Clinical trials in acute heart failure: simpler solutions to complex problems. Consensus document arising from a European Society of Cardiology cardiovascular round-table think tank on acute heart failure, 12 May 2009

This European consensus document aims to identify the main reasons for the apparent lack of progress in the introduction of new medicines for acute heart failure. Relevant issues include not only the heterogeneity of the patient group but also the pharmacology of the medicines themselves and the design of the trials. Above all, this document attempts to provide some pragmatic solutions to this complex syndrome to simplify the execution of meaningful therapeutic endeavours in this area of undoubted unmet clinical need in the future.