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Recognizing Worsening Chronic Heart Failure as an Entity and an End Point in Clinical Trials

Javed Butler, MD, MPH1; Eugene Braunwald, MD2; Mihai Gheorghiade, MD3
[+] Author Affiliations
1Cardiology Division, Emory University, Atlanta, Georgia
2Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
3Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2014;312(8):789-790. doi:10.1001/jama.2014.6643.
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Heart failure has been considered a progressive and often fatal condition. However, clinical trials conducted during the last 2 decades among outpatients with heart failure and reduced ejection fraction have shown that the negative trajectory of this syndrome can be altered with effective therapies, improving the annual mortality risk from approximately 20% to approximately 5% to 8%.1 The same success has not been demonstrated for patients with heart failure and preserved ejection fraction as well as for patients hospitalized for worsening symptoms, irrespective of ejection fraction. Patients hospitalized for heart failure are at a particularly high risk for adverse outcomes after discharge.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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