Evidence map›Paper›PMID 42192308›Full record

Trial reportBMC cardiovascular disorders2026

Prognostic factors related to all-cause mortality in very long-term follow-up of patients with heart failure: the REMADHE trial extended analysis.

Edimar Alcides Bocchi, Guilherme Veiga Guimaraes, Cristhian Espinoza Romero, Silvia Moreira Ayub Ferreira, Bruno Biselli, Paulo Roberto Chizzola, Robinson Tadeu Munhoz, Julia Tizue Fukushima, André Rodrigues Durães, Leonardo Roever and 1 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00505050 (A Long-Term Prospective Randomized Controlled Study Using Repetitive Education at Six-Month Intervals and Monitoring for Adherence in Heart Failure Outpatients - The REMADHE Study), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00505050 phase3completednot on this map

A Long-Term Prospective Randomized Controlled Study Using Repetitive Education at Six-Month Intervals and Monitoring for Adherence in Heart Failure Outpatients - The REMADHE Study

TypeinterventionalSponsorUniversity of Sao PauloRan1999 to 2006ConditionsHeart FailureArmsDisease Program Management
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Edimar Alcides BocchiHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil. dcledimar@incor.usp.br.ORCID http://orcid.org/0000-0001-9204-485X
Guilherme Veiga GuimaraesHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
Cristhian Espinoza RomeroHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
Silvia Moreira Ayub FerreiraHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
Bruno BiselliHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
Paulo Roberto ChizzolaHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
Robinson Tadeu MunhozHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
Julia Tizue FukushimaHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.
André Rodrigues DurãesUnidade de Cardiologia, Hospital das Clínicas, Universidade Federal da Bahia, Salvador, Brazil.
Leonardo RoeverDepartament of Clinical Research - Brazilian Evidence, Uberlandia, Brazil.
Fátima das Dores CruzHeart Failure Clinics, Instituto do Coração (Heart Institute), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr Melo Alves no 690, apto 41, São Paulo, CEP 01417-010, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDisease management programs (DMP) have reduced hospitalizations and improved quality of life in heart failure (HF). However, prognostic factors and survival in very long-term follow-up (> 20 years) have not been reported.

aimsTo evaluate the long-term effects of a disease management program (DMP) on heart failure outcomes and to identify prognostic predictors of all-cause mortality in patients with HF followed for up to 23.6 years.

methodsThe REMADHE trial (NCT00505050, 2007-07-20) was a prospective, single-center, randomized trial (n = 412) comparing DMP versus usual care (C) with initial follow-up of 2.47 years. This extended analysis followed patients for 23.6 years to identify prognostic predictors of all-cause mortality.

resultsThe all-cause mortality rate was 88.3%. HF was the first cause of death followed by sudden death. Mortality was higher in the first 6-year follow-up. The predictive variables in multivariate analysis associated with mortality were age > 52 years (P = 0.015), Chagas etiology (P = 0.010), LVEF < 45% (P = 0.008), digoxin use (P = 0.002), NYHA IV (P = 0.01), blood urea nitrogen (BUN) (P = 0.03), and lymphopenia (P = 0.005). In very long-term follow-up, DMP did not affect mortality in patients under guideline-directed medical therapy (GDMT). HF as a cause of death was more frequent in the C group (41.0% vs. 33.3% in the DMP group; P < 0.02).

conclusionsDMP was not effective in reducing very long-term mortality; however, causes of death differed between groups, with more HF-related deaths in controls. Our findings that age, LVEF, Chagas' disease, NYHA, renal function, lymphocytes, and digoxin use were associated with poor prognosis could influence future strategies to improve HF management.

Indexed as

Heart FailureAdultAgedCause of DeathFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesRisk AssessmentRisk FactorsStroke VolumeTime FactorsTreatment OutcomeChagas diseaseHeart failurePrognosisRenalVery long-term follow-up

Identifiers

PMID42192308
PMCPMC13390230

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.