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Mughal HB, Majeed AI, Aftab M, Ubaid MF, Zahra S, Abbasi MSR, Qadir M, Ahmad M, Akbar A, Tasneem S, Jadoon SK, Tariq M, Hussain S, Khandker SS, Alvi S. Brain natriuretic peptide in acute heart failure and its association with glomerular filtration rate: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e36933. [PMID: 38394539 DOI: 10.1097/md.0000000000036933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Acute heart failure (AHF) is one of the most common cardiovascular diseases. Early diagnosis and prognosis are essential, as they can eventually lead to a fatal condition. Recently, brain natriuretic peptide (BNP) has been recognized as one of the most popular biomarkers for AHF. Changes in glomerular filtration rate (GFR) are often observed in AHF. METHODS We searched PubMed, Google Scholar, and ScienceDirect between March and June 2023. Original case control studies written in English that assessed levels oh BNP in AHF were included. Systematic reviews, letters to editor, correspondence, comprehensive reviews, and duplicated studies were excluded. Funnel plots were constructed to assess publication bias. RESULTS A total of 9 studies were selected and we obtained the mean difference (MD) of BNP level to be 2.57 (95% CI: 1.35, 3.78), and GFR to be -15.52, (95% CI: -23.35, -7.70) in AHF patients. Sensitivity analyses supported the robustness of the outcome. CONCLUSION Results indicated that BNP was a promising prognostic biomarker of AHF, whereas GFR was found to be negatively correlated with AHF.
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Affiliation(s)
- Hamdah Bashir Mughal
- Registered Medical Practitioner, Azad Jammu & Kashmir Medical College, Muzaffarabad, Azad Jammu and Kashmir, Pakistan
| | | | - Maria Aftab
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | | | - Sabahat Zahra
- Acute and General Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | | | - Mamoon Qadir
- Head of Cardiology Department Fed Govt Polyclinic and Kulsum International Hospital, Islamabad, Pakistan
| | - Mumtaz Ahmad
- Abbas Institute of Medical Sciences, Muzaffarabad AJK, Pakistan
| | - Amna Akbar
- District Headquarter Hospital Jhelum Valley, Muzaffarabad AJK, Pakistan
| | | | | | - Maham Tariq
- Gujranwala, Teaching Hospital, Gujranwala, Pakistan
| | | | | | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Zhao D, Gu L, Wei W, Peng D, Yang M, Yuan W, Rong S. Impact of the degree of worsening renal function and B-type natriuretic peptide on the prognosis of patients with acute heart failure. Front Cardiovasc Med 2023; 10:1103813. [PMID: 37077744 PMCID: PMC10106778 DOI: 10.3389/fcvm.2023.1103813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
BackgroundThe impact of the degree of worsening renal function (WRF) and B-type natriuretic peptide (BNP) on the prognosis of patients with acute heart failure (AHF) is still debatable. The present study investigated the influence of different degrees of WRF and BNP levels at discharge on 1-year all-cause mortality in AHF.MethodsHospitalized AHF patients diagnosed with acute new-onset/worsening of chronic heart failure (HF) between January 2015 and December 2019 were included in this study. Patients were assigned into high and low BNP groups based on the median BNP level at discharge (464 pg/ml). According to serum creatinine (Scr) levels, WRF was divided into non-severe WRF (nsWRF) (Scr increased ≥0.3 mg/dl and <0.5 mg/dl) and severe WRF (sWRF) (Scr increased ≥0.5 mg/dl); non-WRF (nWRF) was defined as Scr increased of <0.3 mg/dl). Multivariable cox regression was used to evaluate the association of low BNP value and different degrees of WRF with a all-cause death, as well as testing for an interaction between the two.ResultsAmong 440 patients in the high BNP group, there was a significant difference in WRF on mortality (nWRF vs. nsWRF vs. sWRF: 22% vs. 23.8% vs. 58.8%, P < 0.001). Yet, mortality did not significantly differ across the WRF subgroups in the low BNP group (nWRF vs. nsWRF vs. sWRF: 9.1% vs. 6.1% vs. 15.2%, P = 0.489). In multivariate Cox regression analysis, low BNP group at discharge (HR, 0.265; 95%CI, 0.162–0.434; P < 0.001) and sWRF (HR, 2.838; 95%CI, 1.756–4.589; P < 0.001) were independent predictors of 1-year mortality in AHF.There was a significant interaction between low BNP group and sWRF(HR, 0.225; 95%CI, 0.055–0.918; P < 0.05).ConclusionsnsWRF does not increase the 1-year mortality in AHF patients, whereas sWRF does. A low BNP value at discharge is associated with better long-term outcomes and mitigates the adverse effects of sWRF on prognosis.
