European Heart Journal - Quality of Care and Clinical Outcomes最新文献

{"title":"The Impact of Lifestyle on Cardiovascular Risk in Patients with Gout: a Population-based Cohort Study.","authors":"Seung Min Jung, Sang-Hyuk Jung, Su-Nam Lee, Jin A Choi, Dokyoon Kim, Hong-Hee Won, Ki-Jo Kim, Jae-Seung Yun","doi":"10.1093/ehjqcco/qcae048","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcae048","url":null,"abstract":"<p><strong>Aims: </strong>Gout is associated with a significant burden of cardiovascular disease. The aim of this study was to evaluate the impact of a favorable lifestyle on incident cardiovascular events in patients with gout.</p><p><strong>Methods: </strong>We identified 9 110 patients with gout from the UK Biobank cohort based on self-report and/or hospital diagnostic codes. Lifestyle behaviors, including smoking status, physical activity, obesity, and diet, were categorized into three patterns: favorable (3-4 healthy factors), intermediate (2 healthy factors), and unfavorable (0-1 healthy factor). The cardiovascular risk of participants with and without gout was estimated based on their serum uric acid levels and lifestyle patterns.</p><p><strong>Results: </strong>Among 9 110 patients with gout and 457 596 participants without gout, the median follow-up duration was 8.9 years. The incidence rate of cardiovascular disease was significantly higher in the gout population than in the non-gout population (11.38 vs 5.49 per 1000 person-years). The gout population consistently exhibited a high cardiovascular risk, irrespective of uric acid levels, whereas a positive correlation was observed between uric acid levels and cardiovascular risk in the non-gout population. Adopting a favorable lifestyle pattern was associated with a lower risk of cardiovascular disease in both gout and non-gout populations. Across all categories of uric acid, a favorable lifestyle was found to reduce cardiovascular risk in patients with gout.</p><p><strong>Conclusion: </strong>Patients with gout remain at high risk of developing cardiovascular disease despite having normal uric acid levels. Lifestyle modifications may represent an effective and cost-efficient therapeutic approach for preventing cardiovascular events in this population.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Ischemic Heart Disease from 2022 to 2050: Projections of Incidence, Prevalence, Deaths, and Disability-Adjusted Life Years.","authors":"Hujuan Shi, Yihang Xia, Yiran Cheng, Pengcheng Liang, Mingmei Cheng, Baoliang Zhang, Zhen Liang, Yanzhong Wang, Wanqing Xie","doi":"10.1093/ehjqcco/qcae049","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcae049","url":null,"abstract":"<p><strong>Aims: </strong>Ischemic heart disease (IHD) has been a significant public health issue worldwide. This study aims to predict the global burden of IHD in a timely and comprehensive manner.</p><p><strong>Methods and results: </strong>Incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for IHD from 1990 to 2021 were derived from the Global Burden of Disease 2021 database and three models (linear, exponential, and Poisson regression) were used to estimate their trends over time at the global, regional, and national levels by age, sex, and country groups, with the gross domestic product per capita was applied to adjust the model. The model results revealed that the global burden of IHD is expected to increase continuously by 2050. By 2050, global IHD incidence, prevalence, deaths, and DALYs are projected to reach 67.3 million, 510 million, 16 million, and 302 million, respectively, which represents an increase of 116%, 106%, 80%, and 62% from 2021. Moreover, the results showed that regions with lower socio-demographic index (SDI) bore a greater burden of IHD than those with higher SDI, with men having a higher burden of IHD than women. People over 70 years old account for a major part of the burden of IHD, and premature death of IHD is also becoming more serious.</p><p><strong>Conclusion: </strong>The global burden of IHD will increase further by 2050, potentially due to population aging and economic disparities. Hence, it is necessary to strengthen the prevention of IHD and formulate targeted strategies according to different SDI regions and special populations.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Early Accumulation of Serum Uric Acid Confers More Risk of Heart Failure: A 10-year Prospective Cohort Study.","authors":"Xue Tian, Shuohua Chen, Yijun Zhang, Xue Xia, Qin Xu, Shouling Wu, Anxin Wang","doi":"10.1093/ehjqcco/qcae054","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcae054","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the longitudinal association of serum uric acid (SUA) with the risk of heart failure (HF) was limited and controversial. This study aimed to investigate the associations of cumulative SUA (cumSUA), incorporating its time course of accumulation, with the risk of HF.