Characteristics and in-hospital outcomes of patients with acute coronary syndromes and heart failure in the United Arab Emirates

Electrocardiographic and echocardiographic profile of patients with heart failure

Describing and analyzing the electrocardiographic and echocardiographic profile of patients with heart failure (HF).

METHODS

Documentary, retrospective, quantitative and descriptive research; data collected at the Hospital das Clinicas of Uberlandia with patients diagnosed with HF.

RESULTS

81 patients participated in this study, with the average age of 66.75 years, 4 to 6 years of formal education and family income of approximately two minimum wages. A diagnosis time of 5 to 6 years and Left Ventricular Ejection Fraction (LVEF) of 40.88±11.97% were observed. In the clinical profile, the presence of comorbidities was evident, such as systemic arterial hypertension, arterial disease and cardiac arrhythmias (82.72%, 30.86% and 35.80% respectively).

CONCLUSION

Cardio Vascular Diseases (CVD) directly impacts the lives of thousands of people, presenting an important public expenditure, not to mention the scarcity of diagnostic research, which can contribute to future research and guideline development.

Risk factors for hospital readmission of patients with heart failure: A cohort study

Aim:

The aim of this study was to develop a risk factor model for hospital readmission in patients with heart failure.

Background:

Identification of risk factors and predictors of readmission to hospital in patients with heart failure is very crucial for improved clinical outcomes.

Objective:

The objective of the current study was to investigate and delineate the risk factors that may be implicated in putting a patient at greater risk of readmission due to uncontrolled heart failure.

Materials and Methods:

This is a prospective follow-up cohort study of 170 patients with heart failure at a tertiary hospital in Al Ain city in the United Arab Emirates. We have developed a risk factor model based on the recommendations of validated published data. We have used univariate and multivariate logistic regression analyses on structured steps based on the published data. The main outcome was the risk factors for readmission to hospital due to heart failure.

Results:

A final predictive model (10 variables) was produced for unplanned readmission of patients with heart failure. The risk factors identified in the final model with their odds ratios (ORs) and confidence intervals (CIs) were as follows: four or more prescribed medicines (OR = 4.13; CI = 3.5–4.1; P = 0.003), more than twice daily dosing regimen (OR = 2.34; CI = 1.0–5.0; P = 0.023), poor knowledge of prescribed medications (OR = 4.24; CI = 1.213–14.781; P = 0.006), diabetes mellitus (OR = 3.78; CI = 1.6–8.7; P = 0.006), edema (OR = 2.64; CI = 1.2–5.6; P = 0.011), being house bound (OR = 2.77; CI = 1.2–6.2; P = 0.014), and being prescribed diuretics (OR = 3.69; CI = 1.4–9.2; P = 0.042).

Conclusion:

The specificity of the developed risk prediction model was 82.2%, the sensitivity was 74.3%, and the overall accuracy was 72.9%. The model can be emulated in population with similar characteristics to prevent early readmission of patient with heart failure.

Clinical characteristics and in-hospital outcome of heart failure in women: a single center registry from Egyptian cardiac care unit

Background

This study represents figures from a cardiac care unit (CCU) of a university hospital; it describes an example of a tertiary academic center in Egypt and provides an epidemiological view of the female HF patients, their risk profile, and short-term outcome during hospitalization.

Results

It is a local single-center cross-sectional observational registry of CCU patients 1 year from July 2015 to July 2016. Patient’s data were collected through a special software program. Women with evidence of HF were thoroughly studied.

Among the 1006 patients admitted to CCU in 1 year, 345 (34.2%) patients were females and 118 (34.2%) had evidence of HF, whereas 661 (65.7%) were males and 178 (26.9%) of them had HF. Women with HF showed 11.7% prevalence of the total population admitted to CCU. 72.7% were HFrEF and 27.3% were HFpEF. Compared to men, women with HF were older in age, more obese, less symptomatic than men, had higher incidence of associated co-morbidities, less likely to be re-admitted for HF, and less likely to have ACS and PCI. Valvular heart diseases and cardiomyopathies were the commonest etiologies of their HF. Women had more frequent normal ECG, higher EF%, and smaller LA size. There is no difference in medications and CCU procedures. While females had shorter stay, there is no significant difference in hospital mortality compared to male patients.

Conclusions

Despite higher prevalence of HF in females admitted to CCU and different clinical characteristics and etiology of HF, female gender was associated with similar prognosis during hospital course compared to male gender.

The obesity paradox in patients with acute coronary syndrome: results from the Gulf RACE-2 study

We investigated the association between in-hospital and peri-hospital mortality and body mass index (BMI)/waist circumference (WC) in a prospective acute coronary syndrome (ACS) registry in the Arabian Gulf. No significant associations with in-hospital mortality were found. Normal BMI had highest peri-hospital mortality, notably those with high WC. In logistic regression of mortality on obesity measures and potential confounders, the effects of obesity measures were no longer significant. In-hospital death increased by 5% with age and decreased by 42% in males. Mortality increased 3.7-fold with ST-elevation myocardial infarction (STEMI) and 3.0-fold with heart failure (HF) but decreased by 33% with dyslipidemia. Peri-hospital death increased by 4% with age and decreased by 30% in males. Mortality increased 2.8-fold with STEMI and 2.4-fold with HF. In- and peri-hospital mortality in ACS is significantly associated with age, gender, STEMI, HF, and dyslipidemia but not obesity measures.