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Kido T, Okabe T, Narui S, Fujioka T, Ishigaki S, Usumoto S, Asukai Y, Kimura T, Shimazu S, Saito J, Oyama Y, Igawa W, Ono M, Ebara S, Yamamoto MH, Yakushiji T, Isomura N, Ochiai M. Relationship between early drop in systolic blood pressure, worsening renal function, and in-hospital mortality in patients with heart failure: a retrospective, observational study. Heart Vessels 2023; 38:207-215. [PMID: 36036287 DOI: 10.1007/s00380-022-02160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/18/2022] [Indexed: 01/10/2023]
Abstract
This study aimed to determine the optimal cut-off value of the early drop in systolic blood pressure (SBP) for worsening renal function (WRF) in hospitalized patients with heart failure (HF) and analyze predictors of WRF and the early drop in SBP at that threshold. We retrospectively enrolled 396 patients with acute decompensated HF. The early drop in SBP was defined as the difference between baseline and SBP measured 24 h after hospitalization. We performed receiver operating characteristic (ROC) analysis to determine the optimal cut-off value of the early drop in SBP for WRF and evaluated the effect of the early drop in SBP on in-hospital mortality by multivariate logistic regression analyses. The mean age of the patients was 73.4 ± 14.7 years, and 61.2% were men. A 14.0% drop in SBP was identified as the optimal cut-off value for WRF from the ROC curve analysis. An early drop in SBP ≥ 14.0% was associated with WRF in multivariate logistic regression analysis (odds ratio 7.84; 95% confidence interval 4.06-15.14; P < 0.0001). The dose of intravenous furosemide within 24 h of admission was one of the predictors of the early drop in SBP ≥ 14.0%, while no early drop in SBP was a predictor of in-hospital mortality in multivariate logistic regression models. In conclusion, the optimal cut-off value for WRF in patients with HF was a 14.0% drop in SBP within 24 h of admission. The early drop in SBP ≥ 14.0% was one of the predictors of WRF in patients with HF. However, no early drop in SBP was associated with in-hospital mortality. This study was registered with the University Hospital Medical Information Network in Japan (UMIN000035989).
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Affiliation(s)
- Takehiko Kido
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Toshitaka Okabe
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Shuro Narui
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Tatsuki Fujioka
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Shigehiro Ishigaki
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Soichiro Usumoto
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Yu Asukai
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Taro Kimura
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Suguru Shimazu
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Jumpei Saito
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Yuji Oyama
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Wataru Igawa
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Morio Ono
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Seitaro Ebara
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Myong Hwa Yamamoto
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Tadayuki Yakushiji
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Naoei Isomura
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Masahiko Ochiai
- Division of Cardiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
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Zinc supplementation in patients with acute myocardial infarction. Heart Vessels 2023; 38:889-897. [PMID: 36695857 DOI: 10.1007/s00380-023-02239-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
This single-centre prospective feasibility study (UMIN000030232) evaluated whether zinc supplementation was safe and effective for improving outcomes among patients with acute myocardial infarction (AMI). Within 24 h after successful primary percutaneous coronary intervention, consenting patients with AMI were randomly assigned 1:1 to receive conventional treatment (conventional treatment group) or conventional treatment plus zinc acetate supplementation (zinc supplementation group). The two groups were compared in terms of major adverse cardiovascular events (MACE), and scar size, which was evaluated using cardiac magnetic resonance imaging (CMR) at 4 weeks after discharge. A total of 56 patients underwent randomization (with 26 assigned to the zinc supplementation group and 27 to the conventional treatment group). The two groups had generally similar laboratory findings and clinical characteristics. The two groups also had similar lengths of hospital stay and rates of MACE. Forty of the 53 patients underwent CMR and it revealed that % core zone was numerically lower in the zinc supplementation group than in the conventional treatment group (9.3 ± 6.9% vs. 14.2 ± 9.1%, P = 0.07). This small single-centre study failed to detect a significant reduction in mid-term MACE after AMI among patients who received zinc supplementation.