</p><p><strong>Methods: </strong>This prospective study enrolled 54,606 participants from the Kailuan study. The magnitude of SUA accumulation was expressed as cumSUA, exposure duration, and cumulative burden from baseline to the third survey, with cumSUA, calculated by multiplying mean values between consecutive examinations by time intervals between visits, as the primary exposure.</p><p><strong>Results: </strong>During a median follow-up of 10.00 years, 1,260 cases of incident HF occurred. A higher risk of HF was observed in participants with the highest versus the lowest quartile of cumSUA (adjusted hazard ratio [aHR], 1.54; 95% confidence interval [CI], 1.29-1.84), 6-years (6 years) versus 0-year exposure duration (aHR, 1.87; 95% CI, 1.43-2.45), cumulative burden >0 versus =0 (aHR, 1.55; 95 CI, 1.29-1.86), and those with a negative versus positive SUA slope (aHR, 1.12; 95% CI, 1.02-1.25). When cumSUA was incorporated with its time course, those with cumSUA≥median and a negative SUA slope had the highest risk of HF (aHR, 1.55; 95% CI, 1.29-1.86).</p><p><strong>Conclusions: </strong>Incident HF risk was associated with the magnitude and time course of cumSUA accumulation. Early accumulation resulted in a greater risk of HF than later accumulation, indicating the importance of optimal SUA control earlier in life.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education level and the use of coronary computed tomography, functional testing, coronary angiography, revascularization, and outcomes-a 10-year Danish, nationwide, registry-based follow-up study.","authors":"Marc Meller Søndergaard, Phillip Freeman, Anna Meta Dyrvig Kristensen, Su Min Chang, Khurram Nassir, Martin Bødtker Mortensen, Bjarne Linde Nørgaard, Michael Maeng, Mikkel Porsborg Andersen, Peter Søgaard, Bhupendar Tayal, Manan Pareek, Søren Paaske Johnsen, Lars Køber, Gunnar Gislason, Christian Torp-Pedersen, Kristian Hay Kragholm","doi":"10.1093/ehjqcco/qcad052","DOIUrl":"10.1093/ehjqcco/qcad052","url":null,"abstract":"<p><strong>Background and aims: </strong>Coronary computed tomography angiography (CCTA) can guide downstream preventive treatment and improve patient prognosis, but its use in relation to education level remains unexplored.</p><p><strong>Methods: </strong>This nationwide register-based cohort study assessed all residents in Denmark between 2008 and 2018 without coronary artery disease (CAD) and 50-80 years of age (n = 1 469 724). Residents were divided according to four levels of education: low, lower-mid, higher-mid, and high. Outcomes were CCTA, functional testing, invasive coronary angiography (ICA), revascularization, and major adverse cardiovascular and cerebrovascular events (MACCE).</p><p><strong>Results: </strong>Individuals with the lowest education level underwent CCTA (absolute risk [AR] 3.95% individuals aged ≥50-59, AR 3.62% individuals aged ≥60-69, and AR 2.19% individuals aged ≥70-80) less often than individuals of lower-mid (AR 4.16%, AR 3.90%, and AR 2.41%), higher-mid (AR 4.38%, AR 4.30%, and AR 2.45%) and highest education level (AR 3.98%, AR 4.37%, and AR 2.30%). Similar differences were observed for functional testing. Conversely, use of ICA, and risks of revascularization and MACCE were more common among individuals of lowest education level. Among patients examined with CCTA (n = 50 234), patients of lowest education level less often underwent functional testing and more likely initiated preventive medication, underwent ICA, revascularization, and experienced MACCE.</p><p><strong>Conclusion: </strong>Despite tax-financed healthcare in Denmark, individuals of lowest education level were less likely to undergo CCTA and functional testing than persons of higher education level. Invasive coronary angiography utilization, revascularization, and MACCE risks were higher for individuals of lowest education level. Among CCTA-examined patients, patients of lowest education level were more likely to initiate preventive medication and had the highest risks of revascularization and MACCE when compared to higher education level groups. These findings suggest that the preventive potential of CCTA is underutilized in individuals of lower education level, a proxy for socioeconomic status. Socioeconomic differences in CAD assessment, care, and outcomes are likely even larger without tax-financed healthcare.