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Xu X, Cheng J, Zhang Y, Wang X, Chen M, Xu L, Zhao W. Effectiveness of Heart Failure Checklist Management in Patients with Chronic Heart Failure: An Open-Label, Single-Center Controlled Study During 18 Months of Follow-Up. Ther Clin Risk Manag 2023; 19:983-992. [PMID: 38047039 PMCID: PMC10691431 DOI: 10.2147/tcrm.s417426] [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: 08/09/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023] Open
Abstract
Background The efficacy of chronic heart failure (CHF) checklist management in reducing adverse outcomes of heart failure patients is still uncertain. This study explores whether CHF checklist management is more useful than usual care in reducing adverse health outcomes in the medium- and long-term among CHF patients. Methods In our prospective study, 132 patients with CHF were randomly assigned to CHF management group and usual care group by random number method. Patients in CHF management group were conducted through CHF checklist by cardiologists and general practitioner. Patients assigned to usual care were treated by non-stationary medical group without checklist. All groups were followed up for 18 months. Results There was no significant difference in overall mortality rate between management group and control group during 18 months (12.3% [8/65] vs. 11.7% [7/60], P = 0. 912]). The re-hospitalization rate of heart failure in management group (18.5% [12/65]) was significantly lower than that in usual care group (38.3% [23/60]) after 18 months of follow-up (P = 0.013). Median NT-proBNP level (632.3 ng/l vs. 1678 ng/l, p = 0.004) was lower in management group than that in usual care group. Cardiac ultrasonography was performed at 18 months between the management and usual care group. LVEDD (55.88±7.11 mm vs. 60.92±8.06 mm) and LVESD (43.25±8.42mm vs. 48.41± 9.02mm) were decreased (P<0.01). LVEF was increased (45.36±10.64% vs. 39.96 ±10.15%, P<0.01). The utilization rate of ACEI/ARB/ARNI, β-blocker were high in management group. Conclusion CHF checklist management by cardiologists and general practitioners can significantly reduce the re-hospitalization and improve cardiac function. CHF management through heart failure checklist may improve prognosis in patients with CHF in the medium- and long-term.
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Affiliation(s)
- Xiaorong Xu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
| | - Jing Cheng
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
| | - Yeping Zhang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
| | - Xin Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
| | - Mulei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
| | - Lin Xu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
| | - Wenshu Zhao
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People’s Republic of China
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Shen NN, Wang JL, Fu YP. The microRNA Expression Profiling in Heart Failure: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:856358. [PMID: 35783849 PMCID: PMC9240229 DOI: 10.3389/fcvm.2022.856358] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022] Open
Abstract
Background Heart failure (HF) is a main consequence of cardiovascular diseases worldwide. Abnormal expression levels of microRNAs (miRNAs) in HF are observed in current studies. Novel biomarkers miRNAs may play an important role in the development of HF. Nevertheless, the inconsistency of miRNA expression limits the clinical application. We thus perform this systematic review of the miRNAs expression profiling to identify potential HF biomarkers. Methods The electronic databases of Embase, Medline, and Cochrane Library were systematically searched to identify the miRNA expression profiles between HF subjects and non-HF controls before May 26th, 2021. The pooled results were shown as log10 odds ratios (logORs) with 95% confidence intervals (CI) using random-effect models. Subgroup analyses were conducted according to species, region, and sample source. The quality assessment of included studies was independently conducted based on Diagnostic Accuracy Study 2 (QUADAS-2). The sensitivity analysis was conducted based on sample size. Results A total of 55 miRNA expression articles reporting 276 miRNAs of HF were included. 47 consistently up-regulated and 10 down-regulated miRNAs were identified in the overall analysis, with the most up-regulated miR-21 (logOR 8.02; 95% CI: 6.76–9.27, P < 0.001) and the most down-regulated miR-30c (logOR 6.62; 95% CI: 3.04–10.20, P < 0.001). The subgroup analysis of sample source identified 35 up-regulated and 10 down-regulated miRNAs in blood sample, the most up-regulated and down-regulated miRNAs were miR-210-3p and miR-30c, respectively. In the region sub-groups, let-7i-5p and miR-129 were most up-regulated and down-regulated in Asian countries, while in non-Asian countries, let-7e-5p and miR-30c were the most dysregulated. It’s worth noting that miR-622 was consistently up-regulated in both Asian and non-Asian countries. Sensitivity analysis showed that 46 out of 58 (79.31%) miRNAs were dysregulated. Conclusion A total of 57 consistently dysregulated miRNAs related to HF were confirmed in this study. Seven dysregulated miRNAs (miR-21, miR-30c, miR-210-3p, let-7i-5p, miR-129, let-7e-5p, and miR-622) may be considered as potential non-invasive biomarkers for HF. However, further validation in larger-scale studies are needed to verify our conclusions.
