The importance of registries in today's heart failure therapies
Article Migaj et al., see p. 1064 Heart failure (HF) research and treatment have become an important part of modern day medicine. Over 23 million people worldwide suffer from HF today. Each hospitalisation for congestive HF amounts to an average treatment costs of $ 8000 . HF is currently divided according to the range of left ventricular ejection fraction (LVEF) into three subcategories: HF with reduced (LVEF < 40%), mid-range (40%-49%), and preserved ejection fraction (≥ 50%) . The
... 50%) . The frequency of these three groups is 50%, 25%, and 25%, respectively . We continue to gain more insight into these HF syndromes from contemporary registries . While one-year and five-year mortality rates of patients with HF remain unacceptably high at about 15% and 50%, respectively [7-10], awareness about HF management and prognosis in the general population is still low . It is important to have new therapeutic developments, and prospective randomised controlled trials (RCTs) are the gold standard in providing evidence of efficacy. Registries, however, also play an enormously important role. They can support our understanding of the characteristics of HF patients and currently prescribed treatments across a range of health care systems. Registries can also provide information about the safety of drugs and, importantly, in larger cohorts of patients, over longer periods of follow-up, and in more complex cases (such as patients with comorbidities) than can RCTs. The limitations of registry-derived data on assessing the risk and efficacy of therapies are well known. There are potentially many reasons why patients do or do not receive specific therapies, and only a few of these factors can be measured and adjusted for (e.g. by using propensity score matching)  . However, the advantages of registries, such as the ability to study rarer syndromes , should not be forgotten.