© 2002 European Society of Cardiology
How to assess new treatments for the management of heart failure: composite scoring systems to assess the patients’ clinical journey
Department of Cardiology, Castle Hill Hospital University of Hull, Castle Road, Cottingham, HU16 5JQ, Kingston upon Hull, UK
* Corresponding author. Tel.: +44-1482-624-084; fax: +44-1482-624-085.
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1. Introduction |
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Despite recent successes in the management of heart failure, many patients continue to have debilitating symptoms and prognosis remains poor. Indeed, effective treatment, by increasing longevity, has probably increased the number of patients with heart failure and persisting symptoms. New agents are required either to replace or to add to existing treatment. However, the development of new agents for heart failure is becoming increasingly complex precisely because partially effective treatment now exists.
Therapeutic developments in heart failure have, in some ways, become a victim of their own success. Until the 1990s, no treatment for heart failure had been required to show an effect on mortality. The demonstration that many agents for heart failure could increase mortality and that some could decrease it led regulatory authorities to insist on enough information to exclude a substantial adverse effect on mortality. At the same time, the clinical community began to consider mortality to
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2. Symptoms |
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3. Changes in therapy |
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4. Hospitalisation |
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5. Mortality |
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6. Composite outcomes |
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7. Practical suggestions |
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8. Conclusion |
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