Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure
Results of the initiation management predischarge: process for assessment of carvedilol therapy in heart failure (IMPACT-HF) trial
Wendy A. Gattis, PharmD*,
Christopher M. O'Connor, MD, FACC*,
Dianne S. Gallup, MS*,
Vic Hasselblad, PhD*,
Mihai Gheorghiade, MD, FACC ,* IMPACT-HF Investigators and Coordinators
* Division of Cardiology, Duke University Medical Center and Duke Clinical Research Institute, Durham, North Carolina, USA
Division of Cardiology, Northwestern University/Feinberg School of Medicine, Chicago, Illinois, USA
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Figure 1 Study outline. Patients with reactive airway disease were excluded per protocol, but patients with chronic obstructive pulmonary disease were allowed. The investigator made the determination of pulmonary disease too severe for the patient to be enrolled. AV = atrioventricular; EF = ejection fraction; HF = heart failure; NYHA = New York Heart Association.
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Figure 2 (A) Kaplan-Meier curve depicting time to death + rehospitalization. (B) Kaplan-Meier curve depicting time to death, recurrent hospitalization, unscheduled visit for heart failure,  50% increase in oral diuretic therapy, addition of new oral diuretic therapy excluding spironolactone, or any intravenous therapy with diuretics, inotropes, inodilators, or other vasoactive agents within 60 days post-randomization. Solid lines = predischarge carvedilol initiation group; dashed lines = physician-discretion postdischarge initiation group. HR = hazard ratio.
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