Clinical trials update from the European Society of Cardiology heart failure meeting 2009: CHANCE, B-Convinced, CHAT, CIBIS-ELD, and Signal-HF

This paper provides information and a commentary on trials relevant to the pathophysiology, prevention, and treatment of heart failure presented at the annual meeting of the Heart Failure Association of the European Society of Cardiology held in Nice. The CHANCE study showed a substantial reduction in morbidity and mortality in a randomized controlled trial (RCT) of a multidisciplinary management programme for patients with chronic heart failure in Russia. Data from the B-Convinced study, also an RCT, suggest that continuation of beta-blocker (BB) therapy in patients hospitalized with worsening heart failure may be associated with improved outcomes when compared with treatment discontinuation. The CHAT study suggests that telephone support can improve prognosis in heart failure patients living in remote rural locations. CIBIS-ELD showed that titration of BBs to target doses in older patients with heart failure is more difficult; but tolerance levels were similar for bisoprolol and carvedilol. Signal-HF randomized elderly heart failure patients to treatment guided by NT-proBNP levels or usual care, and showed no effect of NT-proBNP-guided treatment on outcomes.