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Beri B, Fanta K, Bekele F, Bedada W. Management, clinical outcomes, and its predictors among heart failure patients admitted to tertiary care hospitals in Ethiopia: prospective observational study. BMC Cardiovasc Disord 2023; 23:4. [PMID: 36609240 PMCID: PMC9821349 DOI: 10.1186/s12872-022-03008-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/13/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Heart failure is a global pandemic, as it affects approximately 64.34 million people worldwide with a $346.17 billion global economic burden. The prevalence of heart failure has increased from 43.4 to 46.5% in the last 10 years in lower and middle-income countries. Most of the studies conducted in Ethiopia were retrospective cross-sectional, with limited study participants, and conducted in a single setting that commonly addresses the prevalence and pattern of heart failure rather than clinical outcome, associated factors, and specific management in different areas. Hence, this study aimed to assess management, clinical outcomes and their predictors among heart failure patients admitted to tertiary care hospitals in Ethiopia. METHODS A prospective observational study design was conducted on heart failure patients admitted at two tertiary care hospitals in Ethiopia from September 2020 to May 2021. Using semi-structured questionnaires relevant data were collected from patients' medical records and face-to-face interviewing. Data were analyzed using SPSS version 23.0. A multivariate Cox regression model was performed to identify independent predictors of 90-day all-cause mortality. Variables with P values < 0.05 were considered statistically significant. RESULTS Out of 283 patients enrolled in this study, 52.3% were male and the mean (± SD) age was 52.4 ± 17.9 years. The most common medications prescribed during hospitalization and discharge were diuretics (98.9% vs 95.6%), angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers (48.8% vs 67.3%), and beta-blockers (46.6% vs 64.7%), respectively. In the present study, the 90-day all-cause mortality was 10.2%. Hypertension (HR = 3.7, 95% CI 1.2-11.6), cardiogenic shock (HR = 8.7, 95% CI 3.2-20.8), alcohol drinking (HR = 2.8, 95% CI 1.1-7.8), absence of angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers (HR = 0.02, 95% CI 0.0-0.2), and reduced ejection fraction (HR = 1.5, 95% CI 1.1-3.8) were predictors of 90-day all-cause mortality. CONCLUSION High 90-day all-cause mortality was observed among heart failure patients in the present study. In the current study, the majority of heart failure patients were treated with diuretics. Alcohol drinking, hypertension, cardiogenic shock, reduced ejection fraction, and absence of angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers drugs were predictors of poor treatment outcomes for whom restriction of alcohol consumption, early management of hypertension, reduced ejection fraction, cardiogenic shock, and providing angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers drugs for all heart failure patients would be recommended to improve these poor treatment outcomes.
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Affiliation(s)
- Berhanu Beri
- grid.411903.e0000 0001 2034 9160Clinical Pharmacy Course and Research Team, School of Pharmacy, Institute of Health Sciences, Jimma University, P.O.Box: 378, Jimma, Oromia Ethiopia
| | - Korinan Fanta
- grid.411903.e0000 0001 2034 9160Clinical Pharmacy Course and Research Team, School of Pharmacy, Institute of Health Sciences, Jimma University, P.O.Box: 378, Jimma, Oromia Ethiopia
| | - Fekede Bekele
- grid.411903.e0000 0001 2034 9160Clinical Pharmacy Course and Research Team, School of Pharmacy, Institute of Health Sciences, Jimma University, P.O.Box: 378, Jimma, Oromia Ethiopia
| | - Worku Bedada
- Institute of Health Sciences, Adama Comprehensive Specialized Medical College, P.O.Box: 84, Adama, Oromia Ethiopia
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Aynalem M, Adane T, Getawa S. Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital. Vasc Health Risk Manag 2022; 18:617-627. [PMID: 35959111 PMCID: PMC9362846 DOI: 10.2147/vhrm.s371912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Heart disease is a leading cause of hospitalization, death, and poor physical function due to comorbid conditions such as atrial fibrillation and stroke. It affects the blood hemostatic system, vasculature, and flow dynamics, causing both arterial and venous thrombosis. Thus, this study aimed to determine the magnitude of coagulation abnormalities among patients with heart disease attending the University of Gondar Comprehensive Specialized hospital. Methods A cross-sectional study was conducted on a total of 98 patients with heart disease. Pretested structured questionnaires were used to collect data on socio-demographic and clinical variables. About 6 mL of venous blood was collected with the vacutainer method and