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Affiliation(s)
- Nan-Nan Shen
- Department of Pharmacy, Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Jia-Liang Wang
- Department of Pharmacy, Affiliated Hospital of Shaoxing University, Shaoxing, China
- *Correspondence: Jia-Liang Wang,
| | - Yong-ping Fu
- Department of Cardiology, Affiliated Hospital of Shaoxing University, Shaoxing, China
- Yong-ping Fu,
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Allain F, Loizeau V, Chaufourier L, Hallouche M, Herrou L, Hodzic A, Blanchart K, Belin A, Manrique A, Milliez P, Sabatier R, Legallois D. Usefulness of a personalized algorithm-based discharge checklist in patients hospitalized for acute heart failure. ESC Heart Fail 2020; 7:1217-1223. [PMID: 32320135 PMCID: PMC7261525 DOI: 10.1002/ehf2.12604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 11/29/2019] [Accepted: 12/08/2019] [Indexed: 11/20/2022] Open
Abstract
Aims The aim of this study is to evaluate the usefulness of a personalized discharge checklist (PCL) based on simple baseline characteristics on mortality, readmission for heart failure (HF), and quality of care in patients hospitalized for acute HF. Methods and results We designed an algorithm to generate PCL, based on 2016 HF European Society of Cardiology Guidelines and the screening of common comorbidities in elderly HF patients. We prospectively included 139 patients hospitalized for HF from May 2018 to October 2018. A PCL was fulfilled for each patient at admission and 24 to 48 hours before the planned discharge. A control cohort of 182 consecutive patients was retrospectively included from May 2017 to October 2017. The primary composite endpoint was mortality or readmission for HF at 6 months. The secondary endpoints were mortality, readmission for HF, and quality of care (evidence‐based medications, management of HF comorbidities, and planned care plan). There was no difference among baseline characteristics between PCL and control cohorts; mean age was 78.1 ± 12.2 vs. 79.0 ± 12.5 years old (P = 0.46) and 61 patients (43.9%) vs. 63 (34.6%) had HF with left ventricular ejection fraction (LVEF) <40% (P = 0.24). During the 6 month follow‐up period, 59 patients (42.4%) reached the primary endpoint in the PCL cohort vs. 92 patients (50.5%) in the control cohort [hazard ratio (HR): 0.79, 95% confidence interval (CI) (0.57–1.09), P = 0.15]. Subgroup analysis including only patients with either altered (<40%) or mid‐range or preserved (≥40%) LVEF showed no significant difference among groups. There was a non‐significant trend toward a reduction in HF readmission rate in the PCL group [38 patients (27.3%) vs. 64 patients (35.2%), HR: 0.73, 95%CI (0.49–1.09), P = 0.13]. There was no difference regarding survival or the use of evidence‐based medications. A higher proportion of patients were screened and treated for iron and vitamin D deficiencies (53.2% vs. 35.7%, P < 0.01 and 73.4% vs. 29.7%, P < 0.01, respectively), as well as malnutrition supplemented in the PCL group. There was a higher referral to HF follow‐up programme in the PCL group but not to telemedicine or cardiac rehabilitation programs. Conclusions In this preliminary study, the use of a PCL did not improve outcomes at 6 months in patients hospitalized for acute HF. There was a non‐significant trend towards a reduction in HF readmission rate in the PCL group. In addition, the management of HF comorbidities was significantly improved by PCL with a better referral to follow‐up programme. A multicentre study is warranted to assess the usefulness of a simple costless personalized checklist in a large HF patients' population.
