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<title><string language="fre"><![CDATA[Cardiovascular Clinical Trialists (CVCT) Forum – Paris 2012 : Is it always safe to believe in class effect: Spironolactone vs. eplerenone differences and clinical relevance?]]></string></title>
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<string language="fre"><![CDATA[Title : Cardiovascular Clinical Trialists (CVCT) Forum – Paris 2012 : Is it always safe to believe in class effect: Spironolactone vs. eplerenone differences and clinical relevance?
Speaker: Bertram PITT, Ann Arbor, USA
Abstract : Is it always safe to believe in class effect: Spironolactone vs. eplerenone differences and clinical relevance?
L’auteur n’a pas transmis de conflit d’intérêt concernant les données diffusées dans cette vidéo ou publiées dans la référence citée.
9th Global Cardiovascular Clinical Trialists Forum • Paris 2012 
Multidisciplinary expert workshop : achievements challenges and barriers to implantation of the ESC 2012 chronic heart failure guidelines.
Chairpersons: Alain COHEN-SOLAL, Paris, FRA - Adrian VOORS, Groningen, NED
Background: The ESC-HFA chronic and acute heart failure guidelines have recently been published. However, the challenge for guidelines does not cease with a consensus document. Practical implementation is the critical step in establishing higher standards of care for individual patients. Improved guideline uptake is not only an index of better standards but a validation of the process of guideline production.
Improving consensus between guidelines is also important, differences in recommendations may act as a barrier to guideline. The NICE CHF guidance was updated in 2010, and it is not likely to be revised in short term.
Practice differs from the guideline recommendations. Registries suggest differences in guideline interpretation and treatment/management of CHF between different stakeholders. Similarities and differences exist between GPs and hospital physicians’ approaches to management of CHF. One important issue that is not covered by the current guidelines is the class effect issue. Canadian and Australian CHF guideline and 2010 NICE guideline name eplerenone as preferred drug in heart failure, ESC mentions only mineralocorticoid receptor antagonists (MRAs.) as a class.
How to interpret compound vs. class effects while following guideline recommendations is an important issue.
Cost-effectiveness is a key not only to the content of guidelines but also in the assessment of implementation. Limits on healthcare resources mandate that resource-allocation decisions be guided by considerations of cost in relation to expected benefits. In cost-effectiveness analysis, the ratio of net healthcare costs to net health benefits provides an index by which priorities may be set.
Aims: This multidisciplinary consensus workshop aims at discussing CHF guideline implementation issues and the consequences on defining the place of MRA/eplerenone in management of CHF.
Réalisation, production : Canal U/3S et CERIMES
Keyword : Cardiovascular Clinical Trialists, Paris, 2012, Cardiovascular prevention, ESC-HFA, eplerenone]]></string></description>
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NOTE:PITT Bertram, Ann Arbor, USA BERTRAM PITT, M.D. Bertram Pitt is a professor of medicine emeritus at the University Of Michigan School Of Medicine. Dr. Pitt obtained his MD degree from the University of Basel in Switzerland in 1959. He subsequently did a fellowship in cardiology at the Johns Hopkins University School of Medicine and remained on the faculty there until 1977 when he left to direct the division of cardiology at the University of Michigan School of Medicine. He has been chairman or co-chairman of a number of clinical trials in cardiology including: SOLVD; ELITE I and II; Prevent; Rales and Ephesus. He is currently chairman of the steering committee of the NHLBI TOPCAT trial examining the effect of spironolactone in patients with HF and preserved LV systolic function; co-chairman of the Emphasis-HF trial examining the role of eplerenone in patients with NYHA Class II HF; chairman of Break-DHF; co-chairman of STOP-CKD; co-chairman of Exceed; co chairman of Escape-SHF and Escape-DH F; chairman of a study evaluating the role of an aldostereone synthase, inhibitor in patients with HF and is a member of the executive committee of the Accomplish trial. In addition, he serves as the chairman of the DSMB for the NHLBI HF-Action trial and has over 500 articles in peer reviewed journals. Dr. Pitt has been a member of a numerous medical journal editorial boards. He has also been a member of a number of medical organizations and has served as an advisor to the clinical trials branch of the NHLBI and a member of the FDA cardio-renal advisory board. He has been awarded the James B. Herrick Award by the Council of Clinical Cardiology of the American Heart Association and has been elected to the Society of Scholars of the Johns Hopkins University. 
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