The Lesson from the COMPANION Study: How Large Is the Patient Population That May Benefit?

摘要

Nearly 5 million persons living in the United States have heart failure, with 550 000 new cases diagnosed annually. Heart failure is the only cardiovascular disease in which the prevalence is increasing; projections suggest that prevalence will increase two- to three-fold by the year 2010 [1]. This increase is probably the result of aging of the population and the successful treatment of acute coronary syndromes.In addition to its increasing prevalence, heart failure continues to be characterized by frequent morbidity and unacceptably high mortality despite substantial advances in drug therapy [2], Heart failure generally leads to death by one of two mechanisms: sudden death, or death from progressive heart failure. The relative proportion of patients dying from these two mechanisms varies with severity of heart failure. Patients with mild heart failure most commonly die suddenly, while patients who survive to the advanced stages of heart failure predominantly die of progression of heart failure - a gradual loss of ventricular function that leads to inadequate systemic perfusion and death.