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Alharrasi M, Isac C, Kamanyire JK. Heart Failure Burden in Oman as a Mid-East Exemplar Versus Global Perspectives: An Integrative Review. J Saudi Heart Assoc 2023; 35:214-225. [PMID: 37700756 PMCID: PMC10495046 DOI: 10.37616/2212-5043.1345] [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: 03/21/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Heart failure (HF), a clinical syndrome caused by a structural and functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and pulmonary congestion. This study intends to investigate the state of heart failure (HF) in Oman and assess it in comparison of global trends. Ten published literatures from the past 20 years were included after a thorough search of databases (Arab World Research Source, EBSCOhost, Medline, and Google Scholar). These studies were reviewed considering the global literature. We have observed an increase in HF cases especially in older adults, over the past two decades in Oman. Acute coronary syndrome and non-compliance with medication are two factors that contribute to acute HF, according to recent research. Ischemic heart disease is the leading cause of HF in the Omani population. The mortality rate for HF patients in Oman was reported to be 25% after a one-year follow-up. The younger population that is diagnosed with HF in Oman is significantly worse than in other nations, according to these data, which are consistent with global trends. The lack of published studies and data sets hampered our understanding of heart failure (HF); yet prevalence of HF is rising and is anticipated to surge with the rise in diabetes mellitus and hypertension and other related cardiovascular precursors. Therefore, HF requires more investigation. In terms of worldwide trends, HF in Oman appears to be even worse; additional information is required to grasp the full picture on HF.
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Harrington J, Jones WS, Udell JA, Hannan K, Bhatt DL, Anker SD, Petrie MC, Vedin O, Butler J, Hernandez AF. Acute Decompensated Heart Failure in the Setting of Acute Coronary Syndrome. JACC. HEART FAILURE 2022; 10:404-414. [PMID: 35654525 DOI: 10.1016/j.jchf.2022.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 06/15/2023]
Abstract
Acute coronary syndrome (ACS) is frequently complicated by evidence of heart failure (HF). Those at highest risk for acute decompensated HF in the setting of ACS (ACS-HF) are older, female, and have preexisting heart disease, type 2 diabetes mellitus, hypertension, and/or kidney disease. The presence of ACS-HF is strongly associated with higher mortality and more frequent readmissions, especially for HF. Low implementation of guideline-directed medical therapy has further complicated the clinical care of this high-risk population. Improved utilization of current therapies, coupled with further investigation of strategies to manage ACS-HF, is desperately needed to improve outcomes in this vulnerable population, and the results of currently ongoing or recently concluded ACS-HF studies in this population are of great interest. In this review, we explore the pathophysiology, epidemiology, risk factors, and outcomes for patients with ACS-HF, and describe both existing evidence for management of this challenging condition and areas requiring further research.
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Affiliation(s)
- Josephine Harrington
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA
| | - W Schuyler Jones
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Jacob A Udell
- Cardiovascular Division, Department of Medicine, Women's College Hospital; and Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Karen Hannan
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Stefan D Anker
- Department of Cardiology (CVK) and Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany
| | - Mark C Petrie
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Ola Vedin
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Boehringer Ingelheim AB, Stockholm, Sweden
| | - Javed Butler
- Department of Medicine, University of Mississippi, Jackson, Mississippi, USA
| | - Adrian F Hernandez
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
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Alharrasi M, Isac C, Kamanyire J, Alomari K, Panduranga P. Heart failure in oman: Current statistics and recommendations. Heart Views 2021; 22:280-287. [PMID: 35330657 PMCID: PMC8939385 DOI: 10.4103/heartviews.heartviews_2_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 12/22/2021] [Indexed: 11/08/2022] Open
Abstract
This review aims to explore the status of heart failure (HF) practice and research in Oman. Extensive search of databases (Arab World Research Source, EBSCOhost, Medline, and Google Scholar) yielded eight published literatures in the last two decades in Oman. The escalation of HF among older adults in Oman has been documented across the two decades. Ischemic heart disease continues to dominate as the cause for HF among the Omani population. Recent researchers have highlighted that acute coronary syndrome and noncompliance with medications are factors which precipitate an acute HF. One-year follow-up of HF patients in Oman has estimated their mortality rate at 25%. Our knowledge of HF is very limited by the few published research and data sets. However, the prevalence of HF is increasing, and is expected to dramatically increase with the rise in the Omani population in hypertension and diabetes. More research is needed in the area of HF on the Omani population.
