心力衰竭的药物与辅助装置治疗阜外心血管病医院 张健.ppt

* * * * * * * * * * * * * * * * * * * * * * * * no significant differences in 22 variables among the 3 Rx groups) * * * * * * 1. Describe the difference between the primary HF morbidity objective and the secondary HF hospitalization in that for the primary, the patient must have presented with HF symptoms in which IV diuretics or in which was classified as meeting the primary objective even if HF wasn’t the primary reason for the hospitalization, but later developed HF and given IV diuretics while being hospitalized. The secondary objective hospitalization was met if the patient was admitted for HF and may or may not have received IV therapies * You might want to comment that a brief summary of why a Bayesian approach was chosen and how to interpret the data via Bayesian methods will be described in an upcoming slide. * DMC recommended trial be continued at least through October 15; Data in presentation is data through September 24, 2012 (data cleaned and frozen on Oct 15). The medications are bolded showing consistency across both groups at Randomization versus at Baseline. * Key Take-Away: There was demonstrated to be at least a 10% relative reduction in risk (95% upper bound for HR is 0.9) and an estimated 26% relative reduction (estimated HR is 0.74) in mortality/HF urgent care risk and significant increase in left ventricular volume in the BiV arm versus the RV arm. This finding holds up in the CRT-P subjects alone as well. In the CRT-D subjects, the HR estimate was comparable to that of the CRT-P subjects, as were the BiV and RV event rates themselves (see next slide). * Graphs show the composite primary objective without the echo endpoint for both types of devices. Even without LVESVi, we passed. These results demonstrate at least a 19% relative reduction in mortality/HF urgent care (upper 95% confidence bound was 0.81), and an estimated 38% relative reduction in risk of events (estimate for HR was 0.62). In both device groups the confidence bound