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• W2155384963 abstract "The CHAMPION (CardioMEMS Heart sensor Allows for Monitoring of Pressures to Improve Outcomes in NYHA class III patients) Trial demonstrated that treatment based upon pulmonary artery (PA) pressures effectively reduced heart failure (HF) hospitalizations. We now report the therapy changes made to achieve these outcomes. In additon to clinical variables, incorporation of PA pressures into clinical decision making will reduce HF hospitalizations. CHAMPION is a prospective, randomized trial of 550 NYHA Class III HF patients with both reduced and preserved ejection fraction. All patients underwent implantation of the CardioMEMS HF sensor in the distal branch of the pulmonary artery and were then randomized to either a control group (standard care based on ACC/AHA HF guidelines) or a treatment group (standard of care plus adjustment of pharmacologic therapy according to PA pressures-based guidelines. Over 6 months the treatment group had a higher frequency of medication changes/patient/month compared to the control group (1.55 vs 0.65, p<0.0001). In the treatment group, 0.88/1.55 medication changes were made in response to PA pressures and 0.67/1.55 were not. The similar PA pressures-unrelated medication changes in the control group (0.65 medication changes per patient per month) suggest a comparable intensity of HF management in the 2 groups. For all patients, baseline use of anti-neurohormonal medications was high (ACE/ARB 77.6% and beta blocker 90.7%) and similar between the two groups. There were significant increases in the 6 month change in fraction of maximal dose of ACE/ARB (0.11 vs 0.00, p=0.0042) and beta blockers (0.07 vs 0.01, p=0.0481). The total daily nitrates dose change was greater at 6 months in the treatment group than in the control group (17.5mg vs 3.7mg, p=0.0422). Diuretics were the most frequently adjusted medications, but the mean change in total loop diuretic dose was similar in the 2 gorups (25.9mg vs14.3mg, p=0.1214). Knowledge of PA pressures led to enhanced titration of HF therapy with increased doses of anti-neurohormonal agents and vasodilators. Although diuretic adjustment was more frequent in the treatment group, total diuretic dose was not increased." @default.
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• W2155384963 date "2011-08-01" @default.
• W2155384963 modified "2023-09-27" @default.
• W2155384963 title "Medical Management Guided by Pulmonary Artery Pressures in NYHA Functional Class III Heart Failure Patients" @default.
• W2155384963 doi "https://doi.org/10.1016/j.cardfail.2011.06.313" @default.
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