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Meng Y, Fu M, Guo J, Wang Z, Zhang Y, Hou Z. Characteristics and complications of fracture in older adults with chronic kidney disease: a cross-sectional study. J Orthop Surg Res 2022; 17:377. [PMID: 35933366 PMCID: PMC9357309 DOI: 10.1186/s13018-022-03253-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/15/2022] [Indexed: 12/25/2022] Open
Abstract
Background The aim of this study was to analyze the clinical characteristics of older fracture patients with chronic kidney disease (CKD) and to determine the risk factors of perioperative cardiovascular complications. Methods We retrospectively reviewed clinical data of older fracture patients with CKD admitted to the Third Hospital of Hebei Medical University from January 2016 to October 2021. The data we collected included baseline characteristics and complications. We finally determined the risk factors of perioperative cardiovascular complications by using logistic regression. Results We ended up enrolling 224 patients, and there were 91 (40.6%) males and 133 (59.4%) females, with a median age of 79 years. 80–84 years old was the age group with high incidence of fracture. The majority of fracture occurred indoors (130 cases, 58.0%) and morning (98 cases, 43.8%). Hip fracture was most common (183 cases, 81.7%), of which femoral neck fracture (101 cases, 45.0%) was the most prevalent. The most common comorbid condition was hypertension (171 cases, 76.3%), and anemia was the most common complication (148 cases, 66.1%). Age ≥ 80 years (OR = 2.023, 95% CI 1.110–3.688), previously combined with cardiovascular calcification (OR = 1.901, 95% CI 1.047–3.451) and admission hemoglobin level < 100 g/L (OR = 3.191, 95% CI 1.744–5.838) were independent risk factors of perioperative cardiovascular disease (CVD). Conclusion It was especially necessary to enhance fracture prevention for CKD. Patients whose age older than 80, hemoglobin less than 100 g/L on admission and have previous cardiovascular calcification are more likely to develop perioperative CVD. Such patients require reasonable decisions during the perioperative period to avoid the occurrence of CVD.
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Affiliation(s)
- Yao Meng
- Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Mingming Fu
- Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Junfei Guo
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhiqian Wang
- Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China. .,NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang, Hebei, 050051, People's Republic of China. .,Chinese Academy of Engineering, Beijing, 100088, People's Republic of China.
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang, Hebei, 050051, People's Republic of China
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Cheng S, Zhou T, Yu L, Chen Y, Zhang Z, Wang J, Yu Y. The Effect of Sacubitril/Valsartan Treatment on Cardiac and Renal Functions of a Patient With Cardiorenal Syndrome Type 4 and Stage 5 CKD After More Than Three Years of Follow-Up. Front Med (Lausanne) 2022; 9:817833. [PMID: 35360715 PMCID: PMC8962615 DOI: 10.3389/fmed.2022.817833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
It is difficult to treat cardiorenal syndrome (CRS) in clinical practice, which is the common reason for the death of patients. This report aimed to describe the effects of sacubitril/valsartan treatment on cardiac and renal functions of a patient with cardiorenal syndrome type 4 (CRS4) after more than 3 years of follow-up. A 77-year-old Chinese woman was admitted to our hospital because of CRS4 and stage 5 chronic kidney disease (CKD), who had a history of long-term proteinuria and renal failure. The patient's cardiothoracic ratio (CTR) measured by chest X–ray was 0.6. Cardiac ultrasonography showed that the left ventricular ejection fraction (LVEF) was 0.40. The patient had been treated for heart failure (HF) for 5 months, but there was no improvement in clinical manifestations, and the renal function gradually deteriorated. In our hospital, she received sacubitril/valsartan treatment for at least 40 months. The symptoms of HF relieved, and the indices of cardiac function improved. In addition, the patient's renal function was stable. During the treatment, the dosage of sacubitril/valsartan needed to be adjusted to achieve the optimal therapeutic effect. Follow-up results showed that she achieved cardiac function of New York Heart Association (NYHA) class II with an ejection fraction of 0.60 and E/A > 1 indicated by echocardiogram, and did not develop hyperkalemia. In summary, the improvement of cardiac and renal functions of the CRS4 patient was associated with the long-term sacubitril/valsartan treatment.
