Regional differences in the characteristics and treatment of patients participating in an international heart failure trial

Barry M. Massie, John G F Cleland, Paul W. Armstrong, Milton Packer, Philip A. Poole-Wilson, Ryden Lars

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Aims: This study was designed to determine regional differences in patient characteristics and medication use among patients entered into an international heart failure trial. Methods and Results: Data for this analysis were derived from the Assessment of Treatment with Lisinopril and Survival Study (ATLAS), a prospective randomized comparison of high- and low- dose therapy with lisinopril in patients with New York Heart Association class II, III, or IV chronic heart failure, which enrolled 3164 patients in 291 centers in 19 countries on 3 continents. Information was collected at baseline concerning patient demographics, etiology of heart failure, accompanying conditions, prior revascularization procedures, and medication use. The primary findings were a lower incidence of ischemic cardiomyopathy in southern and western Europe, more frequent diabetes in North America, and a greater use of coronary revascularization in the United States and Canada. There was substantial variation in medication use, particularly with regard to digoxin, anticoagulants, and amiodarone. Conclusions: Although there is considerable overlap in guidelines concerning the treatment of heart failure issued by authorities in Europe and North America, there are significant regional variations in medication use. Some, but not all, of these differences can be explained by differences in patient characteristics.

Original languageEnglish (US)
Pages (from-to)3-8
Number of pages6
JournalJournal of Cardiac Failure
Issue number1
StatePublished - Mar 1998


  • Angiotensin-converting enzyme inhibitors
  • Clinical trial
  • Drug therapy
  • Heart failure
  • Practice patterns

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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