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Chen Y, Chen X, Yao M, Chen L, Chen W, Liu X. Association of S100B 3'UTR polymorphism with risk of chronic heart failure in a Chinese Han population. Medicine (Baltimore) 2020; 99:e21018. [PMID: 32590820 PMCID: PMC7328937 DOI: 10.1097/md.0000000000021018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
To study the correlation between single nucleotide polymorphism (SNP) of the 3' untranslated region (UTR) rs9722 locus in S100B and the risk of chronic heart failure (CHF), plasma levels of S100B protein as well as has-miR-340-3p in a Chinese Han population.A total of 215 patients with CHF (124 ischemic cardiomyopathy (ICM) and 91 dilated cardiomyopathy (DCM)) and 215 healthy controls were recruited to analyze the S100B rs9722 genotype by Sanger sequencing. The levels of hsa-miR-340-3p in the plasma were detected by RT-PCR, and S100B levels were detected by ELISA.The risk of CHF in S100B rs9722 locus T allele carriers was 4.24 times higher than that in those with the C allele (95% CI: 2.84-6.33, P < .001). The association of S100B rs9722 locus SNP with ICM and DCM risk was not affected by factors such as age, gender, and body mass index (BMI). The levels of plasma S100B and hsa-miR-340-3p in patients with ICM and DCM were significantly higher than those in the control group (P < .001). There was no significant difference in plasma S100B levels between patients with ICM and DCM (P > .05). Among ICM, DCM, and control subjects, TT genotype carriers had the highest levels of plasma S100B and hsa-miR-340-3p, followed by the CT genotype and TT genotype, and the difference was statistically significant (P < .05). Plasma hsa-miR-340-3p levels were positively correlated with S100B levels in the control subjects and patients with ICM and DCM.The S100B rs9722 locus SNP is associated with CHF risk in a Chinese Han population.
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Affiliation(s)
| | - Xianghong Chen
- Department of General Medicine, The Second Affiliated Hospital of Hainan Medical University, No. 48 Baishuitang Road
| | - Maozhong Yao
- Research Center for Drug Safety Evaluation of Hainan Province, Hainan Medical University, Haikou, Hainan Province, China
| | - Lei Chen
- Department of Cardiovascular Medicine
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Alhamaydeh M, Gregg R, Ahmad A, Faramand Z, Saba S, Al-Zaiti S. Identifying the most important ECG predictors of reduced ejection fraction in patients with suspected acute coronary syndrome. J Electrocardiol 2020; 61:81-85. [PMID: 32554161 DOI: 10.1016/j.jelectrocard.2020.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Non-invasive screening tools of cardiac function can play a significant role in the initial triage of patients with suspected acute coronary syndrome. Numerous ECG features have been previously linked with cardiac contractility in the general population. We sought to identify ECG features that are most predictive for real-time screening of reduced left ventricular ejection fraction (LVEF) in the acute care setting. METHODS We performed a secondary analysis of a prospective, observational cohort study of patients evaluated for suspected acute coronary syndrome. We included consecutive patients in whom an echocardiogram was performed during indexed encounter. We evaluated 554 automated 12-lead ECG features in multivariate linear regression for predicting LVEF. We then used regression trees to identify the most important predictive ECG features. RESULTS Our final sample included 297 patients (aged 63 ± 15, 45% females). The mean LVEF was 57% ± 13 (IQR 50%-65%). In multivariate analysis, depolarization dispersion in the horizontal plane; global repolarization dispersion; and abnormal temporal indices in inferolateral leads were all independent predictors of LVEF (R2 = 0.452, F = 6.679, p < 0.001). Horizontal QRS axis deviation and prolonged ventricular activation time in left ventricular apex were the most important determinants of reduced LVEF, while global QRS duration was of less importance. CONCLUSIONS Poor R wave progression in precordial leads with dominant QS pattern in V3 is the most predictive feature of reduced LVEF in suspected ACS. This feature constitutes a simple visual marker to aid clinicians in identifying those with impaired cardiac function.