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Affiliation(s)
- Florent Allain
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Virginie Loizeau
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | | | - Maya Hallouche
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Laurence Herrou
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Amir Hodzic
- Department of Clinical Physiology, Normandie University, UNICAEN, CHU de Caen Normandie, INSERM Comete, Caen, France
| | - Katrien Blanchart
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Annette Belin
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Alain Manrique
- Department of Nuclear Medicine, Normandie University, UNICAEN, CHU de Caen Normandie, EA4650 Signalisation, Electrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique (SEILIRM), FHU REMOD-VHF, Caen, France.,GIP Cyceron, Investigations chez l'Homme, Campus Jules Horowitz, Caen, France
| | - Paul Milliez
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, EA4650 Signalisation, Electrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique (SEILIRM), FHU REMOD-VHF, Caen, France
| | - Rémi Sabatier
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Damien Legallois
- Department of Cardiology, Normandie University, UNICAEN, CHU de Caen Normandie, EA4650 Signalisation, Electrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique (SEILIRM), FHU REMOD-VHF, Caen, France
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Masip J, Formiga F, Comín-Colet J, Corbella X. Short term prognosis of heart failure after first hospital admission. Med Clin (Barc) 2020; 154:37-44. [PMID: 31153608 DOI: 10.1016/j.medcli.2019.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/08/2019] [Accepted: 03/14/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Death and unexpected readmission are frequent among heart failure patients. We aimed to assess 30-day readmission and mortality rate as well as to identify predictive factors for patients discharged from a first HF related hospital admission. METHODS AND RESULTS Retrospective, single-center, cohort study, using administrative data from a tertiary care hospital in Barcelona, Spain. Patients discharged alive from a first HF related admission from 2010 to 2014 were assessed for 30-day death, readmission and adverse outcome rate. A Linear Logistic Regression Model was fitted for each outcome. The set accounted for 3642 patients; 50.1% female and 49.9% male. Mean age was 76 years (SD=12). 30-Days rates were 9.2% for readmission, 5.6% for death and 13.8% for adverse outcome. Admission to an ED within 30 days was strongly linked to readmission (OR=6.97), death (OR=2.31) and adverse outcome (OR=8.55), as well as chronic kidney disease (OR=1.44/1.61/2.86 respectively). Discharge to a Long Stay Care (LSC) facility was linked to lower readmission and adverse event rates (OR=.57 and OR=.15). CONCLUSION Pre and post-index discharge use of health care resources is related to adverse outcome rates. Our findings point out the potential benefit for a more tailored approach in the management of HF patients.
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Affiliation(s)
- Joan Masip
- Medical Coding Unit, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Comín-Colet
- Heart Failure Program, Cardiology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Cardiovascular Diseases Research Group, Research Programme in Inflammatory, Chronic and Degenerative Diseases, IDIBELL (Bellvitge Biomedical Research Institute), Hospitalet de Llobregat, Barcelona, Spain; Heart Diseases Biomedical Research Group, Research Programme in Inflammatory and Cardiovascular Disorders, IMIM (Hospital del Mar Medical Research Institute), Barcelona Biomedical Research Park, Barcelona, Spain
| | - Xavier Corbella
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
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Belfiore A, Palmieri VO, Di Gennaro C, Settimo E, De Sario MG, Lattanzio S, Fanelli M, Portincasa P. Long-term management of chronic heart failure patients in internal medicine. Intern Emerg Med 2020; 15:49-58. [PMID: 30659413 DOI: 10.1007/s11739-019-02024-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 01/02/2019] [Indexed: 01/17/2023]
Abstract
Chronic heart failure (CHF) is one of the main disabilities in elderly patients requiring frequent hospitalizations with high health care costs. We studied the outcome of CHF outpatient management in reducing hospitalization after discharge from a division of Internal Medicine at a large 3rd referral regional Hospital. 147 CHF inpatients (M:F: 63:84; mean age 76 ± 9.6 years) admitted for acute exacerbation of CHF were followed up as outpatients at 1, 6, 12 and 24 months after discharge. At baseline, patients underwent: laboratory tests, ECG, echocardiogram and a dedicated-intensive health care educational program involving also their families. The rate of hospitalization in the same group of patients was compared with data from the previous 24 months, a period when patients had been seen elsewhere without disease management programs. Patients had high prevalence of comorbidities and the majority was in NYHA class III or IV. Hypertension and valvular heart disease were the most common causes for CHF. Systolic function was preserved (LVEF ≥ 50%) in 61.9% of cases. Functional NYHA class improved significantly after 6 months and remained stable at 24 months. There was a significant increase in the use of the renin-angiotensin system blockers, beta-blockers and diuretics compared to admission to the ward. At 24 months, hospital readmissions were decreased by 42% as compared to the previous 24 months. Risk factors for re-hospitalizations were anemia, NYHA class III or IV and previous hospitalizations. Establishing an intensive outpatient management program for CHF patients leads to long-term beneficial effects with improved clinical parameters and decreased hospitalization in the setting of Internal Medicine.
