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Muse VP, Placido D, Haue AD, Brunak S. Seasonally adjusted laboratory reference intervals to improve the performance of machine learning models for classification of cardiovascular diseases. BMC Med Inform Decis Mak 2024; 24:62. [PMID: 38438861 PMCID: PMC10910795 DOI: 10.1186/s12911-024-02467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Variation in laboratory healthcare data due to seasonal changes is a widely accepted phenomenon. Seasonal variation is generally not systematically accounted for in healthcare settings. This study applies a newly developed adjustment method for seasonal variation to analyze the effect seasonality has on machine learning model classification of diagnoses. METHODS Machine learning methods were trained and tested on ~ 22 million unique records from ~ 575,000 unique patients admitted to Danish hospitals. Four machine learning models (adaBoost, decision tree, neural net, and random forest) classifying 35 diseases of the circulatory system (ICD-10 diagnosis codes, chapter IX) were run before and after seasonal adjustment of 23 laboratory reference intervals (RIs). The effect of the adjustment was benchmarked via its contribution to machine learning models trained using hyperparameter optimization and assessed quantitatively using performance metrics (AUROC and AUPRC). RESULTS Seasonally adjusted RIs significantly improved cardiovascular disease classification in 24 of the 35 tested cases when using neural net models. Features with the highest average feature importance (via SHAP explainability) across all disease models were sex, C- reactive protein, and estimated glomerular filtration. Classification of diseases of the vessels, such as thrombotic diseases and other atherosclerotic diseases consistently improved after seasonal adjustment. CONCLUSIONS As data volumes increase and data-driven methods are becoming more advanced, it is essential to improve data quality at the pre-processing level. This study presents a method that makes it feasible to introduce seasonally adjusted RIs into the clinical research space in any disease domain. Seasonally adjusted RIs generally improve diagnoses classification and thus, ought to be considered and adjusted for in clinical decision support methods.
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Affiliation(s)
- Victorine P Muse
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Davide Placido
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Amalie D Haue
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
- Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2200, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
- Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2200, Copenhagen, Denmark.
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Rossios K, Antza C, Kachtsidis V, Kotsis V. The Modern Environment: The New Secondary Cause of Hypertension? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2095. [PMID: 38138198 PMCID: PMC10744418 DOI: 10.3390/medicina59122095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/15/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
The most important risk factor for cardiovascular disease, the leading cause of death worldwide, is hypertension. Although most cases of hypertension are thought to be essential, the multifactorial associations of the environmental influence on blood pressure seem to play an important role and should be more closely investigated. This review attempts to focus on the recent literature that examines the environmental effects on arterial blood pressure and its management. Seasonal variability and the role of ambient temperature, either occupational or recreational noise pollution, as well as obesity due to environment-caused dietary habits, are recognized as important risk factors, affecting the onset as well as the regulation of hypertension. Furthermore, the effects of seasonal fluctuations in blood pressure, noise pollution, and obesity seem to share a similar pathogenesis, and as such to all further react together, leading to increased blood pressure. The activation of the autonomous nervous system plays a key role and causes an increase in stress hormones that generates oxidative stress on the vascular system and, thus, vasoconstriction. In this review, by focusing on the association of the environmental impact with arterial blood pressure, we come to the question of whether most cases of hypertension-if not all-should, indeed, be considered primary or secondary.
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Affiliation(s)
- Konstantinos Rossios
- Cardiology Clinic, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Christina Antza
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.A.); (V.K.)
| | - Vasileios Kachtsidis
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.A.); (V.K.)
| | - Vasilios Kotsis
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.A.); (V.K.)
