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Karakayali M, Omar T, Artac I, Ilis D, Arslan A, Altunova M, Cagin Z, Karabag Y, Karakoyun S, Rencuzogullari I. The prognostic value of HALP score in predicting in-hospital mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Coron Artery Dis 2023; 34:483-488. [PMID: 37799045 DOI: 10.1097/mca.0000000000001271] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
INTRODUCTION AND OBJECTIVE Despite major advances in reperfusion therapies, morbidity and mortality rates associated with cardiovascular disorders remain high, particularly in patients with ST-segment elevation myocardial infarction (STEMI). Therefore, identifying prognostic variables that can be used to predict morbidity and mortality in STEMI patients is critical for better disease management. The HALP (hemoglobin, albumin, lymphocyte, and platelet) score, a novel index indicating nutritional status and systemic inflammation, provides information about prognosis. In this context, this study was carried out to investigate the relationship between HALP score assessed at admission and in-hospital mortality in STEMI patients. MATERIAL AND METHODS The population of this retrospective study consisted of 1307 consecutive patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention (pPCI). The 1090 patients included in the study sample were divided into two groups based on the median HALP score value of 3.59. In-hospital and all-cause mortality rates during the follow-up were obtained from the registry. RESULTS In-hospital mortality rate was significantly higher in patients with a HALP score of less than 3.59 compared to those with a HALP score of more than 3.59 (7.5% and 0.7%, respectively; P < 0.001). Univariate and multivariate Cox proportional hazard analyses revealed that the HALP score is independently associated with in-hospital mortality. The optimal HALP score cutoff value of <3.72 predicted in-hospital mortality with 95.56% sensitivity and 49.19% specificity. CONCLUSION This study's findings indicate that HALP score may be a significant independent predictor of in-hospital mortality in patients with STEMI treated with pPCI.
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Affiliation(s)
- Muammer Karakayali
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Timor Omar
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Inanç Artac
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Dogan Ilis
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Ayca Arslan
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Mehmet Altunova
- Department of Cardiology, M.D. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital, Istanbul
| | - Zihni Cagin
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Yavuz Karabag
- Department of Cardiology, M.D.Kafkas University School of Medicine, Kars
| | - Suleyman Karakoyun
- Department of Cardiology, M.D. Kocaeli Health and Technology University, Kocaeli, Turkey
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Erdogan A, Genc O, Ozkan E, Goksu MM, Ibisoglu E, Bilen MN, Guler A, Karagoz A. Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction. Angiology 2023; 74:970-980. [PMID: 36625023 DOI: 10.1177/00033197231151559] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The Naples prognostic score (NPS) consists of cholesterol level, albumin concentration, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratios and reflects systemic inflammation, malnutrition, and survival for various conditions. We investigated the relationship of NPS at admission with in-hospital and follow-up outcomes among ST-segment elevation myocardial infarction (STEMI) patients. This retrospective study included 1887 consecutive patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention between March 2020 and May 2022. The study population was divided by NPS into 2; low (0-1-2) and high (3-4). In-hospital adverse events and all-cause mortality rates during follow-up were extracted from the registry. The Median follow-up time was 15 months. The overall mortality rate was 14.6%. The proportions of in-hospital events that included acute respiratory failure, acute kidney injury, malignant arrhythmia, and mortality were significantly higher in the high NPS group than in the low NPS group. Compared with the baseline model, in the full model of Cox regression analysis; NPS was an independent predictor of all-cause mortality (adjusted hazard ratio (aHR): 2.49, 95%CI, 1.75-3.50, P < .001), with a significant improvement in model performance (likelihood ratio χ2, P < .001) and better calibration. In conclusion, we found an association between NPS and in-hospital and follow-up outcomes in STEMI patients.