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Affiliation(s)
- Anna Belfiore
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
| | - Vincenzo Ostilio Palmieri
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - Carla Di Gennaro
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - Enrica Settimo
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - Maria Grazia De Sario
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - Stefania Lattanzio
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - Margherita Fanelli
- Biostatistic, Interdisciplinary Department of Medicine, University of Bari Medical School, Bari, Italy
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
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Legallois D, Chaufourier L, Blanchart K, Parienti JJ, Belin A, Milliez P, Sabatier R. Improving quality of care in patients with decompensated acute heart failure using a discharge checklist. Arch Cardiovasc Dis 2019; 112:494-501. [DOI: 10.1016/j.acvd.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/22/2019] [Accepted: 05/21/2019] [Indexed: 01/31/2023]
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Yan J, Pan Y, Xiao J, Ma W, Li L, Zhong M, Long H, Kong F, Shao W. High Level of Lipoprotein(a) as Predictor for Recurrent Heart Failure in Patients with Chronic Heart Failure: a Cohort Study. Arq Bras Cardiol 2019; 113:197-204. [PMID: 31340235 PMCID: PMC6777886 DOI: 10.5935/abc.20190120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/14/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Elevated plasma levels of Lipoprotein(a) [Lp(a)] are recognized as a significant risk factor for atherosclerotic vascular disease. However, there are limited data regarding association between Lp(a) and recurrent heart failure (HF) in patients with chronic HF caused by coronary heart disease (CHD). OBJECTIVE Elevated levels of Lp(a) might have a prognostic impact on recurrent HF in patients with chronic HF caused by CHD. METHODS A total of 309 patients with chronic HF caused by CHD were consecutively enrolled in this study. The patients were divided into 2 groups according to whether Lp(a) levels were above or below the median level for the entire cohort (20.6 mg/dL): the high Lp(a) group (n = 155) and the low Lp(a) group (n = 154). A 2-sided p < 0.05 was statistically considered significant. RESULTS During the median follow-up period of 186 days, 31 cases out of a total of 309 patients (10.03%) could not be reached during follow-up. A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of recurrent HF than those with lower Lp(a) levels (log-rank < 0.0001). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the incidence of recurrent HF after adjustment of potential confounders (hazard ratio: 2.720, 95 % confidence interval: 1.730-4.277, p < 0.0001). CONCLUSIONS In Chinese patients with chronic HF caused by CHD, elevated levels of Lp(a) are independently associated with recurrent HF.
