title: Early pharmacological treatment of acute heart failure syndromes: a systematic review of clinical trials.
abstract: BACKGROUND
  Acute Heart Failure Syndromes (AHFS) is a common admission diagnosis associated with high mortality and hospital readmissions. Given the mixed results of recent clinical trials, the early management of AHFS remains controversial.
  
  
  OBJECTIVE
  To review the recent evidence regarding current and investigational therapies for the early management of AHFS.
  
  
  METHODS
  A systematic search of peer-reviewed publications was performed on MEDLINE and EMBASE from January 1990 to August 2006. The results of unpublished or ongoing trials were obtained from presentations at national and international meetings and pharmaceutical industry releases. Bibliographies from these references were also reviewed, as were additional articles identified by content experts.
  
  
  METHODS
  Criteria used for study selection were controlled study design, relevance to clinicians and validity based on venue of publication and power analysis.
  
  
  RESULTS
  Although all current intravenous therapies for the early management of AHFS appear to improve hemodynamics, this may not always translate into short-term clinical benefit.
  
  
  CONCLUSIONS
  The results of the trials conducted to date in AHFS have generally been disappointing. There is, therefore, an unmet need for new therapeutic approaches for the early management of AHFS that may improve the short-term and long-term outcomes.
authors: Division of Cardiology, European Hospital, Rome, Italy.
authors: Leonardo
authors: L
authors: De Luca
authors: Gregg C
authors: GC
authors: Fonarow
authors: Alexandre
authors: A
authors: Mebazaa
authors: David D
authors: DD
authors: Shin
authors: Sean P
authors: SP
authors: Collins
authors: Karl
authors: K
authors: Swedberg
authors: Mihai
authors: M
authors: Gheorghiade
mesh_terms: D002303:Cardiac Output, Low / Q000188:drug therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D011379:Prognosis; D013577:Syndrome
chemical_list: D002317:Cardiovascular Agents