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Affiliation(s)
| | - Richard Gregg
- Advanced Algorithms Development Center, Philips Healthcare, Andover, MA, United States of America
| | - Abdullah Ahmad
- University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Ziad Faramand
- University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Samir Saba
- University of Pittsburgh, Pittsburgh, PA, United States of America; Heart and Vascular Institute at University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Salah Al-Zaiti
- University of Pittsburgh, Pittsburgh, PA, United States of America.
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Fukutomi M, Nishihira K, Honda S, Kojima S, Takegami M, Takahashi J, Itoh T, Watanabe T, Takenaka T, Ito M, Takayama M, Kario K, Sumiyoshi T, Kimura K, Yasuda S. Difference in the in-hospital prognosis between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction with high Killip class: Data from the Japan Acute Myocardial Infarction Registry. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2020; 10:2048872620926681. [PMID: 32419479 PMCID: PMC8248829 DOI: 10.1177/2048872620926681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND ST-segment elevation myocardial infarction is known to be associated with worse short-term outcome than non-ST-segment elevation myocardial infarction. However, whether or not this trend holds true in patients with a high Killip class has been unclear. METHODS We analyzed 3704 acute myocardial infarction patients with Killip II-IV class from the Japan Acute Myocardial Infarction Registry and compared the short-term outcomes between ST-segment elevation myocardial infarction (n = 2943) and non-ST-segment elevation myocardial infarction (n = 761). In addition, we also performed the same analysis in different age subgroups: <80 years and ≥80 years. RESULTS In the overall population, there were no significant difference in the in-hospital mortality (20.0% vs 17.1%, p = 0.065) between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction groups. Patients <80 years of age also showed no difference in the in-hospital mortality (15.7% vs 15.2%, p = 0.807) between ST-segment elevation myocardial infarction (n = 2001) and non-ST-segment elevation myocardial infarction (n = 453) groups, whereas among those ≥80 years of age, ST-segment elevation myocardial infarction (n = 942) was associated with significantly higher in-hospital mortality (29.3% vs 19.8%, p = 0.001) and in-hospital cardiac mortality (23.3% vs 15.0%, p = 0.002) than non-ST-segment elevation myocardial infarction (n = 308). After adjusting for covariates, ST-segment elevation myocardial infarction was a significant predictor for in-hospital mortality (odds ratio 2.117; 95% confidence interval, 1.204-3.722; p = 0.009) in patients ≥80 years of age. CONCLUSION Among cases of acute myocardial infarction with a high Killip class, there was no marked difference in the short-term outcomes between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in younger patients, while ST-segment elevation myocardial infarction showed worse short-term outcomes in elderly patients than non-ST-segment elevation myocardial infarction. Future study identifying the prognostic factors for the specific anticipation intensive cares is needed in this high-risk group.
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Affiliation(s)
- Motoki Fukutomi
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Japan
| | - Kensaku Nishihira
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Sunao Kojima
- Department of General Internal Medicine 3, Kawasaki Medical School, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Tomonori Itoh
- Division of Cardiology, Iwate Medical University, Japan
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan
| | | | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | | | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Japan
| | | | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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Liao H, Chen Q, Liu L, Zhong S, Deng H, Xiao C. Impact of concurrent right ventricular myocardial infarction on outcomes among patients with left ventricular myocardial infarction. Sci Rep 2020; 10:1736. [PMID: 32015449 PMCID: PMC6997358 DOI: 10.1038/s41598-020-58713-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/15/2020] [Indexed: 01/06/2023] Open
Abstract
To compare in-hospital outcomes between left ventricular myocardial infarction (LVMI) patients with and without right ventricular myocardial infarction (RVMI). Patients with acute ST-segment elevation MI (STEMI) undergoing primary percutaneous coronary intervention (PCI) were enrolled and divided into LVMI with and without RVMI groups. Between-group differences and in-hospital outcomes were compared. Compared to patients without RVMI, patients with RVMI were more likely to be male, have higher body mass index, serum levels of C-reactive protein (8.9 ± 2.4 vs 6.2 ± 2.1 mg/dL), B-type natriuretic peptide (1295 ± 340 vs 872 ± 166 pg/mL) and cardiac troponin-I (8.6 ± 2.9 vs 5.2 ± 2.1 ng/mL), and have diabetes (36.3% vs 3.4%) and dyslipidemia (53.4% vs 48.1%). Patients with RVMI had lower left and right ventricular ejection fraction (50.5 ± 5.6% vs 53.4 ± 3.8% and 33.6 ± 2.9% vs 45.7 ± 2.0%), but had higher mean pulmonary artery pressure (30.6 ± 3.3 vs 23.8 ± 3.1 mm Hg). Compared to patients without RVMI, patients with RVMI had higher odds of in-hospital all-cause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). After adjusted for confounding factors, LVMI with RVMI remained independently associated with composite outcomes, with odds ratio 1.66 (95% confidence interval 1.39–2.04). Compared to isolated LVMI patients, those with concomitant RVMI have higher odds of in-hospital complications, particularly all-cause mortality and new onset acute heart failure.
