HFSA's annual scientific meeting features four late breaking clinical trials

Sep 15 2009

The 13th Annual Scientific Meeting of the Heart Failure Society of America (HFSA) today featured four late breaking clinical trials at the Hynes Convention Center in Boston. The three-day meeting serves as a forum for heart failure specialists to present research findings and advances in treatment and addresses emerging trends in research and new developments in the approach to treating heart failure patients. Four late breaking trials were presented today:

• Improving evidence based care for heart failure in outpatient cardiology practices: Primary results of IMPROVE HF. This trial tested the effect of a practice specific performance improvement intervention on quality measure in pts with HF in outpatient cardiology practices. The IMPROVE HF initiative resulted in substantial improvements in use of evidence-based therapies in eligible patients with systolic HF in outpatient cardiology practices. Implementation of a defined and scalable practice specific intervention enhances use of guideline-recommended HF therapies demonstrated to improve outcomes.
• Reduction in the risk of heart failure with preventative cardiac resynchronization therapy: MADIT - CRT Trial. This trial was designed to determine if prophylactic CRT with defibrillator would reduce the primary endpoint in all cause mortality or HF events (IV diuretic therapy or hospitalization for HF), whichever occurred first, when compared to patients receiving only an implanted cardiac defibrillator. The results of MADIT-CRT suggest that the use of CRT in asymptomatic or mildly symptomatic cardiac patients with a reduced EF and wide QRS complex is associated with a significant 29% decrease in the risk of death or HF. The benefit of CRT-D in this population was driven by a reduction in heart failure events.
• Superior performance of intrathoracic impedance-derived fluid index versus daily weight monitoring in HF patients: Results of the FAST trial. This trial focused on comparing the relative sensitivity and unexplained detection rate of changes in daily weights vs. intrathoracic impedance changes. The trial concluded that the sensitivity and unexplained detection rate of an intrathoracic fluid index were superior to those for acute weight changes in HF patients with implantable devices. Intrathoracic impedance monitoring represents a positive addition to our armamentarium for managing HF and should be considered for routine use in patients with implanted devices with this feature in addition to daily weight monitoring.
• Effects of rolofylline, a selective adenosine A1 receptor antagonist, in patients hospitalized for acute decompensated heart failure and renal impairment: Findings from the PROTECT study. This trial was designed to test the hypothesis that the selective A1 adenosine receptor antagonist rolofylline would safely improve HF signs and symptoms, reduce the risk of worsening renal function and reduce morbidity and mortality when used with IV loop diuretics in subjects with ADHF, volume overload and renal impairment. Surprisingly and disappointedly, rolofylline was not associated with an improvement in the primary endpoint or the two secondary endpoints including renal function. This trial, the largest to date in ADHF, will require further analysis to help investigators develop new strategies for the important but complicated condition of ADHF.

"Each year we discover new and innovative treatments for patients living with heart failure," said Dr. Douglas Mann, HFSA President. "It is important for the medical community to continue to utilize science and clinical medicine to improve care that we provide to patients with heart failure."