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Jia S, Mou H, Wu Y, Lin W, Zeng Y, Chen Y, Chen Y, Zhang Q, Wang W, Feng C, Xia S. A Simple Logistic Regression Model for Predicting the Likelihood of Recurrence of Atrial Fibrillation Within 1 Year After Initial Radio-Frequency Catheter Ablation Therapy. Front Cardiovasc Med 2022; 8:819341. [PMID: 35155619 PMCID: PMC8828909 DOI: 10.3389/fcvm.2021.819341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 12/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background The clinical factors associated with the recurrence of atrial fibrillation (Af) in patients undergoing catheter ablation (CA) are still ambiguous to date. Purpose 1. To recognize preoperative serologic factors and clinical features associated with Af recurrence after the first ablation treatment. 2. To Develop a Logical Regression Model for Predicting the Likelihood of Recurrence Within 1 Year After the Initial Radio-Frequency Catheter Ablation (RFCA) Therapy. Methods Atrial fibrillation patients undergoing RFCA at our institution from January 2016 to June 2021 were included in the analysis (n = 246). A combined dataset of relevant parameters was collected from the participants (clinical characteristics, laboratory results, and time to recurrence) (n = 200). We performed the least absolute shrinkage and selection operator (Lasso) regression with 100 cycles, selecting variables present in all 100 cycles to identify factors associated with the first recurrence of atrial fibrillation. A logistic regression model for predicting whether Af would recur within a year was created using 70% of the data as a training set and the remaining data to validate the accuracy. The predictions were assessed using calibration plots, concordance index (C-index), and decision curve analysis. Results The left atrial diameter, albumin, type of Af, whether other arrhythmias were combined, and the duration of Af attack time were associated with Af recurrence in this sample. Some clinically meaningful variables were selected and combined with recognized factors associated with recurrence to construct a logistic regression prediction model for 1-year Af recurrence. The receiver operating characteristic (ROC) curve for this model was 0.8695, and the established prediction model had a C-index of 0.83. The performance was superior to the extreme curve in the decision curve analysis. Conclusion Our study demonstrates that several clinical features and serological markers can predict the recurrence of Af in patients undergoing RFCA. This simple model can play a crucial role in guiding physicians in preoperative evaluation and clinical decision-making.
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Affiliation(s)
- Sixiang Jia
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Haochen Mou
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yiteng Wu
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Wenting Lin
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Yajing Zeng
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Yiwen Chen
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Yayu Chen
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Qi Zhang
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Wei Wang
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Chao Feng
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Shudong Xia
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
- *Correspondence: Shudong Xia
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Bai Z, Ma Y, Shi Z, Li T, Hu S, Shi B. Nomogram for the Prediction of Intrahospital Mortality Risk of Patients with ST-Segment Elevation Myocardial Infarction Complicated with Hyperuricemia: A Multicenter Retrospective Study. Ther Clin Risk Manag 2021; 17:863-875. [PMID: 34456567 PMCID: PMC8387320 DOI: 10.2147/tcrm.s320533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to establish an accurate and easy predictive model for ST-segment elevation myocardial infarction (STEMI) patients with hyperuricemia, using readily available features to estimate intrahospital mortality risk. Patients and Methods This was a multicenter retrospective study involving the development of risk prediction models for intrahospital mortality among all STEMI patients with hyperuricemia from Zunyi Medical University Chest Pain Center’s specialized alliance between January 1, 2016 and June 30, 2020. The primary outcome was intrahospital mortality. A total of 48 candidate variables were considered from demographic and clinical data. The least absolute shrinkage and selection operator (LASSO) was used to develop a nomogram. Concordance index values, decision curve analysis, the area under the curve (AUC), and clinical impact curves were examined. In this study, 489 patients with STEMI were included in the training dataset and an additional 209 patients from the 44 chest pain centers were included in the test cohort. B-type natriuretic peptides, α-hydroxybutyrate dehydrogenase (α-HBDH), cystatin C, out-of-hospital cardiac arrest (OHCA), shock index, and neutrophil-to-lymphocyte ratio were associated with intrahospital mortality and included in the nomogram. Results The model showed good discrimination power, and the AUC generated to predict survival in the training set was 0.875 (95% confidence interval, 0.825–0.925). In the validation set, the AUC of survival predictions was 0.87 (95% confidence interval, 0.792–0.947). Calibration plots and decision curve analysis showed good model performance in both datasets. A web-based calculator (https://bzxzmu.shinyapps.io/STEMI-with-Hyperuricemia-intrahospital-mortality/) was established based on the nomogram model, which was used to measure the levels of OHCA, neutrophil-to-lymphocyte ratio, shock index, α-HBDH, cystatin C, and B-type natriuretic peptides. Conclusion For practical applications, this model may prove clinically useful for personalized therapy management in patients with STEMI with hyperuricemia.
