Model for Heart Failure ExAcerbation Reduction Trial
Model for Heart Failure ExAcerbation Reduction Trial
Heart failure is the leading cause of hospitalizations and readmissions in the United States
 and is a tremendous economic strain on our healthcare system. There is currently, based on
 national averages, a 30% readmission rate and 10% mortality rate within 3 months of being
 hospitalized for heart failure. Retrospective studies have shown benefit to using biomarkers
 such as BNP to guide inpatient heart failure management. Our own CCF retrospective study
 showed that decreasing NT-ProBNP by 23%, making patients fluid negative by more than 1.3L,
 and discharging patients with serum sodium above 135 reduces readmission rates significantly.
 The purpose of this study is to prospectively use the above mentioned goals in the treatment
 of heart failure in order to reduce heart failure readmission and mortality rates.
All HF patients admitted to CCF will receive a short consent form. The study will enroll
 patients for one year. Physicians will initiate / titrate medications and obtain consults as
 usual but are highly encourage to keep patients in the hospital until at least 2 of the 3
 (above mentioned) criteria are met. Physicians will receive a copy of consent forms,
 educational bulletins, and discharge forms (as described in the Physician Education document
 which is attached to this application). Log-rank test will be used to compare groups.
 Chi-Square will be used to compare prospective patients with retrospective controls (obtained
 in 2010).
Inclusion Criteria:

 -  Must have either Acute on Chronic Heart Failure or Chronic Heart Failure regardless of
 presenting/primary complaint

 To fulfill CHF Dx, MUST have 2+ of the following:

 -  Clinical: Dyspnea, orthopnea, PND, edema, S3, rales, improve w diuretics

 -  Radiographic: Pulm venous congestion, pleural effs, cardiomegaly

 -  Lab: NT pro BNP > 1000

 Exclusion Criteria:

 -  None