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Affiliation(s)
- Huocheng Liao
- The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China
| | - Qiuyue Chen
- The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China
| | - Lin Liu
- The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China
| | - Sigan Zhong
- The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China
| | - Huazhao Deng
- The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China
| | - Chun Xiao
- The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China.
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Hou Y, Yue Y, Zhao M, Jiang S. Prevalence and association of medication nonadherence with major adverse cardiovascular events in patients with myocardial infarction. Medicine (Baltimore) 2019; 98:e17826. [PMID: 31689870 PMCID: PMC6946490 DOI: 10.1097/md.0000000000017826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Current study was to evaluate the prevalence of guideline recommended medications adherence in myocardial infarction (MI) patients postpercutaneous coronary intervention (PCI) and the association of medication nonadherence and major adverse cardiovascular events (MACEs).MI patients who underwent PCI in the last 12 months were enrolled. Demographic and clinical characteristics were collected and guideline recommended medications were evaluated. Patients were divided into with and without MACEs groups.Compared to patients without MACEs, those with MACEs were older (54.8 ± 16.4 vs 51.1 ± 15.2 years), more likely to be smoker (40.2% vs 31.9%), have higher body mass index (BMI; 25.0 ± 6.1 vs 23.8 ± 5.7 kg/m), diabetes (47.5% vs 37.8%), ischemic stroke (34.4% vs 25.6%), and estimated lower glomerular filtration rate (85.4 ± 9.6 vs 92.6 ± 10.7 mL/minute/1.73 m). Patients with MACEs were also more likely to present with ST-elevation MI (STEMI; 54.1% vs 48.4%) and to undergo urgent PCI (62.3% vs 56.3%). Furthermore, patients with MACEs were less likely to adhere to dual antiplatelet therapy (77.9% vs 85.9%), renin-angiotensin system inhibitor (62.3% vs 69.7%), and beta-blocker (69.7% vs 72.8%) treatment. In unadjusted model, medication nonadherence was associated with 2-fold higher odds of MACEs. After adjustment for demographics, risk factors, comorbidities, and peri-PCI characteristics, medications nonadherence remained independently associated with MACEs, with odds ratio of 1.40 (95% confidence interval: 1.29-1.87).Medications adherence rate among MI patients post-PCI is suboptimal in China, which is independently associated with MACEs.