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Pawar VA, Srivastava S, Tyagi A, Tayal R, Shukla SK, Kumar V. Efficacy of Bioactive Compounds in the Regulation of Metabolism and Pathophysiology in Cardiovascular Diseases. Curr Cardiol Rep 2023; 25:1041-1052. [PMID: 37458865 DOI: 10.1007/s11886-023-01917-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE OF REVIEW An imbalance in reactive oxygen species (ROS) homeostasis can wreak damage to metabolic and physiological processes which can eventually lead to an advancement in cardiovascular diseases (CVD). Mitochondrial dysfunction is considered as a key source of ROS. The purpose of the current review is to concisely discuss the role of bioactive compounds in the modulation of cardiovascular metabolism and their potential application in the management of cardiovascular diseases. RECENT FINDINGS Recently, it has been shown that bioactive compounds exhibit immunomodulatory function by regulating inflammatory pathways and ROS homeostasis. It has also been reported that bioactive compounds regulate mitochondria dynamics, thus modulating the autophagy and energy metabolism in the cells. In the present article, we have discussed the roles of different bioactive compounds in the modulation of different inflammatory drivers. The functional properties of bioactive compounds in mitochondrial dynamics and its impact on cardiac disease protection have been briefly summarized. Furthermore, we have also discussed various aspects of bioactive compounds with respect to metabolism, immune modulation, circadian rhythm, and its impact on CVD's pathophysiology.
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Affiliation(s)
| | - Shivani Srivastava
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, 06520, USA
| | - Anuradha Tyagi
- Department of cBRN, Institute of Nuclear Medicine and Allied Science, Delhi, 110054, India
| | - Rajul Tayal
- National Institute of Plant Genome Research, New Delhi, 110067, India
| | - Surendra Kumar Shukla
- Department of Oncology Science, OU Health Stephenson Cancer Center, Oklahoma City, OK, 73104, USA.
| | - Vinay Kumar
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, 473 W 12th Ave, Columbus, OH, 43210, USA.
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Kim I, Locascio JJ, Sarin R, Hart A, Ciottone GR. Time Series Analysis of Congestive Heart Failure Discharges in Florida (USA) Post Tropical Cyclones. Prehosp Disaster Med 2023; 38:207-215. [PMID: 36691696 DOI: 10.1017/s1049023x23000067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of this study was to analyze congestive heart failure (CHF) discharges in Florida (USA) post tropical cyclones from 2007 through 2017. METHODS This was a retrospective longitudinal time series analysis of hospital CHF quarterly discharges across Florida using the Healthcare Cost and Utilization Project (HCUP) database. The autoregressive integrated moving average (ARIMA) model was used with correlated seasonal regressor variables such as cyclone frequency, maximum cyclone wind speed, average temperature, and reports of influenza-like illness (ILI). RESULTS A total of 3,372,993 patients were identified, with average age in each quarter ranging 72.2 to 73.9 years and overall mortality ranging 4.3% to 6.4%. The CHF discharges within each year peaked from October through December and nadired from April through June with an increasing overall time trend. Significant correlation was found between CHF discharge and the average temperature (P <.001), with approximately 331.8 less CHF discharges (SE = 91.7) per degree of increase in temperature. However, no significant correlation was found between CHF discharges and frequency of cyclones, the maximum wind speed, and reported ILI. CONCLUSIONS This study suggests that with the current methods and the HCUP dataset, there is no significant increase in overall CHF discharges in Florida as a result of recent previous cyclone occurrences.
