduced total mortality (HR=0.38, p=0.01) and improved survival free of HF hospitalisations (HR=0.41, p=0.002) in younger patients, but not in those ≥75years. In addition, quality of life improved less by intensified versus standard therapy in older patients despite similar reductions in symptoms and BNP-levels.
Conclusions: Intensified HF therapy did not improve overall outcome compared to standard treatment. However, it improved survival free of HF hospitalizations overall and it reduced mortality in patients <75 years of age, without similar benefits in older patients. Specific HF trials in very elderly patients are warranted.
Discussant: Dickstein, Kenneth (Norway)
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