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Affiliation(s)
- Yunfeng Hou
- Intensive Care Unit, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong
| | | | - Meiling Zhao
- Department of Critical Care Medicine Zibo Central Hospital, Zibo City, Shandong, China
| | - Shumin Jiang
- Intensive Care Unit, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong
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Tousek P, Staskova K, Mala A, Sluka M, Vodzinska A, Jancar R, Maluskova D, Jarkovsky J, Widimsky P. Incidence, treatment strategies and outcomes of acute coronary syndrome with and without ongoing myocardial ischaemia: results from the CZECH-3 registry. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2017; 8:687-694. [PMID: 28730895 DOI: 10.1177/2048872617720929] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015. Acute coronary syndrome with ongoing myocardial ischaemia was defined by the presence of persistent/recurrent chest pain/dyspnoea and at least one of the following: persistent ST-segment elevation or depression, bundle branch block, haemodynamic or electric instability due to suspected ischaemia. Major adverse cardiac events (death, reinfarction, stroke, unexpected revascularisation, stent thrombosis) and severe bleeding according to Bleeding Academic Research Consortium criteria were evaluated at 30 days. RESULTS Acute coronary syndrome was ruled out during the hospital stay in 434 (24.7%) patients. Out of 1280 patients with confirmed acute coronary syndrome, 732 (57%) had clinical signs of ongoing myocardial ischaemia at first medical contact. Coronary angiography was performed in 94.7% of patients with confirmed acute coronary syndrome with ongoing myocardial ischaemia and 89% of patients with confirmed acute coronary syndrome without ongoing myocardial ischaemia (P<0.001). The major adverse cardiac event rate was 9.8% for patients with confirmed acute coronary syndrome with ongoing myocardial ischaemia and 5.5% for patients without ongoing myocardial ischaemia (P=0.005), the 30-day severe bleeding rate was 1.6% and 1.5% (P=1.0). Patients with ongoing myocardial ischaemia admitted to regional hospitals had higher major adverse cardiac event rates compared with patients admitted directly to cardiocentres with percutaneous coronary intervention capability (13.3% vs. 8.2%, P=0.034). CONCLUSIONS Ongoing myocardial ischaemia was present in more than half of patients hospitalised with acute coronary syndrome. These very high-risk patients may benefit from direct admission to percutaneous coronary intervention-capable centres.
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Affiliation(s)
- Petr Tousek
- Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Czech Republic
| | - Klara Staskova
- Regional Hospital Ceske Budejovice, Department of Cardiology, Czech Republic
| | - Anna Mala
- Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Czech Republic
| | - Martin Sluka
- Cardiocenter, Univesity Hospital Olomouc, Czech Republic
| | | | - Radek Jancar
- Department of Cardiology, Municipal Hospital Ostrava, Czech Republic
| | - Denisa Maluskova
- Institute of Biostatistics and Analyses, Masaryk University, Faculty of Medicine, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Faculty of Medicine, Czech Republic
| | - Petr Widimsky
- Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Czech Republic
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10
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Jeger RV, Pfister O, Radovanovic D, Eberli FR, Rickli H, Urban P, Pedrazzini G, Stauffer JC, Nossen J, Erne P. Heart failure in patients admitted for acute coronary syndromes: A report from a large national registry. Clin Cardiol 2017; 40:907-913. [PMID: 28598569 DOI: 10.1002/clc.22745] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/20/2017] [Accepted: 05/23/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Data on temporal trends of heart failure (HF) in acute coronary syndrome (ACS) are scarce. HYPOTHESIS Improved treatment options may have led to lower case-fatality rates (CFRs) during the last years in ACS complicated by HF. METHODS Patients of the nationwide Acute Myocardial Infarction in Switzerland (AMIS)-Plus ACS registry were analyzed from 2000 to 2014. RESULTS Of 36 366 ACS patients, 3376 (9.3%) had acute or chronic HF, 2111 (5.8%) de novo acute HF (AHF), 964 (2.7%) chronic HF (CHF), and 301 (0.8%) acute decompensated CHF (ADCHF). In-hospital CFRs were highest in patients with ADCHF (32.6%) and de novo AHF (29.7%), followed by patients with CHF (12.9%) and without HF (3.2%, P < 0.001). Although in-hospital CFRs gradually decreased in CHF patients (14.3% to 4.5%, P = 0.003) and patients without HF (3.5% to 2.2%, P < 0.001), they remained high in patients with ADCHF (36.4% to 40.0%, P = 0.45) and de novo AHF (50.0% to 29.4%, P = 0.37). Although there was an increase in specific ACS therapies in the cohort over time, ACS patients with HF received significantly less pharmacological and interventional ACS therapies than patients without HF. There was no significant change in HF medication rates except less frequent use of β-blockers and diuretics in de novo AHF patients in recent years. CONCLUSIONS HF is present in 1 out of 10 patients presenting with ACS and is associated with high in-hospital CFRs, particularly in acute HF. Although advances in ACS therapy improved in-hospital CFRs in patients with no HF or CHF, CFRs remained unchanged and high in patients with acute HF and ACS over the last decade.