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Affiliation(s)
- Zhixun Bai
- Department of Internal Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,College of Medicine, Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Yi Ma
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Yinjiang County People's Hospital of Zunyi Medical University, Tongren, Guizhou, People's Republic of China
| | - Zhiyun Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Qianxi County People's Hospital of Zunyi Medical University, Bijie, Guizhou, People's Republic of China
| | - Ting Li
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Dafang County People's Hospital of Zunyi Medical University, Bijie, Guizhou, People's Republic of China
| | - Shan Hu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,College of Medicine, Soochow University, Suzhou, Jiangsu, People's Republic of China.,Department of Cardiology, Affiliated Tongzi County People's Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,College of Medicine, Soochow University, Suzhou, Jiangsu, People's Republic of China
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Aspromonte N, Cappannoli L, Scicchitano P, Massari F, Pantano I, Massetti M, Crea F, Valle R. Stay Home! Stay Safe! First Post-Discharge Cardiologic Evaluation of Low-Risk-Low-BNP Heart Failure Patients in COVID-19 Era. J Clin Med 2021; 10:jcm10102126. [PMID: 34069041 PMCID: PMC8156599 DOI: 10.3390/jcm10102126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 11/22/2022] Open
Abstract
Background. The COVID-19 pandemic has had a deep impact on periodic outpatient evaluations. The aim of this study was to evaluate the impact of low brain natriuretic peptide (BNP) values in predicting adverse events in heart failure (HF) patients in order to evaluate implications for safe delay of outpatient visits. Methods. This was a retrospective study. One-thousand patients (mean age: 72 ± 10 years, 561 women) with HF and BNP values <250 pg/mL at discharge were included. A 6-month follow-up was performed. The primary endpoint was a combination of deaths and readmissions for HF within 6-month after discharge. Results. At 6-month follow-up, 104 events (10.4%) were recorded (65 HF readmissions and 39 all-cause deaths). Univariate Cox analysis identified as significant predictors of outcome were age (p < 0.001, hazard ratio [HR] = 1.044), creatinine (p = 0.001, HR = 1.411), and BNP (p < 0.001, HR = 1.010). Multivariate Cox regression confirmed that BNP (p < 0.001, HR = 1.009), creatinine (p = 0.016, HR = 1.247), and age (p = 0.013, HR = 1.027) were independent predictors of events in HF patients with BNP values <250 pg/mL at discharge. Patients with BNP values >100 pg/mL and creatinine >1.0 mg/dL showed increased events rates (from 4.3% to 19.0%) as compared to those with lower values (p < 0.000, HR = 4.014). Conclusions. Low pre-discharge BNP levels were associated with low rates of cardiovascular events in HF patients, independently of the frequency of follow-up.
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Affiliation(s)
- Nadia Aspromonte
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy; (M.M.); (F.C.)
- Institute of Cardiology, Catholic University of the Sacred Heart, 00168 Rome, Italy;
- Correspondence:
| | - Luigi Cappannoli
- Institute of Cardiology, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Pietro Scicchitano
- Cardiology Section, F. Perinei Hospital, 70022 Altamura (BA), Italy; (P.S.); (F.M.)
| | - Francesco Massari
- Cardiology Section, F. Perinei Hospital, 70022 Altamura (BA), Italy; (P.S.); (F.M.)
| | - Ivan Pantano
- Cardiology Department, Madonna della Navicella Hospital, 30015 Chioggia (VE), Italy; (I.P.); (R.V.)
| | - Massimo Massetti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy; (M.M.); (F.C.)
- Institute of Cardiology, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Filippo Crea
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy; (M.M.); (F.C.)
- Institute of Cardiology, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Roberto Valle
- Cardiology Department, Madonna della Navicella Hospital, 30015 Chioggia (VE), Italy; (I.P.); (R.V.)
