What about any morbidity benefit (decreased hospitalizations for decompensated HF)? A lot of emphasis is placed on mortality benefit in cardiology trials. Morbidity benefit (if it can be proven) would be very important for the patient (improved quality of life) and for CMS (since HF is the biggest contributor to CMS budget). I'm not sure…
What about any morbidity benefit (decreased hospitalizations for decompensated HF)? A lot of emphasis is placed on mortality benefit in cardiology trials. Morbidity benefit (if it can be proven) would be very important for the patient (improved quality of life) and for CMS (since HF is the biggest contributor to CMS budget). I'm not sure that the meta analysis 'proves' GDMT is inappropriate for patients with HF and AF. Perhaps a more nuanced discussion would be to clarify endpoints (goals of therapy). Sometimes death is not the worst outcome; prolonged debilitation and / or suffering can be far worse outcome for many. This is not at all to dismiss premature death in young and middle aged as a source of much grief and suffering.
What about any morbidity benefit (decreased hospitalizations for decompensated HF)? A lot of emphasis is placed on mortality benefit in cardiology trials. Morbidity benefit (if it can be proven) would be very important for the patient (improved quality of life) and for CMS (since HF is the biggest contributor to CMS budget). I'm not sure that the meta analysis 'proves' GDMT is inappropriate for patients with HF and AF. Perhaps a more nuanced discussion would be to clarify endpoints (goals of therapy). Sometimes death is not the worst outcome; prolonged debilitation and / or suffering can be far worse outcome for many. This is not at all to dismiss premature death in young and middle aged as a source of much grief and suffering.