Heart Failure Clinical Trial
Effects of Carvedilol on Health Outcomes in Heart Failure
Summary
The purpose of our study was to determine if a strategy of starting a heart medication (Beta-blocker) before patients leave the hospital and then being seen by a nurse manager would reduce subsequent hospitalizations compared to usual care.
Hypothesis: A nurse-directed heart failure management program with inpatient initiation of beta blockers will improve health outcomes in a vulnerable, predominantly Hispanic and African American population.
Full Description
Heart failure is a leading cause of death and hospitalization in the US. Designing practical approaches to improving heart failure care is therefore a national health priority. One retrospective study suggested that patients taking beta-blockers while hospitalized for heart failure had a lower risk of rehospitalization at 6-months. One prospective study suggested that starting beta blockers among hospitalized heart failure patients is safe and improves compliance. However, improved outcomes of this approach have not been prospectively demonstrated.
Comparison: Inpatient initiation of the beta-blocker carvedilol coupled with outpatient follow-up with a nurse manager was compared to usual care by internists and cardiologists.
Eligibility Criteria
Inclusion Criteria:
primary hospitalization with heart failure and LVEF < 40%
patient informed consent has been obtained
absence of pulmonary congestion
age > 18 years
Exclusion Criteria:
End-stage renal or hepatic disease
Acute myocardial infarction as primary diagnosis during index hospitalization
Life-expectancy < 6-months
Contraindication to beta blocker use
Current beta-blocker therapy
Planned bypass or valve surgery during index hospitalization
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There is 1 Location for this study
Denver Colorado, 80204, United States
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