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"294-304"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of incident cardiovascular disease among patients with gastrointestinal disorder: a prospective cohort study of 330 751 individuals.","authors":"Jie Chen, Yuhao Sun, Tian Fu, Shiyuan Lu, Wenming Shi, Jianhui Zhao, Sen Li, Xue Li, Shuai Yuan, Susanna C Larsson","doi":"10.1093/ehjqcco/qcad059","DOIUrl":"10.1093/ehjqcco/qcad059","url":null,"abstract":"<p><strong>Background and aims: </strong>The associations between gastrointestinal diseases (GIs) and cardiovascular disease (CVD) were unclear. We conducted a prospective cohort study to explore their associations.</p><p><strong>Methods: </strong>This study included 330 751 individuals without baseline CVD from the UK Biobank cohort. Individuals with and without GIs were followed up until the ascertainment of incident CVDs, including coronary heart disease (CHD), cerebrovascular disease (CeVD), heart failure (HF), and peripheral artery disease (PAD). The diagnosis of diseases was confirmed with combination of the nationwide inpatient data, primary care data, and cancer registries. A multivariable Cox proportional hazard regression model was used to estimate the associations between GIs and the risk of incident CVD.</p><p><strong>Results: </strong>During a median follow-up of 11.8 years, 31 605 incident CVD cases were diagnosed. Individuals with GIs had an elevated risk of CVD (hazard ratio 1.37; 95% confidence interval 1.34-1.41, P < 0.001). Eleven out of 15 GIs were associated with an increased risk of CVD after Bonferroni-correction, including cirrhosis, non-alcoholic fatty liver disease, gastritis and duodenitis, irritable bowel syndrome, Barrett's esophagus, gastroesophageal reflux disease, peptic ulcer, celiac disease, diverticulum, appendicitis, and biliary disease. The associations were stronger among women, individuals aged ≤60 years, and those with body mass index ≥25 kg/m2.</p><p><strong>Conclusions: </strong>This large-scale prospective cohort study revealed the associations of GIs with an increased risk of incident CVD, in particular CHD and PAD. These findings support the reinforced secondary CVD prevention among patients with gastrointestinal disorders.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"357-365"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41117046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workforce affiliation in primary and secondary prevention implantable cardioverter defibrillator patients: a nationwide Danish study.","authors":"Simone H Rosenkranz, Charlotte H Wichmand, Lærke Smedegaard, Sidsel Møller, Jenny Bjerre, Morten Schou, Christian Torp-Pedersen, Berit T Philbert, Charlotte Larroudé, Thomas M Melchior, Jens C Nielsen, Jens B Johansen, Sam Riahi, Teresa Holmberg, Gunnar Gislason, Anne-Christine Ruwald","doi":"10.1093/ehjqcco/qcad054","DOIUrl":"10.1093/ehjqcco/qcad054","url":null,"abstract":"<p><strong>Background and aim: </strong>There are a paucity of studies investigating workforce affiliation in connection with first-time implantable cardioverter defibrillator (ICD)-implantation. This study explored workforce affiliation and risk markers associated with not returning to work in patients with ICDs.</p><p><strong>Methods: </strong>Using the nationwide Danish registers, patients with a first-time ICD-implantation between 2007 and 2017 and of working age (30-65 years) were identified. Descriptive statistic and logistic regression models were used to describe workforce affiliation and to estimate risk markers associated with not returning to work, respectively. All analyses were stratified by indication for implantation (primary and secondary prevention).</p><p><strong>Results: </strong>Of the 4659 ICD-patients of working age, 3300 patients (71%) were members of the workforce (employed, on sick leave or unemployed) (primary: 1428 (43%); secondary:1872 (57%)). At baseline, 842 primary and 1477 secondary prevention ICD-patients were employed. Of those employed at baseline, 81% primary and 75% secondary prevention ICD-patients returned to work within 1 year, whereof more than 80% remained employed the following year. Among patients receiving sick leave benefits at baseline, 25% were employed after 1 year. Risk markers of not returning to work were 'younger age' in primary prevention ICD-patients, while 'female sex', left ventricular ejection fraction 'LVEF ≤40', 'lower income', and '≥3 comorbidities' were risk markers in secondary prevention ICD-patients. Lower educational level was a risk marker in both patient groups.</p><p><strong>Conclusion: </strong>High return-to-work proportions following ICD-implantation, with a subsequent high level of employment maintenance were found. Several significant risk markers of not returning to work were identified including 'lower educational level' that posed a risk in both patient groups.