title: Worse prognosis of real-world patients with acute heart failure from the Czech AHEAD registry in comparison to patients from the RELAX-AHF trial.
abstract: OBJECTIVE
  The randomized clinical trial RELAX-AHF demonstrated a positive effect of vasodilator therapy with serelaxin in the treatment of AHF patients. The aim of our study was to compare clinical characteristics and outcomes of patients from the AHEAD registry who met criteria of the RELAX-AHF trial (relax-comparable group) with the same characteristics and outcomes of patients from the AHEAD registry who did not meet those criteria (relax-non-comparable group), and finally with characteristics and outcomes of patients from the RELAX-AHF trial.
  
  
  RESULTS
  A total of 5856 patients from the AHEAD registry (Czech registry of AHF) were divided into two groups according to RELAX-AHF criteria: relax-comparable (n= 1361) and relax-non-comparable (n= 4495). As compared with the relax-non-comparable group, patients in the relax-comparable group were older, had higher levels of systolic and diastolic blood pressure, lower creatinine clearance, and a higher number of comorbidities. Relax-comparable patients also had significantly lower short-term as well as long-term mortality rates in comparison to relax-non-comparable patients, but a significantly higher mortality rate in comparison to the placebo group of patients from the RELAX-AHF trial. Using AHEAD score, we have identified higher-risk patients from relax-comparable group who might potentially benefit from new therapeutic approaches in the future.
  
  
  CONCLUSIONS
  Only about one in five of all evaluated patients met criteria for the potential treatment with the new vasodilator serelaxin. AHF patients from the real clinical practice had a higher mortality when compared with patients from the randomized clinical trial.
authors.affiliation: Department of Internal Medicine and CardiologyUniversity Hospital BrnoBrnoCzech Republic; Faculty of MedicineMasaryk UniversityBrnoCzech Republic.
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine Masaryk University Brno Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.affiliation: Faculty of MedicineMasaryk UniversityBrnoCzech Republic; 1st Department of Internal Medicine, Cardiology and AngiologySt. Anne's University Hospital BrnoBrnoCzech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
authors.affiliation: Faculty of MedicineMasaryk UniversityBrnoCzech Republic; 1st Department of Internal Medicine, Cardiology and AngiologySt. Anne's University Hospital BrnoBrnoCzech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Vitovec
authors.affiliation: 2nd Department of Internal Medicine, Cardiology and Angiology, First Faculty of Medicine Charles University in Prague, General University Hospital in Prague Prague Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
authors.affiliation: University Hospital Kralovske Vinohrady, Third Faculty of Medicine Charles University in Prague Prague Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
authors.affiliation: Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Miklik
authors.affiliation: Department of Internal Medicine Hospital Frydek-Mistek Frydek-Mistek Czech Republic.
authors.forename: Kamil
authors.initials: K
authors.lastname: Zeman
authors.affiliation: 2nd Department of Internal Medicine, Cardiology and Angiology, First Faculty of Medicine Charles University in Prague, General University Hospital in Prague Prague Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Belohlavek
authors.affiliation: Department of Cardiology Na Homolce Hospital Prague Czech Republic.
authors.forename: Filip
authors.initials: F
authors.lastname: Malek
authors.affiliation: Department of Internal Medicine University Hospital Olomouc Olomouc Czech Republic.
authors.forename: Cestmir
authors.initials: C
authors.lastname: Cihalik
authors.affiliation: Faculty of MedicineMasaryk UniversityBrnoCzech Republic; 2nd Department of Internal MedicineSt. Anne's University Hospital BrnoBrnoCzech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Spac
authors.affiliation: Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Felsoci
authors.affiliation: Department of Cardiology Na Homolce Hospital Prague Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Ostadal
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine Masaryk University Brno Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
authors.affiliation: Department of Cardiology Institute of Clinical and Experimental Medicine Prague Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kettner
authors.affiliation: Department of Internal Medicine University Hospital Olomouc Olomouc Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Vaclavik
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine Masaryk University Brno Czech Republic.
authors.forename: Simona
authors.initials: S
authors.lastname: Littnerova
authors.affiliation: Department of Internal Medicine Hospital Znojmo Znojmo Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Monhart
authors.affiliation: Department of Internal Medicine Hospital Havlickuv Brod Havlickuv Brod Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Malek
authors.affiliation: Department of Internal Medicine and CardiologyUniversity Hospital BrnoBrnoCzech Republic; Faculty of MedicineMasaryk UniversityBrnoCzech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Parenica
keywords: AHEAD registry; Acute heart failure; Blood pressure; Mortality; Vasodilator therapy