Meta-Analysis Global Group in Chronic heart failure (MAGGIC)

Hyponatraemia (usually defined as a serum sodium concentration,135 mmol/L)1 is observed in 20% of patients admitted to hospital for heart failure (HF).2 – 4 Studies conducted in various patient populations of chronic and acutely decompensated HF have shown an association between low serum sodium concentration and poor prognosis.2 – 7 Most of these studies were focused on short-term outcomes.2 – 4 Risk models developed in different HF cohorts of outpatients 8,9 and hospitalized patients10212 have suggested that hyponatraemia is one of the most powerful predictors of mortality in HF. Few studies that investigated the relationship between serum sodium concentration and outcome have included patients with heart failure and preserved ejection fraction (HF-PEF).2,9,12 – 14 It is now clear that HF-PEF accounts for a substantial proportion of cases of HF15,16 and has distinct features compared with heart failure with reduced ejection fraction (HF-REF).16 The prognostic role of hyponatraemia has not been well investigated in HF-PEF. Despite an increasing awareness of the prognostic role of hyponatraemia in HF, treatment strategies remain elusive and, in recent clinical trials, vasopressin receptor antagonists did not reduce mortality

Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis

While the populations of patients with heart failure (HF) studied in clinical trials are dominated by men, in routine clinical practice half or more of all patients with HF are women.1,2 Whether prognosis differs for men and women with HF is controversial. Many studies have associated female sex with better survival,1 – 14 although several failed to identify such an association15 – 18 and one study has reported worse prognosis for women.19 Moreover, in HF populations, sex is strongly associated with a number of clinical variables that influence prognosis such as age, aetiology, and in particular left ventricular ejection fraction (EF), associations which may confound the independent effect of sex on survival. Assessment of the relationship between sex and prognosis is further complicated by the relatively small numbers of women in randomized, controlled trials involving patients with HF, in large part due to the exclusion from these trials of older patients and patients with HF with preserved EF, both of which are more prevalent among women with HF

Renal dysfunction in patients with heart failure with preserved versus reduced ejection fraction impact of the new chronic kidney disease-epidemiology collaboration group formula

BACKGROUND: Prior studies in heart failure (HF) have used the Modification of Diet in Renal Disease (MDRD) equation to calculate estimated glomerular filtration rate (eGFR). The Chronic Kidney Disease-Epidemiology Collaboration Group (CKD-EPI) equation provides a more-accurate eGFR than the MDRD when compared against the radionuclide gold standard. The prevalence and prognostic import of renal dysfunction in HF if the CKD-EPI equation is used rather than the MDRD is uncertain. METHODS AND RESULTS: We used individual patient data from 25 prospective studies to stratify patients with HF by eGFR using the CKD-EPI and the MDRD equations and examined survival across eGFR strata. In 20 754 patients (15 962 with HF with reduced ejection fraction [HF-REF] and 4792 with HF with preserved ejection fraction [HF-PEF]; mean age, 68 years; deaths per 1000 patient-years, 151; 95% CI, 146-155), 10 589 (51%) and 11 422 (55%) had an eGFR <60 mL/min using the MDRD and CKD-EPI equations, respectively. Use of the CKD-EPI equation resulted in 3760 (18%) patients being reclassified into different eGFR risk strata; 3089 (82%) were placed in a lower eGFR category and exhibited higher all-cause mortality rates (net reclassification improvement with CKD-EPI, 3.7%; 95% CI, 1.5%-5.9%). Reduced eGFR was a stronger predictor of all-cause mortality in HF-REF than in HF-PEF. CONCLUSIONS: Use of the CKD-EPI rather than the MDRD equation to calculate eGFR leads to higher estimates of renal dysfunction in HF and a more-accurate categorization of mortality risk. Renal function is more closely related to outcomes in HF-REF than in HF-PEF.3.986 SJR (2012) Q1, 9/332 Cardiology and cardiovascular medicine, 35 de 1854 Medicine (miscellaneous

Demographic characteristics of “final gene-positive” cases.

<p>Demographic characteristics of “final gene-positive” cases.</p

Distribution of pathogenic variants and variants of uncertain significance per age group.

<p>Distribution of pathogenic variants and variants of uncertain significance per age group.</p

Demographic characteristics of “final gene-positive” cases.

<p>Demographic characteristics of “final gene-positive” cases.</p

Description of genetic variants and evidence of pathogenicity.

<p>Description of genetic variants and evidence of pathogenicity.</p

Demographic characteristics, description of events, medical and family history of gene-positive cases.

<p>Demographic characteristics, description of events, medical and family history of gene-positive cases.</p