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Gutzwiller F.S.,University of Basel | Schwenkglenks M.,University of Basel | Schwenkglenks M.,University Zrich | Blank P.R.,University of Basel | And 8 more authors.
European Journal of Heart Failure | Year: 2012

Aims The purpose of this study was to evaluate the cost-effectiveness of iron repletion using intravenous (i.v.) ferric carboxymaltose (FCM) in chronic heart failure (CHF) patients with iron deficiency with or without anaemia. Cost-effectiveness was studied from the perspective of the National Health Service in the UK. Methods and Results A model-based cost-effectiveness analysis was used to compare iron repletion with FCM with no iron treatment. Using data from the FAIR-HF trial and publicly available sources and publications, per patient costs and clinical effectiveness of FCM were estimated compared with placebo. Cost assessment was based on study drug and administration costs, cost of CHF treatment, and hospital length of stay. The incremental cost-effectiveness ratio (ICER) of FCM use was expressed as cost per quality-adjusted life year (QALY) gained, and sensitivity analyses were performed on the base case. The time horizon of the analysis was 24 weeks. Mean QALYs were higher in the FCM arm (difference 0.037 QALYs; bootstrap-based 95 confidence interval 0.0170.060). The ICER of FCM compared with placebo was €4414 per QALY gained for the FAIR-HF dosing regimen. Sensitivity analyses confirmed the base case result to be robust. Conclusion From the UK payers' perspective, managing iron deficiency in CHF patients using i.v. FCM was cost-effective in this analysis. The base case ICER was clearly below the threshold of €22 200€33 300/QALY gained (£20 000£30 000) typically used by the UK National Institute for Health and Clinical Excellence and proved to be robust in sensitivity analysis. Improved symptoms and better quality of life contributed to this result. © 2012 The Author. Source


Rowaiye O.O.,Wroclaw Medical University | Jankowska E.A.,Wroclaw Medical University | Jankowska E.A.,Center for Heart Diseases | Ponikowska B.,Wroclaw Medical University
Cardiology Journal | Year: 2013

Diabetes mellitus (DM) is a disease of increasing incidence and prevalence. Arterial baroreceptors are stretch-sensitive receptors, which in a reflex manner are involved in the homeostatic control of arterial blood pressure. Diabetic subjects have depressed baroreflex sensitivity (BRS), although the exact pathomechanisms are unclear. In this review, we discuss the features, clinical and prognostic implications of reduced BRS for diabetic patients and the potential involvement of cardiovascular autonomie neuropathy and atherosclerosis. Finally, we demonstrate evidence on interventions (e.g. pioglitazone, alpha-lipoic acid, leptin, fluvastatin, physical training etc.) which could improve BRS and ameliorate cardiovascular autonomie dysfunction in diabetic patients. © 2013 Via Medica. Source


Sliwa K.,University of Cape Town | Hilfiker-Kleiner D.,Molekulare Kardiologie | Mebazaa A.,University Paris Diderot | Petrie M.C.,Golden Jubilee National Hospital | And 17 more authors.
European Journal of Heart Failure | Year: 2014

Background The EURObservational Research Programme is a rolling programme of cardiovascular registries and surveys of the European Society of Cardiology (ESC). These registries will provide information on the nature of cardiovascular disease and its management. This manuscript provides an update on new literature on peripartum cardiomyopathy (PPCM), published since the 2010 Position Statement from the Heart Failure Association of the European Society of Cardiology Working Group on PPCM, and describes a new registry on this under-recognized condition. Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of the pregnancy, or in the months following delivery, where no other cause for heart failure is found. Aims The PPCM Registry aims to describe disease presentation, comorbidities, diagnostic and therapeutic management of patients with PPCM, as well as information on their offspring. Centres not only from ESC and ESC-affiliated countries, but from around the world, are encouraged to participate. Methods A prospective registry on patients presenting with PPCM. At the time of writing, approximately 100 patients have been enrolled from 20 countries. All data entry is online via secure passwords and is supported by well-trained information technology personnel. Conclusion The EURObservational Research Programme will allow a comparison of women from around the world, from different ethnic backgrounds, presenting with PPCM and will report on their 6month and 12month outcomes. The study aims to include 1000 patients and follow them for 1year. New centres volunteering to participate in the study will be welcomed. © 2014 The Authors. Source


Jankowska E.A.,Wroclaw Medical University | Jankowska E.A.,Center for Heart Diseases | Anker S.D.,Center for Clinical and Basic Research | MacDougall I.C.,Kings College | And 2 more authors.
European Heart Journal | Year: 2013

Iron is a micronutrient essential for cellular energy and metabolism, necessary for maintaining body homoeostasis. Iron deficiency is an important co-morbidity in patients with heart failure (HF). A major factor in the pathogenesis of anaemia, it is also a separate condition with serious clinical consequences (e.g. impaired exercise capacity) and poor prognosis in HF patients. Experimental evidence suggests that iron therapy in iron-deficient animals may activate molecular pathways that can be cardio-protective. Clinical studies have demonstrated favourable effects of i.v. iron on the functional status, quality of life, and exercise capacity in HF patients. It is hypothesized that i.v. iron supplementation may become a novel therapy in HF patients with iron deficiency. © The Author 2012. Source


Ponikowski P.,Wroclaw Medical University | Ponikowski P.,Center for Heart Diseases | Jankowska E.A.,Wroclaw Medical University | Jankowska E.A.,Center for Heart Diseases
Revista Espanola de Cardiologia | Year: 2015

Acute heart failure constitutes a heterogeneous clinical syndrome, whose pathophysiology is complex and not completely understood. Given the diversity of clinical presentations, several different pathophysiological mechanisms along with factors triggering circulatory decompensation are involved. This article discusses the available evidence on the pathophysiological phenomena attributed or/and associated with episodes of acute heart failure and describes different clinical profiles, which, from a clinical perspective, constitute a key element for therapeutic decision-making. Full English text available from: www.revespcardiol.org/en © 2015 Sociedad Española de Cardiología. Source

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