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Zhang Y, Ding M, Pu Z, Peng W. His bundle pacing therapy for patients with chronic heart failure: A protocol for meta-analysis based on prospective studies. Medicine (Baltimore) 2021; 100:e25079. [PMID: 33761667 PMCID: PMC9281952 DOI: 10.1097/md.0000000000025079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/08/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION A considerable amount of studies have been published with the results of clinical benefit from his bundle pacing (HBP) for chronic heart failure (CHF) patients and these researches led a uncertain conclusion for clinics. Thus, we will conduct a meta-analysis to evaluate the effect of his bundle pacing therapy for chronic heart failure. METHODS Pubmed, EMBASE, the Cochrane Library, Web of Science and Chinese online databases including Chinese National Knowledge Infrastructure, China Biology Medicine disc, Chinese Scientifific Journals Database (VIP), and Wanfang Database will be searched from these databases construction to the end of November, 2020. The STATA 13.0 will be used for data synthesis and meta-analysis. RESULTS The outcome measures included QRS duration, left ventricular ejection fraction, pacing threshold, New York Heart Association (NYHA), left ventricular end-diastolic diameter, left ventricular end-systolic diameter, mitral regurgitation, tricuspid regurgitation, and BNP will be analyzed and synthesized. CONCLUSION This meta-analysis will evaluate the effect of his bundle pacing therapy for chronic heart failure. REGISTRATION NUMBER INPLASY202110109.
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Affiliation(s)
- Yongzheng Zhang
- Department of CCU, Gansu Provincial Third Hospital, Lanzhou, China
| | - Mingwang Ding
- Department of CCU, Gansu Provincial Third Hospital, Lanzhou, China
| | - Zhihong Pu
- Department of CCU, Gansu Provincial Third Hospital, Lanzhou, China
| | - Wenjia Peng
- Department of CCU, Gansu Provincial Third Hospital, Lanzhou, China
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11
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Okabe T, Yakushiji T, Kido T, Kimura T, Asukai Y, Shimazu S, Saito J, Oyama Y, Igawa W, Ono M, Ebara S, Yamashita K, Yamamoto MH, Amemiya K, Isomura N, Ochiai M. Poor prognosis of heart failure patients with in-hospital worsening renal function and elevated BNP at discharge. ESC Heart Fail 2020; 7:2912-2921. [PMID: 32643875 PMCID: PMC7524072 DOI: 10.1002/ehf2.12901] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/23/2020] [Accepted: 06/24/2020] [Indexed: 11/29/2022] Open
Abstract
Aims Our purpose was to investigate the association between the B‐type natriuretic peptide (BNP) level at discharge, the occurrence of worsening renal function (WRF), and long‐term outcomes in patients with heart failure (HF). Methods and results We enrolled hospitalized acute HF patients. We divided patients into four groups on the basis of BNP <250 pg/mL (BNP−) or BNP ≥250 pg/mL (BNP+) at discharge and the occurrence of WRF during admission: BNP−/WRF−, BNP−/WRF+, BNP+/WRF−, and BNP+/WRF+. We evaluated the association between BNP at discharge, WRF, and cardiovascular/all‐cause mortality/hospitalization due to HF. Clinical follow‐up was completed in 301 patients. At discharge, percentages of the patients with clinical signs of HF were low and similar among four groups. The median follow‐up period was 1206 days (interquartile range, 733–1825 days). The composite endpoint of cardiovascular mortality and HF hospitalization was significantly different between the four groups [12.9% (BNP−/WRF−), 22.7% (BNP−/WRF+), 35.8% (BNP+/WRF−), and 55.4% (BNP+/WRF+), P < 0.0001]. All‐cause mortality was also different etween the four groups (15.1%, 38.6%, 28.7%, and 39.3%, respectively, P = 0.003). In the multivariate Cox proportional hazards model, the combination of BNP ≥250 pg/mL and WRF showed the highest hazard ratio (HR) for composite endpoint (HR, 5.201; 95% confidence interval, 2.582–11.11; P < 0.0001), and BNP−/WRF+ was associated with increased all‐cause mortality (HR, 2.286; 95% confidence interval, 1.089–4.875; P = 0.03). Patients in BNP+/WRF+ had a higher cardiovascular mortality (28.6%), and those in BNP−/WRF+ had a high non‐cardiovascular mortality (29.5%). Conclusions Heart failure patients with BNP ≥250 pg/mL at discharge and in‐hospital occurrence of WRF had the highest risk for the composite endpoint (cardiovascular mortality and HF hospitalization) among groups.
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Affiliation(s)
- Toshitaka Okabe
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Tadayuki Yakushiji
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Takehiko Kido
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Taro Kimura
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Yu Asukai
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Suguru Shimazu
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Jumpei Saito
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Yuji Oyama
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Wataru Igawa
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Morio Ono
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Seitaro Ebara
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Kennosuke Yamashita
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Myong Hwa Yamamoto
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Kisaki Amemiya
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Naoei Isomura
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
| | - Masahiko Ochiai
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki, Yokohama, 224-8503, Japan
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