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    Outcome measures

    The main efficacy outcomes included in-hospital, 30-day and 6-month mortality and longer-term survival. NYHA class was also reported, which is described below. Safety outcomes included complications such as bleeding, limb ischaemia, stroke and acute kidney failure.

    New York Heart Association (NYHA) functional class

    The NYHA functional class is used to classify heart failure according to severity of symptoms and limitation of physical activity:

    • Class 1 - no limitation of physical activity. Ordinary physical activity does not cause undue fatigue, breathlessness, or palpitations.

    • Class 2 - slight limitation of physical activity. Comfortable at rest but ordinary physical activity results in undue breathlessness, fatigue, or palpitations.

    • Class 3 - marked limitation of physical activity. Comfortable at rest but less than ordinary physical activity results in undue breathlessness, fatigue, or palpitations.

    • Class 4 - unable to carry out any physical activity without discomfort. Symptoms at rest can be present. If any physical activity is undertaken discomfort is increased.