Author + information
- Uwe Zeymer,
- Mathias Hochadel,
- Christiane Angermann and
- Jochen Senges
Aims: Patients enrolled in randomized clinical trials might not be representative for daily clinical practice. Therefore we sought to compare the patients included in the PARADIGM trial with a real world population of patients with systolic heart failure with respect to baseline criteria, treatment and clinical outcome.
Methods and Results: Data prospectively collected of 7360 patients in three German registries of patients with systolic heart failure with an ejection fraction < 40% were compared with the PARADIGM population. The rate of patients fulfilling the in- and exclusion criteria of PARADIGM in the three registiries ranged between 41% and 52%. The mean age of the 7360 registry patients was 63.8 yrs compared to 63.8 yrs in the PARADIGM trial. Mean LV-EF was 28.4 % versus 29.4 %. Treatment with betablockers was 71.9 % versus 92.9%, with MRAs 34.4 % versus 57.0%. ICD rates were 19.0% versus 14.7 %.
The 12-month event rates were 14.7% versus 11.8%, 9.8 % versus 9.6 %, 12.5% versus 12.9 %, in the PARADIGM versus non-PARADIGM patients in the registries versus 8.0 % in the PARADIGM study. There was no difference in baseline data and events during follow-up between patients treated with enalapril versus other ACE-Inhibitors or ARBs.
Conclusions: Patients enrolled in the PARADIGM trial represent about 50 % oft he general population of patients with heart failure with an EF < 40 %. In real life patients received less often guideline recommemded therapy with beta-blockers and MRAs, but similar rates of ICDs. Mortality was higher in real life, both in PARADIGM eligible and non-eligible patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Is Just a Revolving Door
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1293-254
- 2017 American College of Cardiology Foundation