analyzed using Huma cue-due plus and Sysmex KX-21N hematology analyzers for assessing coagulation abnormalities. Stool samples were processed via a direct wet mount. Thin and thick blood films were examined to assess malaria parasites. Data was entered into EPI-Info version 3.5.3 and then transported to SPSS version 20 for analysis. Descriptive statistics were summarized using frequency and percentage. Univariate and multivariate logistic regression models were fitted to identify factors associated with coagulopathy. P-value <0.05 was considered to be statistically significant. Results The overall magnitude of coagulation abnormalities (thrombocytopenia, prolonged prothrombin time, and activated partial thromboplastin time) in patients with heart diseases was 85.7% (95% CI: 81.96, 89.45). Besides, prolonged prothrombin time, prolonged activated partial thromboplastin time, and thrombocytopenia were detected in 83.7%, 33.7%, and 12.2% of the study participants, respectively. Participants who are taking medications for chronic disease (AOR = 0.17; 95% CI: 0.04, 0.69), participants with stroke (AOR = 20; 95% CI: 14.7, 35), and participants taking antibiotics (AOR = 8.17; 95% CI: 1.66, 40.27) were significantly associated with prolonged coagulation time. Conclusion This study showed that patients with heart disease had prolonged prothrombin time, activated partial thromboplastin time, and thrombocytopenia. Therefore, coagulation parameters are required to be checked regularly to monitor coagulation disorders and their complications in heart disease patients.
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Affiliation(s)
- Melak Aynalem
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Solomon Getawa, Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia, Tel +251-914-665-736, Email
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Mo L, Lu G, Ou X, Ouyang D. Formulation and development of novel control release transdermal patches of carvedilol to improve bioavailability for the treatment of heart failure. Saudi J Biol Sci 2022; 29:266-272. [PMID: 35002418 PMCID: PMC8717168 DOI: 10.1016/j.sjbs.2021.08.088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022] Open
Abstract
The main aim of this study is to optimize and evaluate transdermal patch of Carvedilol by the use of different polymer and different permeation enhancers which help to release drug in controlled action and thereby increase the bioavailability of the drug. Main objective was to avoid first pass metabolism of Carvedilol. Transdermal patches were developed by solvent evaporation method. The combination of Eudragit RS-100 as rate controlling polymer and Span 80 as a permeation enhancer was found to be ideal formulation (Formulation F7) with maximum drug release i.e. 100.29 ± 0.44 % within 12 h. Formulation F7 showed maximum bioavailability and showed maximum drop of BP at 6 h. From this study the conclusion was, transdermal patch of Carvedilol which contains Eudragit RS-100 polymer and Span 80 as penetration enhancer produced sustained and continued drug release.
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Affiliation(s)
- Long Mo
- Department of cardiology, Xiangya hospital central south university, Changsha, Hunan 410008, China
| | - Guijing Lu
- Department of cardiology, Xiangya hospital central south university, Changsha, Hunan 410008, China
| | - Xiping Ou
- Department of cardiology, Xiangya hospital central south university, Changsha, Hunan 410008, China
| | - Dongsheng Ouyang
- Institute of clinical pharmacology, Central South University, Changsha, Hunan 410005, China
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İlaslan E, Özer Z. Web-Based Training and Telephone Follow-up of Patients With Heart Failure: Randomized Controlled Trial. Comput Inform Nurs 2021; 40:82-89. [PMID: 34570004 DOI: 10.1097/cin.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study was carried out to determine the effect of Web-based training and telephone follow-up on symptom burden and health status in patients with heart failure. Patient training and postdischarge follow-up are necessary to improve symptom management and quality of life in patients with heart failure. In Turkey, Web-based education and phone monitoring are not very common yet. In this parallel randomized controlled trial, patients were allocated to a control group (n = 32) or an intervention group (n = 32). The control group received routine care, and the intervention group was administered the following interventions in addition to routine care: Web-based training, four-session telephone follow-up, and one text message weekly. All results regarding symptom management and quality of life were assessed beginning and at the 12th week. The Consolidated Standards of Reporting Trials checklist was used. In the 12th week after discharge, patients in the intervention group showed a significant improvement in terms of symptom burden and health status compared with the control group.