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Affiliation(s)
- Aslan Erdogan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Omer Genc
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Eyüp Ozkan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Muhammed M Goksu
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ersin Ibisoglu
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Mehmet N Bilen
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Guler
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Clinic of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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Shakoor A, Emans ME, van Gent MWF, Hendrix A, Faber N, Springeling TS, de Vette LC, Manintveld OC, Denham RN, van de Meerendonk C, van der Boon RMA, Brugts JJ. Regional management of worsening heart failure: rationale and design of the CHAIN-HF registry. ESC Heart Fail 2023; 10:2074-2083. [PMID: 36965147 DOI: 10.1002/ehf2.14354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/27/2023] Open
Abstract
AIMS Heart failure (HF) is a progressive disease in which periods of clinical stability are interrupted by episodes of clinical deterioration known as worsening heart failure (WHF). Patients who develop WHF are at high risk of subsequent death, rehospitalization, and excessive healthcare costs. As such, WHF could be seen as a separate disease stage and precursor of advanced HF. Whether WHF has a substantial health, societal, and economic impact evidence regarding its multifactorial nature and the specific barriers in treatment, including advanced HF therapies, remains scarce. The CHAIN-HF registry aims to describe the incidence, characteristics, current treatment, and outcomes of WHF. Additionally, it will promote structured regional collaboration and educate on increasing awareness for WHF and describe the implementation of guideline directed medical therapy and utilization of advanced HF therapies in a collaborative network. METHODS AND RESULTS The CHAIN-HF registry is a prospective, observational, and multicentre study from the collaborating hospitals (Rijnmond HF Network) in the Rotterdam area. Unselected and consecutive patients (irrespective of ejection fraction) with a WHF event will be included. Comprehensive data including demographics, co-morbidities, treatment, and in-hospital and post-discharge outcomes will be collected. Notably, data on socio-economic status, treatment decisions, and referral for advanced HF therapies will be included. CONCLUSIONS CHAIN-HF will be the first prospective, dedicated WHF registry in a collaborative network of hospitals that will provide robust real-world evidence on the incidence, characteristics, and outcomes of WHF. Moreover, it will provide information on of the value of regional collaboration to improve awareness and outcomes of WHF.
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Affiliation(s)
- Abdul Shakoor
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Mireille E Emans
- Department of Cardiology, Ikazia Hospital, Rotterdam, The Netherlands
| | - Marco W F van Gent
- Department of Cardiology, Albert Schweitzer Hospital, Rotterdam, The Netherlands
| | - Anneke Hendrix
- Department of Cardiology, Franciscus & Vlietland Hospital, Rotterdam, The Netherlands
| | - Nikola Faber
- Department of Cardiology, Bravis Hospital, Bergen op Zoom/Roosendaal, The Netherlands
| | | | - Liesbeth C de Vette
- Department of Cardiology, van Weel Bethesda Hospital, Dirksland, The Netherlands
| | | | - Robert N Denham
- Department of Cardiology, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - Chajja van de Meerendonk
- Department of Cardiology, Maasstad Ziekenhuis, Rotterdam, The Netherlands
- Department of Cardiology, Spijkenisse Medical Center, Spijkenisse, The Netherlands
| | | | - Jasper J Brugts
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
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Wong CWY, Yu DSF, Li PWC, Chan BS. The prognostic impacts of frailty on clinical and patient-reported outcomes in patients undergoing coronary artery or valvular surgeries/procedures: A systematic review and meta-analysis. Ageing Res Rev 2023; 85:101850. [PMID: 36640867 DOI: 10.1016/j.arr.2023.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/27/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Frailty is emerging as an important prognostic indicator for patients undergoing cardiac surgeries/procedures. We sought to evaluate the prognostic and differential impacts of frailty on patients undergoing coronary artery or valvular surgical procedures of different levels of invasiveness, and to explore the differential predictability of various frailty measurement models. METHODS Eight databases were searched for prospective cohort studies that have adopted validated measure(s) of frailty and reported clinical, healthcare service utilization, or patient-reported outcomes in patients undergoing coronary artery or valvular surgeries/procedures. RESULTS Sixty-two articles were included (N = 16,679). Frailty significantly predicted mortality (short-term [≤ 30 days]: odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.28-4.26; midterm [6 months to 1 year]: OR: 3.93, 95%CI: 2.65-5.83; long-term [>1 year]: HR: 2.23, 95%CI: 1.60-3.11), postoperative complications (ORs: 2.54-3.57), discharge to care facilities (OR: 5.52, 95%CI: 3.84-7.94), hospital readmission (OR: 2.00, 95%CI: 1.15-3.50), and reduced health-related quality of life (HRQoL; standardized mean difference: -0.74, 95%CI: -1.30 to -0.18). Subgroup analyses showed that frailty exerted a greater impact on short-term mortality in patients undergoing open-heart surgeries than those receiving transcatheter procedures. Multidimensional and physical-aspect-focused frailty measurements performed equally in predicting mortality, but multidimensional measurements were more predictive of hospital readmission than physical-aspect-focused measurements. CONCLUSION Frailty was predictive of postoperative mortality, complications, increased healthcare service utilization, and reduced HRQoL. The impact of frailty on short-term mortality was more prominent in patients undergoing open-heart surgeries than those receiving transcatheter procedures. Multidimensional measures of frailty enhanced prognostic risk estimation, especially for hospital readmission.
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Affiliation(s)
- Cathy W Y Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 543, 5/Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong.
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 521, 5/Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong.
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 523, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong.
| | - Bernice Shinyi Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 543, 5/Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong.