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Affiliation(s)
- Inkyu Kim
- Harvard Medical School, Boston, MassachusettsUSA; currently: Harvard-Affiliated Emergency Medicine Residency at Massachusetts General Hospital and Brigham and Women's Hospital, Boston, Massachusetts USA
| | | | - Ritu Sarin
- Beth Israel Deaconess Medical Center, Disaster Medicine Fellowship, Boston, MassachusettsUSA
| | - Alexander Hart
- Beth Israel Deaconess Medical Center, Disaster Medicine Fellowship, Boston, MassachusettsUSA
| | - Gregory R Ciottone
- Beth Israel Deaconess Medical Center, Disaster Medicine Fellowship, Boston, MassachusettsUSA
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ‘‘U’’ shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth’s climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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Weather Trumps Festivity? More Cardiovascular Disease Events Occur in Winter than in December Holidays in Queensland, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910158. [PMID: 34639460 PMCID: PMC8508171 DOI: 10.3390/ijerph181910158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022]
Abstract
Objective: Cardiovascular disease (CVD) is the leading cause of hospitalisations and deaths in Australia. This study estimates the excess CVD hospitalisations and deaths across seasons and during the December holidays in Queensland, Australia. Methods: The study uses retrospective, longitudinal, population-based cohort data from Queensland, Australia from January 2010 to December 2015. The outcomes were hospitalisations and deaths categorised as CVD-related. CVD events were grouped according to when they occurred in the calendar year. Excess hospitalisations and deaths were estimated using the multivariate ordinary least squares method after adjusting for confounding effects. Results: More CVD hospitalisations and deaths occurred in winter than in summer, with 7811 (CI: 1353, 14,270; p < 0.01) excess hospitalisations and 774 (CI: 35, 1513; p < 0.01) deaths compared to summer. During the coldest month (July), there was an excess of 42 hospitalisations and 7 deaths per 1000 patients. Fewer CVD hospitalisations (-20 (CI: -29, -9; p < 0.01)) occurred during the December holidays than any other period during the calendar year. Non-CVD events were mostly not statistically significant different between periods. Conclusion: Most CVD events in Queensland occurred in winter rather than during the December holidays. Potentially cost-effective initiatives should be explored such as encouraging patients with CVD conditions to wear warmer clothes during cold temperatures and/or insulating the homes of CVD patients who cannot otherwise afford to.
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Moholdt T, Afoakwah C, Scuffham P, McDonald CF, Burrell LM, Stewart S. Excess mortality at Christmas due to cardiovascular disease in the HUNT study prospective population-based cohort in Norway. BMC Public Health 2021; 21:549. [PMID: 33743642 PMCID: PMC7980726 DOI: 10.1186/s12889-021-10503-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/12/2021] [Indexed: 01/08/2023] Open
Abstract
Background Although it is known that winter inclusive of the Christmas holiday period is associated with an increased risk of dying compared to other times of the year, very few studies have specifically examined this phenomenon within a population cohort subject to baseline profiling and prospective follow-up. In such a cohort, we sought to determine the specific characteristics of mortality occuring during the Christmas holidays. Methods Baseline profiling and outcome data were derived from a prospective population-based cohort with longitudinal follow-up in Central Norway - the Trøndelag Health (HUNT) Study. From 1984 to 1986, 88% of the target population comprising 39,273 men and 40,353 women aged 48 ± 18 and 50 ± 18 years, respectively, were profiled. We examined the long-term pattern of mortality to determine the number of excess (all-cause and cause-specific) deaths that occurred during winter overall and, more specifically, the Christmas holidays. Results During 33.5 (IQR 17.1–34.4) years follow-up, 19,879 (50.7%) men and 19,316 (49.3%) women died at age-adjusted rate of 5.3 and 4.6 deaths per 1000/annum, respectively. Overall, 1540 (95% CI 43–45 deaths/season) more all-cause deaths occurred in winter (December to February) versus summer (June to August), with 735 (95% CI 20–22 deaths per season) of these cardiovascular-related. December 25th–27th was the deadliest 3-day period of the year; being associated with 138 (95% CI 96–147) and 102 (95% CI 72–132) excess all-cause and cardiovascular-related deaths, respectively. Accordingly, compared to 1st–21st December (equivalent winter conditions), the incidence rate ratio of all-cause mortality increased to 1.22 (95% CI 1.16–1.27) and 1.17 (95% 1.11–1.22) in men and women, respectively, during the next 21 days (Christmas/New Year holidays). All observed differences were highly significant (P < 0.001). A less pronounced pattern of mortality due to respiratory illnesses (but not cancer) was also observed. Conclusion Beyond a broader pattern of seasonally-linked mortality characterised by excess winter deaths, the deadliest time of year in Central Norway coincides with the Christmas holidays. During this time, the pattern and frequency of cardiovascular-related mortality changes markedly; contrasting with a more stable pattern of cancer-related mortality. Pending confirmation in other populations and climates, further research to determine if these excess deaths are preventable is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10503-7.
