Unanswered Questions in Contemporary Heart Failure

Lauren G. Gilstrap, David Snipelisky, Omar AbouEzzeddine, Justin Vader, Lauren Cooper, Jacob Kelley, Antonio Perez, Kenneth Varian, Anuradha Lala, Monica Shah, Lynne W. Stevenson

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objective The epidemiology of heart failure (HF) is changing. This study aimed to describe questions that arise during the routine care of HF patients that are unanswered by the current literature and describe how the type and focus of these questions has changed over time. Methods Investigators from the National Heart, Lung, and Blood Institute–sponsored Heart Failure Apprentice Network collected and categorized questions from 5 academic hospitals over 12 months. A total of 174 unanswered questions were collected and analyzed. Results Compared with 2004, there were more unanswered questions about “whether” to use therapies and fewer about “how” to use therapies. There were fewer questions about what therapeutic targets, therapy adjustment, and combination therapies. There were more questions about whether or how to stop therapies and how to add therapies back. Newly prominent topics, not observed in 2004, including novel therapeutics, refractory ventricular tachycardia, right heart failure, and nutrition/frailty, accounted for 24% of questions. Conclusions Compared with 2004, there are fewer unanswered questions about how to use, adjust, and combine therapies. There were more unanswered questions about whether and how to stop therapies. Almost 25% of unanswered questions dealt with topics indicative of more advanced disease which were not observed in 2004.

Original languageEnglish
Pages (from-to)770-774
Number of pages5
JournalJournal of cardiac failure
Issue number10
StatePublished - Oct 2017


  • Heart failure
  • epidemiology
  • evidence based medicine
  • treatment


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