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Affiliation(s)
- Jianlong Yan
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Yanbin Pan
- Huadu District People's Hospital, Southern Medical University - Intensive Care Unit., Guangzhou - China
| | - Junhui Xiao
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Wenxue Ma
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Li Li
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Mingjiang Zhong
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Haiquan Long
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Fanliang Kong
- Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China
| | - Wenming Shao
- The First Affiliated Hospital of Jinan University - Emergency, Guangzhou - China
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9
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Rodríguez-Mañero M, Grigorian-Shamagian L, Rábago G, Abou-Jokh C, Álvarez B, Brion M, González-Juanatey JR. Innovative Strategies in Heart Failure: Present and Future. Arch Med Res 2018; 49:558-567. [DOI: 10.1016/j.arcmed.2018.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 12/28/2022]
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Masson S, Batkai S, Beermann J, Bär C, Pfanne A, Thum S, Magnoli M, Balconi G, Nicolosi GL, Tavazzi L, Latini R, Thum T. Circulating microRNA-132 levels improve risk prediction for heart failure hospitalization in patients with chronic heart failure. Eur J Heart Fail 2017; 20:78-85. [PMID: 29027324 DOI: 10.1002/ejhf.961] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 01/13/2023] Open
Abstract
AIMS Non-coding microRNAs (miRNAs) are critically involved in cardiovascular pathophysiology. Since they are measurable in most body fluids, they have been proposed as circulating biomarkers. We examined the prognostic value of a specific candidate miRNA in a large cohort of patients with chronic heart failure (HF) enrolled in a multicentre clinical trial. METHODS AND RESULTS Plasma levels of miR-132 were measured using miRNA-specific PCR-based technologies at randomization in 953 patients with chronic, symptomatic HF from the GISSI-Heart Failure trial. The association with fatal (all-cause and cardiovascular death) and non-fatal events (time to first admission to hospital for cardiovascular reasons or worsening of HF) and the incremental risk prediction were estimated in adjusted models. Higher circulating miR-132 levels were independently associated with younger age, better renal filtration, ischaemic aetiology of HF, more severe HF symptoms, higher diastolic blood pressure, higher cholesterol, and male sex. After extensive adjustment for demographic, clinical, and echocardiographic risk factors and baseline NT-proBNP concentrations, miR-132 remained associated only with HF hospitalizations (hazard ratio 0.79, 95% confidence interval 0.66-0.95, P = 0.01) and improved its risk prediction with the continuous net reclassification index (cNRI 0.205, P = 0.001). CONCLUSION In well characterized patients with chronic HF, circulating miR-132 levels rise with the severity of HF. Lower circulating miR-132 levels improved risk prediction for HF readmission beyond traditional risk factors, but not for mortality. MiR-132 may be helpful to intensify strategies aimed at reducing re-hospitalization, which has a substantial health and economic burden in HF.
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Affiliation(s)
- Serge Masson
- Department of Cardiovascular Research, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - Sandor Batkai
- Institute of Molecular and Translational Therapeutic Strategies and Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany
| | - Julia Beermann
- Institute of Molecular and Translational Therapeutic Strategies and Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies and Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany
| | - Angelika Pfanne
- Institute of Molecular and Translational Therapeutic Strategies and Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany
| | - Sabrina Thum
- Institute of Molecular and Translational Therapeutic Strategies and Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany
| | - Michela Magnoli
- Department of Cardiovascular Research, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - Giovanna Balconi
- Department of Cardiovascular Research, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | | | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research - E.S. Health Science Foundation, Cotignola, (RA), Italy
| | - Roberto Latini
- Department of Cardiovascular Research, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies and Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany.,National Heart and Lung Institute, Imperial College London, London, UK
