Time to move on from 'time-to-first': should all events be included in the analysis of clinical trials?

Anker, S.D. and McMurray, J.J.V. (2012) Time to move on from 'time-to-first': should all events be included in the analysis of clinical trials? European Heart Journal, 33(22), pp. 2764-2765. (doi:10.1093/eurheartj/ehs277)

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Abstract

Not that long ago a diagnosis of heart failure was a death sentence. For example, a patient hospitalized with heart failure in the late 1980s had a median survival of <1.25 years after discharge. Those with reduced ejection fraction (HF-REF) died either from progressive pump failure or suddenly, mainly due to ventricular arrhythmias. This picture has been transformed in the past two decades. Angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and devices (implanted cardioverter defibrillators and cardiac resynchronization therapy) have completely changed the prognosis for patients with HF-REF. Systolic heart failure has been converted from a relatively short-term and quickly fatal condition to a chronic disease characterized by recurrent non-fatal events (hospital admissions) and delayed death that is now nearly as often due to a non-cardiovascular as a cardiovascular cause.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMurray, Professor John
Authors: Anker, S.D., and McMurray, J.J.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Heart Journal
ISSN:0195-668X
Published Online:27 August 2012

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