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Declining Risk of Sudden Death in Heart Failure.

Abstract The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, and mineralocorticoid-receptor antagonists. We sought to examine this trend in detail.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the new england journal of medicine
Publication Year Start




PMID- 28679089
OWN - NLM
STAT- In-Process
DA  - 20170705
LR  - 20170705
IS  - 1533-4406 (Electronic)
IS  - 0028-4793 (Linking)
VI  - 377
IP  - 1
DP  - 2017 Jul 06
TI  - Declining Risk of Sudden Death in Heart Failure.
PG  - 41-51
LID - 10.1056/NEJMoa1609758 [doi]
AB  - BACKGROUND: The risk of sudden death has changed over time among patients with
      symptomatic heart failure and reduced ejection fraction with the sequential
      introduction of medications including angiotensin-converting-enzyme inhibitors,
      angiotensin-receptor blockers, beta-blockers, and mineralocorticoid-receptor
      antagonists. We sought to examine this trend in detail. METHODS: We analyzed data
      from 40,195 patients who had heart failure with reduced ejection fraction and
      were enrolled in any of 12 clinical trials spanning the period from 1995 through 
      2014. Patients who had an implantable cardioverter-defibrillator at the time of
      trial enrollment were excluded. Weighted multivariable regression was used to
      examine trends in rates of sudden death over time. Adjusted hazard ratios for
      sudden death in each trial group were calculated with the use of Cox regression
      models. The cumulative incidence rates of sudden death were assessed at different
      time points after randomization and according to the length of time between the
      diagnosis of heart failure and randomization. RESULTS: Sudden death was reported 
      in 3583 patients. Such patients were older and were more often male, with an
      ischemic cause of heart failure and worse cardiac function, than those in whom
      sudden death did not occur. There was a 44% decline in the rate of sudden death
      across the trials (P=0.03). The cumulative incidence of sudden death at 90 days
      after randomization was 2.4% in the earliest trial and 1.0% in the most recent
      trial. The rate of sudden death was not higher among patients with a recent
      diagnosis of heart failure than among those with a longer-standing diagnosis.
      CONCLUSIONS: Rates of sudden death declined substantially over time among
      ambulatory patients with heart failure with reduced ejection fraction who were
      enrolled in clinical trials, a finding that is consistent with a cumulative
      benefit of evidence-based medications on this cause of death. (Funded by the
      China Scholarship Council and the University of Glasgow.).
FAU - Shen, Li
AU  - Shen L
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Jhund, Pardeep S
AU  - Jhund PS
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Petrie, Mark C
AU  - Petrie MC
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Claggett, Brian L
AU  - Claggett BL
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Barlera, Simona
AU  - Barlera S
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Cleland, John G F
AU  - Cleland JGF
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Dargie, Henry J
AU  - Dargie HJ
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Granger, Christopher B
AU  - Granger CB
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Kjekshus, John
AU  - Kjekshus J
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Kober, Lars
AU  - Kober L
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Latini, Roberto
AU  - Latini R
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Maggioni, Aldo P
AU  - Maggioni AP
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Packer, Milton
AU  - Packer M
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Pitt, Bertram
AU  - Pitt B
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Solomon, Scott D
AU  - Solomon SD
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Swedberg, Karl
AU  - Swedberg K
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Tavazzi, Luigi
AU  - Tavazzi L
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Wikstrand, John
AU  - Wikstrand J
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Zannad, Faiez
AU  - Zannad F
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - Zile, Michael R
AU  - Zile MR
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
FAU - McMurray, John J V
AU  - McMurray JJV
AD  - From the British Heart Foundation Glasgow Cardiovascular Research Centre,
      Institute of Cardiovascular and Medical Sciences (L.S., P.S.J., M.C.P.,
      J.J.V.M.), and Robertson Centre for Biostatistics and Clinical Trials, Institute 
      of Health and Wellbeing (J.G.F.C.), University of Glasgow, the Department of
      Cardiology, Golden Jubilee National Hospital (M.C.P.), and the Cardiology
      Department, Glasgow Royal Infirmary (H.J.D.), Glasgow, and the National Heart and
      Lung Institute, Imperial College London, London (J.G.F.C.) - all in the United
      Kingdom; the Department of Medicine, Brigham and Women's Hospital and Harvard
      Medical School, Boston (B.L.C., S.D.S.); the Department of Cardiovascular
      Research, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di
      Ricerche Farmacologiche Mario Negri, Milan (S.B., R.L.), Associazione Nazionale
      Medici Cardiologi Ospedalieri Research Center, Florence (A.P.M.), and Maria
      Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini Health
      Science Foundation, Cotignola (L.T.) - all in Italy; Duke Clinical Research
      Institute, Duke University, Durham, NC (C.B.G.); Rikshospitalet University
      Hospital, Oslo (J.K.); the Department of Cardiology, Rigshospitalet Copenhagen
      University Hospital, Copenhagen (L.K.); Baylor Heart and Vascular Institute,
      Baylor University Medical Center, Dallas (M.P.); the Department of Medicine,
      University of Michigan, Ann Arbor (B.P.); the Center for Person-Centered Care
      (K.S.) and Sahlgrenska Academy (J.W.), University of Gothenburg, Gothenburg,
      Sweden; INSERM Centre d'Investigation Clinique 1433, Universite de Lorraine and
      Centre Hospitalier Universitaire, Nancy, France (F.Z.); and the Medical
      University of South Carolina and Ralph H. Johnson Veterans Affairs Medical
      Center, Charleston (M.R.Z.).
LA  - eng
PT  - Journal Article
PL  - United States
TA  - N Engl J Med
JT  - The New England journal of medicine
JID - 0255562
EDAT- 2017/07/06 06:00
MHDA- 2017/07/06 06:00
CRDT- 2017/07/06 06:00
AID - 10.1056/NEJMoa1609758 [doi]
PST - ppublish
SO  - N Engl J Med. 2017 Jul 6;377(1):41-51. doi: 10.1056/NEJMoa1609758.