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Affiliation(s)
- Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,The Women's Clinic, St.Olav Hospital, Trondheim, Norway
| | - Clifford Afoakwah
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Paul Scuffham
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Christine F McDonald
- Department of Respiratory and Sleep Medicine, Austin Health, Institute for Breathing and Sleep, University of Melbourne, Melbourne, Australia
| | - Louise M Burrell
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Simon Stewart
- Torrens University Australia, South Australia, Wakefield Campus, Adelaide, SA, 5000, Australia. .,University of Glasgow, Glasgow, Scotland, UK.
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Kang J, Jeong YJ, Jang JH, Lee M. Risk Factors for Frailty in Critical Care Survivors: A secondary analysis. Intensive Crit Care Nurs 2020; 64:102981. [PMID: 33358896 DOI: 10.1016/j.iccn.2020.102981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 10/26/2020] [Accepted: 11/15/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of frailty and its risk factors among critical care survivors who were discharged after receiving treatment in an intensive care unit. METHODS This was a secondary analysis using data from a methodological study conducted between June and August 2018. The sample included 494 adults who had been admitted to the intensive care unit for more than 48 hours within a year. Only post-intensive care frailty was evaluated using the Kihon Checklist. The sociodemographic and intensive care-related risk factors for frailty were analysed using multivariate logistic regression. RESULTS The prevalence of frailty in the sample was 65.8%. The risk factors for frailty were female sex (adjusted odds ratio [aOR] = 1.68, 95% CI: 1.02-2.78), aged 70 years or older (aOR = 4.16, 95% CI: 2.00-8.65), unemployment (aOR = 2.41, 95% CI: 1.39-4.17) and longer ICU days (aOR = 2.29, 95% CI: 1.35-3.91). Analysis of differences in risk factors according to sex revealed that risk factors for frailty were unemployment and longer ICU length of stay for male and older age for female. CONCLUSION Health care providers should be aware of frailty risk factors in female and male patients and provide patient-specific interventions for preventing frailty.
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Affiliation(s)
- Jiyeon Kang
- College of Nursing, Dong-A University, Busan, South Korea
| | - Yeon Jin Jeong
- Department of Nursing, Dongju College, Busan, South Korea
| | - Jun Hee Jang
- Department of Nursing, Dongju College, Busan, South Korea
| | - Minju Lee
- Department of Nursing, Youngsan University, Yangsan, South Korea.
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Ikäheimo TM, Jokelainen J, Näyhä S, Laatikainen T, Jousilahti P, Laukkanen J, Jaakkola JJK. Cold weather-related cardiorespiratory symptoms predict higher morbidity and mortality. ENVIRONMENTAL RESEARCH 2020; 191:110108. [PMID: 32841633 DOI: 10.1016/j.envres.2020.110108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/13/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Symptoms perceived in cold weather reflect physiological responses to body cooling and may worsen the course of a pre-existing disease or precipitate disease events in ostensibly healthy individuals. However, the associations between cold-related symptoms and their health effects have remained unknown. We examined whether cold-related cardiac and respiratory symptoms perceived in cold weather predict future morbidity and mortality. METHODS Cold-related symptoms were inquired in four national FINRISK surveys conducted in 1997, 2002, 2007, 2012 in Finland including altogether 17 040 respondents. A record linkage was made to national hospital discharge and cause-of-death registers. The participants were followed up until the first hospital admission due to a cardiovascular or respiratory disease or death, or until the end of 2015. The individual follow-up times ranged from 0 to 18 years (mean 11 years). The association of cold-related symptoms with morbidity and mortality was examined by Kaplan-Meyer and Cox-regression analyses. RESULTS Cold-related cardiac [hazard ratio (HR), 1.76 and its 95% confidence interval (95% CI), 1.44-2.15] and combined cardiac and respiratory symptoms [1.50 (1.29-1.73)] were associated with hospitalization due to cardiovascular causes. The respective HRs for admissions due to respiratory causes were elevated for cold-related respiratory [1.22 (1.07-1.40)], cardiac [1.24 (0.88-1.75)] and cardiorespiratory [1.82 (1.50-2.22)] symptoms. Cold-related cardiorespiratory symptoms were associated with deaths from all natural [1.38 (1.11-1.72)], cardiovascular [1.77 (1.28-2.44)] and respiratory [2.19 (0.95-5.06)] causes. INTERPRETATION Cold weather-related symptoms predict a higher occurrence of hospital admissions and mortality. The information may prove useful in planning measures to reduce cold-related adverse health effects.