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Affiliation(s)
- Raban V Jeger
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Otmar Pfister
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Dragana Radovanovic
- AMIS Plus Data Centre, Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Franz R Eberli
- Department of Cardiology, Triemli Hospital, Zurich, Switzerland
| | - Hans Rickli
- Department of Cardiology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | - Philip Urban
- Cardiovascular Department, La Tour Hospital, Geneva, Switzerland
| | | | | | - Jörg Nossen
- Department of Internal Medicine, Lucerne Cantonal Hospital, Sursee, Switzerland
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11
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Ajlan M, Almazroa L, AlHabib KF, Elasfar AA, Alfaleh H, Albackr H, Kashour T, Hersi A, Hussein GA, Mimish L, Almasood A, AlHabeeb W, AlGhamdi S, Alsharari M, Chakra E, Malik A, Soomro R, Ghabashi A, Al-Murayeh M, Abuosa A. Atrial Fibrillation in Patients Hospitalized With Heart Failure: Patient Characteristics and Outcomes From the HEARTS Registry. Angiology 2017; 69:151-157. [PMID: 28592150 DOI: 10.1177/0003319717711764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Effect of atrial fibrillation (AF) on short- and long-term outcomes in heart failure (HF) is controversial. Accordingly, we examined this relationship in a national multicenter project using data from the Hearts Function Assessment Registry Trial in Saudi Arabia that studied the clinical features and outcomes of patients admitted with de novo and acute on chronic HF. Out of 2593 patients with HF, 449 (17.8%) had AF at presentation. Patients with AF were more likely to be males and older (mean age 65.2 ± 15.0 vs 60.5 ± 14.8 years) to have a history of ventricular tachycardia/ventricular fibrillation (3.1% vs 1.9%) or cerebrovascular accident (15.0% vs 8.5%). However, they were less likely to have diabetes (66.0% vs 55.9%) or coronary artery disease (55.6% vs 42.3%). The 1-, 2-, and 3-year crude mortality rates were significantly higher in patients with AF (23.2% vs 18.3%, 27.4% vs 22.3%, and 27.8% vs 23.2%, respectively). However, there was no significant difference in mortality after adjusting for covariates. Thus, in patients admitted with HF, AF upon presentation was not associated with increased mortality.
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Affiliation(s)
- M Ajlan
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - L Almazroa
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid F AlHabib
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdelfatah A Elasfar
- 2 Prince Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
- 3 Cardiology Department, Tanta University, Egypt
| | - Hussam Alfaleh
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hanan Albackr
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tarek Kashour
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- 2 Prince Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ahmad Hersi
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Layth Mimish
- 5 King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ali Almasood
- 6 Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Waleed AlHabeeb
- 1 King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saleh AlGhamdi
- 7 Madina Cardiac Center, Al Madina Al Monaoarah, Saudi Arabia
| | | | | | - Asif Malik
- 10 King Fahad General Hospital, Jeddah, Saudi Arabia
| | | | | | | | - Ahmed Abuosa
- 14 National Guard Hospital, Jeddah, Saudi Arabia
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12
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Brunetti ND, Guerra A, Ieva R, Correale M, Santoro F, Tarantino N, Di Biase M. Scared for the scar: fearsome impact of acute cardiovascular disease on perceived kinesiophobia (fear of movement). Clin Cardiol 2017; 40:480-484. [PMID: 28272813 DOI: 10.1002/clc.22682] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/12/2017] [Accepted: 01/14/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND To assess levels of kinesiophobia (fear of movement) in patients hospitalized for acute cardiovascular disease. HYPOTHESIS Increased levels of kinesiophobia can be found in subjects hospitalized for acute cardiovascular disease. METHODS Seventy-four consecutive patients admitted for acute coronary syndrome and 58 for acute heart failure were enrolled in the study and assessed by the Tampa Scale for the evaluation of kinesiophobia. Subjects were compared with a reference population with stable coronary artery disease and healthy controls. RESULTS No significant differences were found between acute coronary syndrome and acute heart failure in terms of kinesiophobia, even considering the rates of high kinesiophobia (Tampa score >37) and the 4 groups of questionnaire items (danger, fear, avoidance, dysfunction). Differences, however, were significant comparing our population with an historical population of subjects with stable coronary artery disease and controls (43 ± 5 vs 35 ± 7 vs 33 ± 6, P < 0.0001 in both cases). A significant correlation was found between the grade of kinesiophobia in the Tampa Scale and the age of subjects (r = 0.27, P = 0.001) and inversely with level of education (r = -0.33, P < 0.0001). CONCLUSIONS Increased levels of kinesiophobia can be found in subjects hospitalized for acute cardiovascular disease. Kinesiophobia is related to age and education. Kinesiophobia should be carefully considered in subjects hospitalized in acute cardiac care units.
