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This editorial discusses the rationale for the REPORT-HF global registry to address the heterogeneity and lack of clinical trial success in heart failure across different geographic regions.
Highlights the need for global registries like REPORT-HF to better understand the interplay between geographic region, patient profile, and outcomes in heart failure.
This article refers to ‘International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT–HF): rationale for and design of a global registry’†by Gerasimos Filippatos et al., published in this issue, European Journal of Heart Failure (2015); 17: 527–533. The public health and economic burden of heart failure (HF) is a worldwide problem afflicting more than 25 million people globally.1 By virtue of current epidemiological trends (especially the aging population and the transition of low-income countries to economic prosperity) and advancements in cardiovascular care and public health infrastructure, the prevalence of HF is only expected to increase over time. Randomized controlled trials represent the cornerstone of evidence-based medicine and have been instrumental in bringing life-saving therapies for HF to the bedside. However, with few notable exceptions,2,3 successes in the HF clinical trial arena over the last decade have been few and far between. Particularly alarming is the complete lack of trial success among hospitalized heart failure (HHF) patients and those with HF and preserved ejection fraction. Possible reasons for these negative trials include the wide heterogeneity of the patient population, failure to match the study therapy to the appropriate patient subset, suboptimal study endpoints, and potential problems with study execution and enrolment at study sites.4 Further complicating matters, patient characteristics, inpatient and outpatient care patterns, therapy utilization, and clinical outcomes may differ markedly by geographic region of enrolment and multiple areas of the world such as Africa and Asia/Pacific remain poorly characterized.5-8 Thus, for purposes of improving the efficiency of therapy development and maximizing patient survival and quality of life, a more nuanced understanding of the interplay between geographic region, patient profile, study site performance, and patient outcomes is needed.
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Greene et al. (2015) conducted an editorial in Heart failure. REPORT-HF registry was evaluated. This editorial discusses the rationale for the REPORT-HF global registry to address the heterogeneity and lack of clinical trial success in heart failure across different geographic regions.
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