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Improving Survival After Heart Failure

Heart failure (HF) is among the leading causes of hospitalization in the United States, afflicting more than 5.8 million men and women each year. The disease has been associated with substantial morbidity, mortality, and healthcare expenditures. The 5-year mortality rate for HF has been estimated at more than 50%, and roughly $40 billion is spent annually in costs related to HF. Previous studies have shown that there are gaps, variation, and disparities in the use of evidence-based, guideline-recommended therapies for HF. Regardless of the clinical setting, many eligible HF patients do not receive one or more of the therapies that have been proven to be effective in reducing all-cause mortality in clinical trials and analyses. Non-adherence to recommended HF therapies can significantly reduce quality of life and lifespan in sufferers with the disease. Examining Benefits of Proven HF Therapies A study published in the February 21, 2012 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Diseases evaluated the individual and incremental benefits of guideline-recommended therapies. “While certain therapies are recommended for HF patients in national guidelines from the American College of Cardiology and the American Heart Association, our study was the first to examine the specific incremental contribution of each of these therapies in improving survival when combined in a real-world clinical practice,” says Gregg C. Fonarow, MD, who was the lead author on the investigation. The study by Dr. Fonarow and colleagues utilized a nested case-control design that included HF patients who were enrolled in the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) cohort. The analysis involved 1,376...

Increasing Awareness of Atrial Fibrillation

Research has shown that atrial fibrillation (AFib) is one of the most common sustained heart rhythm abnormalities, affecting an estimated 2.3 million Americans, but other investigations suggest that the condition may affect millions more. “Atrial fibrillation is a potentially serious condition,” says Nassir F. Marrouche, MD. “The irregular heartbeat associated with AFib can cause blood to pool in the atria, which can result in the formation of clots. These blood clots can travel from the heart to the brain, where they can lead to stroke.” According to current estimates, AFib increases the risk of stroke nearly five-fold. About 15% of all strokes in the United States are associated with AFib. Strokes that are associated with AFib are about twice as likely to be fatal or severely disabling as non–AFib-related strokes. In the United States, studies have predicted that as many as 5.6 million American adults will have AFib by 2050. One of the largest demographics to be affected by AFib includes elderly individuals. It has been estimated that 3% to 5% of elderly Americans have AFib, but that number may be larger because symptoms often go unrecognized by patients and physicians alike. Spotting AF Symptoms One of the aspects of AFib that makes it difficult to manage is that the condition is not always accompanied with symptoms. Published studies have shown that several symptoms may be attributable to AFib, including racing or irregular heartbeat, fluttering in the chest, heart palpitations, and shortness of breath. Other symptoms of AFib include chest pain, fatigue when exercising, sweating, and weakness, dizziness, or faintness. “It’s challenging for physicians to identify AFib because the...
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