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Affiliation(s)
- Tiina M Ikäheimo
- Center for Environmental and Respiratory Health Research, University of Oulu, FI-90014, Oulu, Finland; Medical Research Center, University of Oulu, University Hospital of Oulu, Oulu, Finland.
| | - Jari Jokelainen
- Medical Faculty, P.O. Box 5000, University of Oulu, FI-90014, Oulu, Finland; Unit of General Practice, Oulu University Hospital, FI-90029, Oulu, Finland
| | - Simo Näyhä
- Center for Environmental and Respiratory Health Research, University of Oulu, FI-90014, Oulu, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), FI-00271, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, FI-70211, Kuopio, Finland; Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), FI-80210, Joensuu, Finland
| | - Pekka Jousilahti
- Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), FI-00271, Helsinki, Finland
| | - Jari Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, FI-70211, Kuopio, Finland; Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, FI-90014, Oulu, Finland; Medical Research Center, University of Oulu, University Hospital of Oulu, Oulu, Finland
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Imamura T, Combs P, Siddiqi U, Cohen W, Besser S, LaBuhn C, Mirzai S, Jeevanandam V. Winter LVAD implantation is associated with adverse clinical outcomes. Int J Artif Organs 2020; 44:188-193. [PMID: 32907458 DOI: 10.1177/0391398820951810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The seasonal variation of incidence and severity of heart failure is well known. However, the impact of seasonal variation on clinical outcomes following left ventricular assist device (LVAD) implantation remains unknown. METHODS We retrospectively reviewed consecutive patients who received LVAD implantation between January 2014 and December 2016 along with their first year of post-implant outcomes. Clinical outcomes were compared between those with winter LVAD implantation (between October and March) and those with non-winter LVAD implantation. RESULTS 168 patients with a median age of 57 years and 130 males were included. There was no seasonal difference in the number of LVAD implantations. One-year survival free from major adverse events was significantly lower in the winter implant group (n = 88) compared to the non-winter group (n = 80) (44% vs 61%) with an adjusted hazard ratio of 1.81 (95% confidence interval 1.11-2.90, p = 0.014), largely due to a higher rate of heart failure readmission in the winter implant patients (incidence rate ratio 2.29, 95% confidence interval 0.89-5.84). CONCLUSION Patients who underwent LVAD implantation during the winter season had a higher heart failure readmission rate. A detailed mechanism and therapeutic strategy given our findings warrant further investigation.
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Affiliation(s)
- Teruhiko Imamura
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.,Second Department of Medicine, University of Toyama, Toyama, Japan
| | - Pamela Combs
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - Umar Siddiqi
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - William Cohen
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - Stephanie Besser
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Colleen LaBuhn
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - Saeid Mirzai
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
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Seasonal variation in blood pressure: Evidence, consensus and recommendations for clinical practice. Consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens 2020; 38:1235-1243. [DOI: 10.1097/hjh.0000000000002341] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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12
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Dent E, Ambagtsheer RC, Beilby J, Stewart S. Editorial: Frailty and Seasonality. J Nutr Health Aging 2020; 24:547-549. [PMID: 32510104 PMCID: PMC7164411 DOI: 10.1007/s12603-020-1367-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 01/10/2023]
Affiliation(s)
- E Dent
- Elsa Dent, Torrens University Australia, Adelaide, South Australia, Australia,
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