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Yan H, Ma F, Zhang Y, Wang C, Qiu D, Zhou K, Hua Y, Li Y. miRNAs as biomarkers for diagnosis of heart failure: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96:e6825. [PMID: 28562533 PMCID: PMC5459698 DOI: 10.1097/md.0000000000006825] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND With the rapid development of molecular biology, the kind of mircoRNA (miRNA) has been introduced into emerging role both in cardiac development and pathological procedure. Thus, we conduct this meta-analysis to find out the role of circulating miRNA as a biomarker in detecting heart failure. METHODS We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and World Health Organization clinical trials registry center to identify relevant studies up to August 2016. We performed meta-analysis in a fixed/random-effect model using Meta-disc 1.4. We used STATA 14.0 to estimate the publication bias and meta-regression. Besides, we took use of SPSS 17.0 to evaluate variance between several groups. Information on true positive, false positive, false negative, and true negative, as well as the quality of research was extracted. RESULTS We use results from 10 articles to analyze the pooled accuracy. The overall performance of total mixed miRNAs (TmiRs) detection was: pooled sensitivity, 0.74 (95% confidence interval [CI], 0.72 to 0.75); pooled specificity, 0.69 (95%CI, 0.67 to 0.71); and area under the summary receiver operating characteristic curves value (SROC), 0.7991. The miRNA-423-5p (miR-423-5p) detection was: pooled sensitivity, 0.81 (95%CI, 0.76 to 0.85); pooled specificity, 0.67 (95%CI, 0.61 to 0.73); and SROC, 0.8600. However, taken the same patients population, we extracted the data of BNP for detecting heart failure and performed meta-analysis with acceptable SROC as 0.9291. Among the variance analysis, the diagnostic performance of miR-423-5p claimed significant advantages of other pooled results. However, the combination of miRNAs and BNP could increase the accuracy of detecting of heart failure. Unfortunately, there was no dramatic advantage of miR-423-5p compared to BNP protocol. CONCLUSION Despite interstudy variability, the performance test of miRNA for detecting heart failure revealed that miR-423-5p demonstrated the potential to be a biomarker. However, other miRNAs were not able to provide enough evidence on promising diagnostic value for heart failure based on the current data. Moreover, the combination of miRNAs and BNP could work as a better method to detection. Unfortunately, BNP was still the most convinced biomarker for such disease.
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Affiliation(s)
- Hualin Yan
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
- West China Medical School
| | - Fan Ma
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
- West China Medical School
| | - Yi Zhang
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
| | - Chuan Wang
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
| | - Dajian Qiu
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
| | - Kaiyu Zhou
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
- Program for Changjiang Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yimin Hua
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
- Program for Changjiang Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yifei Li
- Department of Pediatric Cardiology, West China Second University Hospital
- Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital
- Department of Cardiology, Boston Children's Hospital, Harvard University, Boston, USA
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12
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Chaudhry SP, Stewart GC. New pharmacological and technological management strategies in heart failure. Vasc Health Risk Manag 2017; 13:111-121. [PMID: 28356751 PMCID: PMC5367380 DOI: 10.2147/vhrm.s106841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Heart failure is a complex clinical syndrome resulting from impairment of ventricular filling or ejection of blood associated with symptoms of dyspnea, fatigue, as well as peripheral and/or pulmonary edema. This syndrome is progressive and characterized by worsening quality of life despite escalating levels of care, affecting 5.7 million Americans with an annual cost of over ≥30 billion US dollars. Treatment for this syndrome has evolved over three distinct eras: the nonpharmacological era, the pharmacological era, and the device era, with the focus shifting from symptomatic relief to decreasing morbidity and mortality. Over the past 10 years, the field has undergone a renaissance, with the development of new pharmacologic, hemodynamic monitoring, and device therapies proven to improve outcomes in patients with heart failure. This article will review several recent innovations in the management of patients with heart failure.
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Affiliation(s)
| | - Garrick C Stewart
- Division of Cardiovascular Medicine, Center for Advanced Heart Disease, Brigham and Women's Hospital, Boston, MA, USA
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13
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Escobar C, Barrios V, Cosin-Sales J, Marzal D, Calderón A. Selección de lo mejor del año 2016 en cardiología clínica: continuidad asistencial; relación entre cardiología y atención primaria. Rev Esp Cardiol (Engl Ed) 2017. [DOI: 10.1016/j.recesp.2016.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Escobar C, Barrios V, Cosin-Sales J, Marzal D, Calderón A. Selection of the Best of 2016 in Clinical Cardiology: Continuum of Care; Relationship Between Cardiology and Primary Care. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2017; 70:122-123. [PMID: 28131403 DOI: 10.1016/j.rec.2016.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 08/24/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Carlos Escobar
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain.
| | - Vivencio Barrios
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Juan Cosin-Sales
- Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain
| | - Domingo Marzal
- Servicio de Cardiología, Complejo Hospitalario de Mérida, Badajoz, Spain
| | - Alberto Calderón
- Centro de Salud Doctor Pedro Laín Entralgo, Alcorcón, Madrid, Spain
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