Heart Failure With Mid-Range Ejection Fraction: A Distinct Clinical Entity? Insights From The Trial of Intensified Versus Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF)
Why the study?
Does NT-proBNP-guided therapy improve survival free of HF hospitalizations in elderly patients with HFmrEF compared to standard therapy?
Population
622 elderly patients with established heart failure including the whole spectrum of LVEF
Comparison
N-terminal pro-B-type natriuretic peptide-guided… vs Standard therapy
Design
RCT
Follow-up
median 794 days
Authors
Discussion
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Member takes
Implication
Structure:* "[Verdict clause]; [confirms / challenges / extends / leaves open].
Structured PICO
Does NT-proBNP-guided therapy improve survival free of HF hospitalizations in elderly patients with HFmrEF compared to standard therapy?
P
Population
622 elderly patients with established heart failure including the whole spectrum of LVEF (HFrEF LVEF < 40%, HFmrEF LVEF 40-49% [n=108, 17%], HFpEF LVEF ≥ 50%)
I
Intervention
N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided therapy
C
Comparator
Standard therapy
O
Outcome
Mortality and survival free of HF hospitalizationshard clinical
HFmrEF shares clinical characteristics with both HFrEF and HFpEF but responds to NT-proBNP-guided therapy similarly to HFrEF, suggesting it may be best categorized and managed alongside HFrEF.
Cite This Study
Rickenbacher et al. (2017) studied this question.