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Wei D, Sun Y, Chen R, Meng Y, Wu W. The Charlson comorbidity index and short-term readmission in patients with heart failure: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e32953. [PMID: 36820540 PMCID: PMC9907905 DOI: 10.1097/md.0000000000032953] [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] [Indexed: 02/12/2023] Open
Abstract
The relationship between the Charlson comorbidity index (CCI) and short-term readmission is as yet unknown. Therefore, we aimed to investigate whether the CCI was independently related to short-term readmission in patients with heart failure (HF) after adjusting for other covariates. From December 2016 to June 2019, 2008 patients who underwent HF were enrolled in the study to determine the relationship between CCI and short-term readmission. Patients with HF were divided into 2 categories based on the predefined CCI (low < 3 and high > =3). The relationships between CCI and short-term readmission were analyzed in multivariable logistic regression models and a 2-piece linear regression model. In the high CCI group, the risk of short-term readmission was higher than that in the low CCI group. A curvilinear association was found between CCI and short-term readmission, with a saturation effect predicted at 2.97. In patients with HF who had CCI scores above 2.97, the risk of short-term readmission increased significantly (OR, 2.66; 95% confidence interval, 1.566-4.537). A high CCI was associated with increased short-term readmission in patients with HF, indicating that the CCI could be useful in estimating the readmission rate and has significant predictive value for clinical outcomes in patients with HF.
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Affiliation(s)
- Dongmei Wei
- Department of Cardiovascular, Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, China
- Department of Cardiovascular, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
| | - Yang Sun
- Guangxi University of Chinese Medicine, Nanning, China
| | - Rongtao Chen
- Guangxi University of Chinese Medicine, Nanning, China
| | - Yuanting Meng
- Guangxi University of Chinese Medicine, Nanning, China
| | - Wei Wu
- Department of Cardiovascular, Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, China
- * Correspondence: Wei Wu, Department of Cardiovascular, Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou 510405, China (e-mail: )
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Parenica J, Benesova K, Radvan M, Sanca O, Hlasensky J, Lokaj P, Ondrus T, Helanova K, Kala P, Dusek L, Jarkovsky J. COVID-19 vaccine booster significantly decreases the risk of intensive care unit hospitalization in heart failure patients during the Omicron variant wave: A population-based study. Front Cardiovasc Med 2022; 9:998842. [PMID: 36337877 PMCID: PMC9631812 DOI: 10.3389/fcvm.2022.998842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022] Open
Abstract
Background Heart failure (HF) patients are at higher risk of severe coronavirus disease 2019 (COVID-19). The Omicron variant has many novel mutations including those in the spike protein, leading to questions about vaccine effectiveness. The aim of this analysis was to evaluate the effectiveness of the COVID-19 vaccine with or without a booster (i.e., after the third dose) during the Omicron variant wave. Methods Chronic heart failure patients in the Czech Republic were included in the analysis. COVID-19 infection was monitored from January 1st 2022 to March 31st 2022. The analysis was conducted on data collected in the National Health Information System. Vaccine effectiveness of vaccinated (with or without booster) vs. unvaccinated patients was analyzed for incidence of COVID-19, COVID-19-related hospitalizations, COVID-19 related intensive care unit admissions, and COVID-19 related mechanical ventilation/extracorporeal membrane oxygenation treatment. Findings From a total 165,453 HF patients in the Czech Republic, 9,728 contracted COVID-19 (22.9% of them not vaccinated, 23.2% vaccinated and 53.8% vaccinated and boosted). Risk of intensive care unit (ICU) hospitalization was 7.6% in the unvaccinated group, 4.8% in the vaccinated group and 2.9% in the boosted group. The calculated effectiveness of the COVID-19 vaccine in prevention of ICU hospitalization in the vaccinated group was 41.9 and 76.6% in the boosted group. Interpretation The results demonstrated moderate vaccine effectiveness in the prevention of severe COVID-19 in vaccinated but not boosted HF patients. Much stronger effectiveness was found in those who were vaccinated and boosted.
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Affiliation(s)
- Jiri Parenica
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Klara Benesova
- Department of Data Collection and Processing, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Institute of Biostatistics and Analysis, Masaryk University, Brno, Czechia
| | - Martin Radvan
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ondrej Sanca
- Department of Data Collection and Processing, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Institute of Biostatistics and Analysis, Masaryk University, Brno, Czechia
| | - Jiri Hlasensky
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Petr Lokaj
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tomas Ondrus
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Katerina Helanova
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Petr Kala
- Internal and Cardiology Department, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ladislav Dusek
- Department of Data Collection and Processing, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Institute of Biostatistics and Analysis, Masaryk University, Brno, Czechia
| | - Jiri Jarkovsky
- Department of Data Collection and Processing, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Institute of Biostatistics and Analysis, Masaryk University, Brno, Czechia
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