TOP 40: Therapy Outcome and Prevention in case of LV-EF <40% - Project description
Background
Heart failure is the only cardiovascular disease whose incidence and prevalence are increasing in Germany as well as worldwide. Its course is progressive and medicated inadequately its prognosis resembles malignant diseases. Numerous controlled studies on selected patients have proven that due to a stage-adapted therapy both morbidity and mortality can be reduced considerably and the quality of life can be improved. However, the penetration of these results in the daily clinical routine is insufficient. On the one hand, the currently increasing hospitalization- and mortality rates account primarily to older patients who are underrepresented in the randomized studies. On the other hand, the implementation of evidence based therapy measures on suitable patients is insufficient, at least because of economic constraints. In contrast to other heart diseases as Myocardial Infarction or Atrial Fibrillation, whose epidemiology and supply situation are well examined within the scope of national and regional registers (Berlin Myocardial Infarction Registry), no systematical examinations with representative data exist when it comes to heart failure.
Objective
“TOP 40” is the breeding ground of a Berlin Heart Failure Registry which is to determine the supply situation of hospitalized patients with systolic heart failure. Special attention will be given to evidence based heart failure medication and device therapy (ICD, CRT). Results of the pilot project are to serve as basis for concepts for quality assurance and for an optimization of regional supply structures.
Implementation
“TOP 40” is a prospective, multi-center study at Berlin hospitals of all health care levels. Included are hospitalized patients with a LV-EF < 40%, NYHA class I-IV, of all etiology and age groups (> 18 years). After a follow up of 12 months, prognostic parameters regarding morbidity and mortality are collected. The study has started on 1. March, 2009.
Added value via networking
“TOP 40” is a joint project of the Heart Failure Center at the “Jüdisches Krankenhaus Berlin”, the “Charité – Campus Virchow Klinikum”, and the Berlin hospitals of the “Verein zur Errichtung Evangelischer Krankenhäuser”. The implementation of 450 consecutive patients takes place within the scope of a network of Berlin hospitals of all health care levels. “TOP 40” is an associated project of the German Competence Network on Heart Failure (CNHF). The CRF of the CNHF serve as basis for the data collection. The KKSL indemnifies biometrics and data management.