Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure: The Weight Monitoring in Heart Failure (WHARF) trial
Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure: The Weight Monitoring in Heart Failure (WHARF) trial
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DOI：
10.1016/s0002-8703(03)00393-4
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发表时间：
2003-10-01
影响因子：
4.8
通讯作者：
Loh, E
中科院分区：
文献类型：
--
作者：
Goldberg, LR;Piette, JD;Loh, E
心力衰竭治疗指南强调心力衰竭患者的每日体重监测，但支持这一做法的数据尚未确定。使用基于技术的心力衰竭监测系统，我们确定是否每日报告的体重和症状的晚期心力衰竭患者将减少再住院和死亡率，尽管积极的指南驱动的心力衰竭care.Methods这是一个随机对照试验。因纽约心脏协会III级或IV级心力衰竭住院且左心室射血分数小于或等于35%的患者随机接受心力衰竭计划治疗或心力衰竭计划治疗加AleeNet系统（Alere Medical，里诺，内华达州），并随访6个月。主要终点是6个月的再入院率。次要终点包括死亡率、心力衰竭住院再入院率、急诊室就诊率和生活质量。结果来自美国16个心力衰竭中心的280例患者被随机分组：138例接受AleeNet系统治疗，142例接受标准治疗。平均年龄为59 ± 15岁，68%为男性。人群患有非常晚期的心力衰竭，纽约心脏协会III级（75%）或IV级（25%），如血清去甲肾上腺素水平、6分钟步行距离和结局所证明的。未观察到住院率差异。死亡率降低56.2%（P
Background Heart failure treatment guidelines emphasize daily weight monitoring for patients with heart failure, but data to support this practice are locking. Using a technology-based heart failure monitoring system, we determined whether daily reporting of weight and symptoms in patients with advanced heart failure would reduce rehospitalization and mortality rates despite aggressive guideline-driven heart failure care.Methods This was a randomized, controlled trial. Patients hospitalized with New York Heart Association class III or IV heart failure, with a left ventricular ejection fraction less than or equal to35% were randomized to receive heart failure program care or heart failure program care plus the AlereNet system (Alere Medical, Reno, Nev) and followed-up for 6 months. The primary end point was 6-month hospital readmission rate. Secondary end points included mortality, heart failure hospitalization readmission rate, emergency room visitation rate, and quality of life.Results Two hundred eighty patients from 16 heart failure centers across the United States were randomized: 138 received the AlereNet system and 142 received standard care. Mean age was 59 +/- 15 years and 68% were male. The population had very advanced heart failure, New York Heart Association class III (75%) or IV-(25%), as evidenced by serum norepinepherine levels, 6-minute walk distance and outcomes. No differences in hospitalization rates were observed. There was a 56.2% reduction in mortality (P