</p><p><strong>Trial registration number: </strong>Capital Region of Denmark, P-2019-051.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"314-325"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cost-effectiveness analysis of hypertrophic cardiomyopathy sudden cardiac death risk algorithms for implantable cardioverter defibrillator decision-making.","authors":"Nathan Green, Yang Chen, Constantinos O'Mahony, Perry M Elliott, Roberto Barriales-Villa, Lorenzo Monserrat, Aristides Anastasakis, Elena Biagini, Juan Ramon Gimeno, Giuseppe Limongelli, Menelaos Pavlou, Rumana Z Omar","doi":"10.1093/ehjqcco/qcad050","DOIUrl":"10.1093/ehjqcco/qcad050","url":null,"abstract":"<p><strong>Aims: </strong>To conduct a contemporary cost-effectiveness analysis examining the use of implantable cardioverter defibrillators (ICDs) for primary prevention in patients with hypertrophic cardiomyopathy (HCM).</p><p><strong>Methods: </strong>A discrete-time Markov model was used to determine the cost-effectiveness of different ICD decision-making rules for implantation. Several scenarios were investigated, including the reference scenario of implantation rates according to observed real-world practice. A 12-year time horizon with an annual cycle length was used. Transition probabilities used in the model were obtained using Bayesian analysis. The study has been reported according to the Consolidated Health Economic Evaluation Reporting Standards checklist.</p><p><strong>Results: </strong>Using a 5-year SCD risk threshold of 6% was cheaper than current practice and has marginally better total quality adjusted life years (QALYs). This is the most cost-effective of the options considered, with an incremental cost-effectiveness ratio of £834 per QALY. Sensitivity analyses highlighted that this decision is largely driven by what health-related quality of life (HRQL) is attributed to ICD patients and time horizon.</p><p><strong>Conclusion: </strong>We present a timely new perspective on HCM-ICD cost-effectiveness, using methods reflecting real-world practice. While we have shown that a 6% 5-year SCD risk cut-off provides the best cohort stratification to aid ICD decision-making, this will also be influenced by the particular values of costs and HRQL for subgroups or at a local level. The process of explicitly demonstrating the main factors, which drive conclusions from such an analysis will help to inform shared decision-making in this complex area for all stakeholders concerned.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"285-293"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer and the risk of perioperative arterial ischaemic events.","authors":"Babak B Navi, Cenai Zhang, Jed H Kaiser, Vanessa Liao, Mary Cushman, Scott E Kasner, Mitchell S V Elkind, Scott T Tagawa, Saketh R Guntupalli, Mario F L Gaudino, Agnes Y Y Lee, Alok A Khorana, Hooman Kamel","doi":"10.1093/ehjqcco/qcad057","DOIUrl":"10.1093/ehjqcco/qcad057","url":null,"abstract":"<p><strong>Background and aims: </strong>Most cancer patients require surgery for diagnosis and treatment. This study evaluated whether cancer is a risk factor for perioperative arterial ischaemic events.</p><p><strong>Methods: </strong>The primary cohort included patients registered in the National Surgical Quality Improvement Program (NSQIP) between 2006 and 2016. The secondary cohort included Healthcare Cost and Utilization Project (HCUP) claims data from 11 US states between 2016 and 2018. Study populations comprised patients who underwent inpatient (NSQIP, HCUP) or outpatient (NSQIP) surgery. Study exposures were disseminated cancer (NSQIP) and all cancers (HCUP). The primary outcome was a perioperative arterial ischaemic event, defined as myocardial infarction or stroke diagnosed within 30 days after surgery.</p><p><strong>Results: </strong>Among 5 609 675 NSQIP surgeries, 2.2% involved patients with disseminated cancer. The perioperative arterial ischaemic event rate was 0.96% among patients with disseminated cancer vs. 0.48% among patients without (hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.90-2.13). In Cox analyses adjusting for demographics, functional status, comorbidities, surgical specialty, anesthesia type, and clinical factors, disseminated cancer remained associated with higher risk of perioperative arterial ischaemic events (HR, 1.37; 95% CI, 1.28-1.46). Among 1 341 658 surgical patients in the HCUP cohort, 11.8% had a diagnosis of cancer. A perioperative arterial ischaemic event was diagnosed in 0.74% of patients with cancer vs. 0.54% of patients without cancer (HR, 1.35; 95% CI, 1.27-1.43). In Cox analyses adjusted for demographics, insurance, comorbidities, and surgery type, cancer remained associated with higher risk of perioperative arterial ischaemic events (HR, 1.31; 95% CI, 1.21-1.42).