Evolution of biomarker guided therapy for heart failure: current concepts and trial evidence.

Optimizing management of patients with heart failure remains quite challenging despite many significant advances in drug and device therapy for this syndrome. Although a large body of evidence from robust clinical trials supports multiple therapies, utilization of these well-established treatments remains inconsistent and outcomes suboptimal in "real-world" patients with heart failure. Disease management programs may be effective, but are difficult to implement due to cost and logistical issues.

Trastuzumab-induced cardiotoxicity.

Purpose/objectives: To review trastuzumab-related cardiotoxic effects in the breast cancer adjuvant setting, present a system for pretreatment screening for cardiovascular risk factors, describe monitoring recommendations, provide a tool to facilitate adherence to monitoring guidelines, and discuss implications for patient education.

Data Sources: Literature regarding cardiotoxicity and trastuzumab in breast cancer.

Data Synthesis: Trastuzumab was approved in 2006 for use in the adjuvant setting.

Prediction of rehospitalization and death in severe heart failure by physicians and nurses of the ESCAPE trial.

Background: The predictive accuracy of physician investigators and nurse coordinators in estimating the risk of rehospitalization and death was determined for 373 hospitalized patients with severe advanced heart failure enrolled in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial.

Methods And Results: Estimates were made at discharge, and patients were followed for 6 months after hospitalization. A statistical prognostic model was developed from clinical and laboratory data for the end points of rehospitalization and death.