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In their recent systematic review and meta-analysis of the overall impact of multidisciplinary management programs on the risk of readmission and all-cause mortality in patients with chronic heart failure (CHF), Gwadry-Sridhar et al¹ concluded that this type of intervention had a positive impact on morbidity but minimal impact on mortality. Our own meta-analysis of these same programs² concluded that CHF management programs not only reduce the risk of readmission (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.75-0.93) but also reduce the risk of all-cause mortality (RR, 0.83; 95% CI, 0.70-0.99). There are 2 important explanations why these analyses reached different conclusions.

First, for reasons that are not clear, Gwadry-Sridhar et al¹ chose to limit their analysis to 7 trials involving 1113 patients with CHF, published prior to the year 2000 (plus their own unpublished study, involving an additional 126 patients). Notably, 2 large randomized trials published in Lancet and . . . [Full Text of this Article]

AUTHOR INFORMATION
Simon Stewart, PhD, FESC, FAHA; Finlay A. McAlister, MD, MSc, FRCPC; John J. V. McMurray, MD, FESC, FACC

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