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Affiliation(s)
| | - Antonio Guerra
- Cardiology Department, University of Foggia, Foggia, Italy
| | - Riccardo Ieva
- Cardiology Department, Riuniti Hospital, Foggia, Italy
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13
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Arrigo M, Gayat E, Parenica J, Ishihara S, Zhang J, Choi DJ, Park JJ, Alhabib KF, Sato N, Miro O, Maggioni AP, Zhang Y, Spinar J, Cohen-Solal A, Iwashyna TJ, Mebazaa A. Precipitating factors and 90-day outcome of acute heart failure: a report from the intercontinental GREAT registry. Eur J Heart Fail 2016; 19:201-208. [PMID: 27790819 DOI: 10.1002/ejhf.682] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/12/2016] [Accepted: 09/21/2016] [Indexed: 12/11/2022] Open
Abstract
AIMS Several clinical conditions may precipitate acute heart failure (AHF) and influence clinical outcome. In this study we hypothesized that precipitating factors are independently associated with 90-day risk of death in AHF. METHODS AND RESULTS The study population consisted of 15 828 AHF patients from Europe and Asia. The primary outcome was 90-day all-cause mortality according to identified precipitating factors of AHF [acute coronary syndrome (ACS), infection, atrial fibrillation (AF), hypertension, and non-compliance]. Mortality at 90 days was 15.8%. AHF precipitated by ACS or by infection showed increased 90-day risk of death compared with AHF without identified precipitants [hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.44-1.97, P < 0.001; and HR 1.51, 95% CI 1.18-1.92, P = 0.001), while AHF precipitated by AF showed lower 90-day risk of death (HR 0.56, 95% CI 0.42-0.75, P < 0.001), after multivariable adjustment. The risk of death in AHF precipitated by ACS was the highest during the first week after admission, while in AHF precipitated by infection the risk of death had a delayed peak at week 3. In AHF precipitated by AF, a trend toward reduced risk of death during the first weeks was shown. At weeks 5-6, AHF precipitated by ACS, infection, or AF showed similar risk of death to that of AHF without identified precipitants. CONCLUSIONS Precipitating factors are independently associated with 90-day mortality in AHF. AHF precipitated by ACS or infection is independently associated with higher, while AHF precipitated by AF is associated with lower 90-day risk of death.
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Affiliation(s)
- Mattia Arrigo
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, and Department of Anaesthesiology and Critical Care Medicine, APHP-Saint Louis Lariboisière University Hospitals, Paris, France.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Etienne Gayat
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, and Department of Anaesthesiology and Critical Care Medicine, APHP-Saint Louis Lariboisière University Hospitals, Paris, France
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Shiro Ishihara
- Division of Cardiology and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaki, Japan
| | - Jian Zhang
- Heart Failure Center Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dong-Ju Choi
- Division Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Jin Joo Park
- Division Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Khalid F Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Naoki Sato
- Division of Cardiology and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaki, Japan
| | - Oscar Miro
- Emergency Department, Hospital Clínic and 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, Barcelona, Spain
| | | | - Yuhui Zhang
- Heart Failure Center Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jindrich Spinar
- Department of Cardiology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Alain Cohen-Solal
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, and Department of Cardiology, APHP-Lariboisière University Hospital, Paris, France
| | | | - Alexandre Mebazaa
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, and Department of Anaesthesiology and Critical Care Medicine, APHP-Saint Louis Lariboisière University Hospitals, Paris, France
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