</p><p><strong>Conclusion: </strong>Cancer is an independent risk factor for perioperative arterial ischaemic events.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"345-356"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy, clinical characteristics, and prognostic differences of patients with acute myocarditis according to inclusion criteria.","authors":"Roman Roy, Antonio Cannata, Mohammad Al-Agil, Emma Ferone, Antonio Jordan, Brian To-Dang, Matthew Sadler, Aamir Shamsi, Mohammad Albarjas, Susan Piper, Mauro Giacca, Ajay M Shah, Theresa McDonagh, Daniel I Bromage, Paul A Scott","doi":"10.1093/ehjqcco/qcad061","DOIUrl":"10.1093/ehjqcco/qcad061","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of acute myocarditis (AM) is complex due to its heterogeneity and typically is defined by either Electronic Healthcare Records (EHRs) or advanced imaging and endomyocardial biopsy, but there is no consensus. We aimed to investigate the diagnostic accuracy of these approaches for AM.</p><p><strong>Methods: </strong>Data on ICD 10th Revision(ICD-10) codes corresponding to AM were collected from two hospitals and compared to cardiac magnetic resonance (CMR)-confirmed or clinically suspected (CS)-AM cases with respect to diagnostic accuracy, clinical characteristics, and all-cause mortality. Next, we performed a review of published AM studies according to inclusion criteria.</p><p><strong>Results: </strong>We identified 291 unique admissions with ICD-10 codes corresponding to AM in the first three diagnostic positions. The positive predictive value of ICD-10 codes for CMR-confirmed or CS-AM was 36%, and patients with CMR-confirmed or CS-AM had a lower all-cause mortality than those with a refuted diagnosis (P = 0.019). Using an unstructured approach, patients with CMR-confirmed and CS-AM had similar demographics, comorbidity profiles and survival over a median follow-up of 52 months (P = 0.72). Our review of the literature confirmed our findings. Outcomes for patients included in studies using CMR-confirmed criteria were favourable compared to studies with endomyocardial biopsy-confirmed AM cases.</p><p><strong>Conclusion: </strong>ICD-10 codes have poor accuracy in identification of AM cases and should be used with caution in clinical research. There are important differences in management and outcomes of patients according to the selection criteria used to diagnose AM. Potential selection biases must be considered when interpreting AM cohorts and requires standardization of inclusion criteria for AM studies.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"366-378"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and societal costs in patients with dilated cardiomyopathy.","authors":"Isabell Wiethoff, Maurits Sikking, Silvia Evers, Andrea Gabrio, Michiel Henkens, Michelle Michels, Job Verdonschot, Stephane Heymans, Mickaël Hiligsmann","doi":"10.1093/ehjqcco/qcad056","DOIUrl":"10.1093/ehjqcco/qcad056","url":null,"abstract":"<p><strong>Aims: </strong>Dilated cardiomyopathy (DCM) is a major cause of heart failure impairing patient wellbeing and imposing a substantial economic burden on society, but respective data are missing. This study aims to measure the quality of life (QoL) and societal costs of DCM patients.</p><p><strong>Methods and results: </strong>A cross-sectional evaluation of QoL and societal costs of DCM patients was performed through the 5-level EuroQol and the Medical Consumption Questionnaire and Productivity Cost Questionnaire, respectively. QoL was translated into numerical values (i.e. utilities). Costs were measured from a Dutch societal perspective. Final costs were extrapolated to 1 year, reported in 2022 Euros, and compared between DCM severity according to NYHA classes. A total of 550 DCM patients from the Maastricht cardiomyopathy registry were included. Mean age was 61 years, and 34% were women. Overall utility was slightly lower for DCM patients than the population mean (0.840 vs. 0.869, P = 0.225). Among EQ-5D dimensions, DCM patients scored lowest in 'usual activities'. Total societal DCM costs were €14 843 per patient per year. Cost drivers were productivity losses (€7037) and medical costs (€4621). Patients with more symptomatic DCM (i.e. NYHA class III or IV) had significantly higher average DCM costs per year compared to less symptomatic DCM (€31 099 vs. €11 446, P < 0.001) and significantly lower utilities (0.631 vs. 0.883, P < 0.001).</p><p><strong>Conclusion: </strong>DCM is associated with high societal costs and reduced QoL, in particular with high DCM severity.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"334-344"},"PeriodicalIF":4.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}