Subject(s)
Heart Failure , Sodium-Glucose Transporter 2 Inhibitors , Benzhydryl Compounds , Glucosides , HumansSubject(s)
Pneumonia, Viral/epidemiology , Renin-Angiotensin System , Betacoronavirus , COVID-19 , Coronavirus Infections , Humans , Pandemics , SARS-CoV-2Subject(s)
Cause of Death , Drug-Related Side Effects and Adverse Reactions , Organ Transplantation/trends , Substance-Related Disorders/epidemiology , Tissue Donors , Adult , Brain Death , Epidemics , Europe/epidemiology , Humans , Poisoning/mortality , Substance-Related Disorders/mortality , United States/epidemiologySubject(s)
Cardiac Output, Low , Hydrazones , Cardiac Surgical Procedures , Cardiotonic Agents , Humans , Pyridazines , SimendanSubject(s)
Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2 , Humans , Incidence , Time FactorsSubject(s)
Cholesterol, LDL/blood , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hypercholesterolemia/drug therapy , Practice Guidelines as Topic , Aged , Cardiovascular Diseases/complications , Coronary Artery Disease/complications , Humans , Hypercholesterolemia/complications , Male , Middle Aged , Risk Assessment , Risk FactorsSubject(s)
Anticholesteremic Agents/therapeutic use , Azetidines/therapeutic use , Cholesterol, LDL/blood , Hyperlipoproteinemia Type II/drug therapy , Simvastatin/therapeutic use , Drug Therapy, Combination , Ezetimibe , Humans , Hyperlipoproteinemia Type II/pathology , Triglycerides/blood , Tunica Intima/pathology , Tunica Media/pathologySubject(s)
Bundle-Branch Block/therapy , Cardiac Pacing, Artificial/methods , Heart Failure/therapy , Bundle-Branch Block/complications , Bundle-Branch Block/physiopathology , Cardiac Pacing, Artificial/adverse effects , Heart Conduction System/physiology , Heart Conduction System/physiopathology , Heart Failure/complications , Heart Ventricles , Humans , Male , Middle Aged , Pacemaker, Artificial , Practice Guidelines as TopicSubject(s)
Aspirin/therapeutic use , Cardiovascular Diseases/drug therapy , Platelet Aggregation Inhibitors/therapeutic use , Ticlopidine/analogs & derivatives , Cardiovascular Diseases/mortality , Cardiovascular Diseases/prevention & control , Clopidogrel , Confidence Intervals , Data Interpretation, Statistical , Drug Therapy, Combination , Humans , Risk Factors , Ticlopidine/therapeutic useABSTRACT
BACKGROUND: Therapies for heart failure (HF) with a low ejection fraction (EF) have delayed disease progression and prolonged survival, but the implications of these therapies on the end stages of HF have not been examined. METHODS AND RESULTS: Patients seen by the Brigham and Women's cardiomyopathy service with an EF < or =35%, at least 1 outpatient visit or at least 30 days of follow-up who died between January 1, 2000, and October 20, 2003, were evaluated retrospectively. Of the 160 patients who died since 2000, 80 (50%) were outpatients. In the 6 months before death, 93% of patients had New York Heart Association (NYHA) class III or IV symptoms. The NYHA class, clinical characteristics, medications, and comorbidities differed little between inpatient and outpatient deaths. Renal insufficiency and hyponatremia were worse in the months preceding death than at the time of death (creatinine: 3.2 versus 2.3 mg/dL, P < .0001; sodium: 128 versus 135 mmol/L, P < .0001, respectively). Death was considered sudden in only 21% of patients. CONCLUSION: Deaths in the current era of HF management occur in patients with long-standing HF characterized by biventricular dysfunction and advanced symptoms. Most deaths are heralded by hyponatremia, acute on chronic renal insufficiency, and frequent hospitalizations.