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Affiliation(s)
- Emine İlaslan
- Author Affiliations: Kumluca Faculty of Health Sciences (Dr İlaslan) and Faculty of Nursing (Dr Özer), Akdeniz University, Antalya/Turkey
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Gachpazan M, Mohammadinejad A, Saeidinia A, Rahimi HR, Ghayour-Mobarhan M, Vakilian F, Rezayi M. A review of biosensors for the detection of B-type natriuretic peptide as an important cardiovascular biomarker. Anal Bioanal Chem 2021; 413:5949-5967. [PMID: 34396470 DOI: 10.1007/s00216-021-03490-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/31/2021] [Accepted: 06/17/2021] [Indexed: 12/26/2022]
Abstract
Heart disease, as the most serious threat to human health globally, is responsible for rising mortality rates, largely due to lifestyle and diet. Unfortunately, the main problem for patients at high risk of heart disease is the validation of prognostic tests. To this end, the detection of cardiovascular biomarkers has been employed to obtain pathological and physiological information in order to improve prognosis and early-stage diagnosis of chronic heart failure. Short-term changes in B-type natriuretic peptide are known as a standard and important biomarker for diagnosis of heart failure. The most important problem for detection is low concentration and short half-life in the blood. The normal concentration of BNP in blood is less than 7 nM (25 pg/mL), which increases significantly to more than 80 pg/mL. Therefore, the development of new biosensors with better sensitivity, detection limit, and dynamic range than current commercial kits is urgently needed. This review classifies the biosensors designed for detection of BNP into electrochemical, optical, microfluidic, and lateral-flow immunoassay techniques. The review clearly demonstrates that a variety of immunoassay, aptasensor, enzymatic and catalytic nanomaterials, and fluorophores have been successfully employed for detection of BNP at low attomolar ranges. Dtection of B-type natriuretic peptide with biosensors.
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Affiliation(s)
- Meysam Gachpazan
- Medical Genetics Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran
| | - Arash Mohammadinejad
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran
| | - Amin Saeidinia
- Pediatric Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.,Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, 9196773117, Iran
| | - Hamid Reza Rahimi
- Vascular and Endovascular Surgery Research Center, Alavi Hospital, Mashhad University of Medical Sciences, Mashhad, 9177899191, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran
| | - Farveh Vakilian
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9176699199, Iran
| | - Majid Rezayi
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran. .,Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran. .,Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.
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Gedfew M, Ayenew T, Mengst B, Yirga T, Zelalem M, Worku Y, Liknaw T. <p>Incidence and Predictors of Congestive Heart Failure Among Hemodialysis Patients at Felege Hiote Referral Hospital, Northwest Ethiopia, 2020: Retrospective Cohort Study</p>. RESEARCH REPORTS IN CLINICAL CARDIOLOGY 2020. [DOI: 10.2147/rrcc.s274942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Mahmoudi S, Jalali A, Ahmadi M, Abasi P, Salari N. Identifying critical success factors in Heart Failure Self-Care using fuzzy DEMATEL method. Appl Soft Comput 2019. [DOI: 10.1016/j.asoc.2019.105729] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Koirala B, Himmelfarb CD, Budhathoki C, Tankumpuan T, Asano R, Davidson PM. Factors affecting heart failure self-care: An integrative review. Heart Lung 2018; 47:539-545. [PMID: 30316455 DOI: 10.1016/j.hrtlng.2018.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Binu Koirala
- School of Nursing, Johns Hopkins University, United States.
| | - Cheryl Dennison Himmelfarb
- Institute for Clinical Translational Research, School of Nursing, Johns Hopkins University, United States
| | | | | | - Reiko Asano
- School of Nursing, Johns Hopkins University, United States
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