Early pharmacological treatment of acute heart failure syndromes: A systematic review of clinical trials

Leonardo De Luca, Gregg C. Fonarow, Alexandre Mebazaa, David D. Shin, Sean P. Collins, Karl Swedberg, Mihai Gheorghiade*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Context: Acute Heart Failure Syndromes (AHFS) is a common admission diagnosis associated with high mortality and hospital readmissions. Given the mixed results of recent clinical trials, the early management of AHFS remains controversial. Objective: To review the recent evidence regarding current and investigational therapies for the early management of AHFS. Data Sources: A systematic search of peer-reviewed publications was performed on MEDLINE and EMBASE from January 1990 to August 2006. The results of unpublished or ongoing trials were obtained from presentations at national and international meetings and pharmaceutical industry releases. Bibliographies from these references were also reviewed, as were additional articles identified by content experts. Study Selection and Data Extraction: Criteria used for study selection were controlled study design, relevance to clinicians and validity based on venue of publication and power analysis. Data Synthesis: Although all current intravenous therapies for the early management of AHFS appear to improve hemodynamics, this may not always translate into short-term clinical benefit. Conclusion: The results of the trials conducted to date in AHFS have generally been disappointing. There is, therefore, an unmet need for new therapeutic approaches for the early management of AHFS that may improve the short-term and long-term outcomes.

Original languageEnglish (US)
Pages (from-to)10-21
Number of pages12
JournalAcute cardiac care
Issue number1
StatePublished - Apr 26 2007


  • Acute heart failure
  • Blood pressure
  • Classification
  • Epidemiology
  • Prognostic factors
  • Treatment
  • Trials

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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