The American journal of cardiology最新文献

Prognostic Value of Liver Fibrotic Markers in Patients With Heart Failure. 肝纤维化标志物在心力衰竭患者中的预后价值。

The American journal of cardiology Pub Date : 2023-06-10 DOI: 10.2139/ssrn.4333060

A. Tada, T. Nagai, Yoshiya Kato, N. Oyama-Manabe, S. Tsuneta, M. Nakai, Y. Yasui, S. Kazui, Y. Takahashi, K. Saiin, S. Naito, S. Takenaka, Y. Mizuguchi, Y. Kobayashi, S. Ishizaka, K. Omote, Takuma Sato, T. Konishi, K. Kamiya, K. Kudo, T. Anzai

{"title":"Prognostic Value of Liver Fibrotic Markers in Patients With Heart Failure.","authors":"A. Tada, T. Nagai, Yoshiya Kato, N. Oyama-Manabe, S. Tsuneta, M. Nakai, Y. Yasui, S. Kazui, Y. Takahashi, K. Saiin, S. Naito, S. Takenaka, Y. Mizuguchi, Y. Kobayashi, S. Ishizaka, K. Omote, Takuma Sato, T. Konishi, K. Kamiya, K. Kudo, T. Anzai","doi":"10.2139/ssrn.4333060","DOIUrl":"https://doi.org/10.2139/ssrn.4333060","url":null,"abstract":"Several liver fibrotic markers are associated with prognosis in patients with heart failure (HF). However, the optimal markers for outcome prediction remain unclear. This study aimed to simultaneously investigate the prognostic value of liver fibrotic markers and the associations between these markers and clinical parameters in patients with HF without organic liver disease. We prospectively examined 211 consecutive patients with chronic HF between April 2018 and August 2021, excluding those with organic liver disease, using liver magnetic resonance imaging and ultrasound. A total of 7 representative liver fibrotic markers were measured in all patients. The primary outcome of interest was the composite of all-cause death and hospitalization for worsening HF. During a median follow-up period of 747 (interquartile range 465 to 1,042) days, the primary outcome occurred in 45 patients. Patients with higher hyaluronic acid and type III procollagen N-terminal peptide (P-III-P) levels showed a significantly higher incidence of the primary outcome than those without (p <0.001 and p = 0.005, respectively). The multivariable Cox regression analysis revealed that hyaluronic acid and P-III-P levels were independently associated with the risk of adverse events (hazard ratio 1.84, 95% confidence interval 1.18 to 2.87 and hazard ratio 2.89, 95% confidence interval 1.32 to 6.34, respectively) even after adjustment for a mortality prediction model, whereas the other 5 markers were not associated with the primary outcome. In conclusion, among the representative liver fibrotic markers, hyaluronic acid and P-III-P might be the optimal markers for outcome prediction in patients with HF.","PeriodicalId":443997,"journal":{"name":"The American journal of cardiology","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121563208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Medical Costs of Chronic Kidney Disease and Type 2 Diabetes Among Newly Diagnosed Heart Failure Patients With Reduced, Mildly Reduced, and Preserved Ejection Fraction. 射血分数降低、轻度降低和保留的新诊断心力衰竭患者慢性肾病和2型糖尿病的医疗费用

The American journal of cardiology Pub Date : 2023-05-18 DOI: 10.2139/ssrn.4107080

G. Nichols, Q. Qiao, S. Linden, B. Kraus

{"title":"Medical Costs of Chronic Kidney Disease and Type 2 Diabetes Among Newly Diagnosed Heart Failure Patients With Reduced, Mildly Reduced, and Preserved Ejection Fraction.","authors":"G. Nichols, Q. Qiao, S. Linden, B. Kraus","doi":"10.2139/ssrn.4107080","DOIUrl":"https://doi.org/10.2139/ssrn.4107080","url":null,"abstract":"The economic burden of heart failure (HF) is enormous, but studies of HF costs typically consider the disease to be a single entity. We sought to distinguish the medical costs for patients with HF with reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF). We identified 16,516 adult patients with an incident HF diagnosis and an echocardiogram from 2005 to 2017 in the electronic medical record of Kaiser Permanente Northwest. Using the echocardiogram nearest to the first diagnosis date, we classified patients with HFrEF (ejection fraction [EF] ≤40%), HFmrEF (EF 41% to 49%), or HFpEF (EF ≥50%). We calculated annualized inpatient, outpatient, emergency, pharmaceutical medical utilization and costs and total costs in $2,020, adjusted for age and gender using generalized linear models, with further analysis of the effects of co-morbid chronic kidney disease (CKD) and type 2 diabetes (T2D). For all HF types, 1 in 5 patients were affected by both CKD and T2D, and costs were significantly higher when both co-morbidities were present. Total per-person costs were significantly higher for HFpEF ($33,740, 95% confidence interval $32,944 to $34,536) than HFrEF ($27,669, $25,649 to $29,689) or HFmrEF ($29,484, $27,166 to $31,800), driven by in- and outpatient visits. Across HF types, visits approximately doubled with the presence of both co-morbidities. Due to greater prevalence, HFpEF accounted for the majority of total and resource-specific treatment costs of HF, regardless of the presence of CKD and/or T2D. In summary, the economic burden was greater per HFpEF patient and was further amplified by co-morbid CKD and T2D. HFpEF accounted for the large majority of total HF costs, underscoring the need to implement effective treatments.","PeriodicalId":443997,"journal":{"name":"The American journal of cardiology","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134138906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Direct Oral Anticoagulants Affect Activated Clotting Time During and Bleeding Events After Percutaneous Coronary Intervention 直接口服抗凝剂影响经皮冠状动脉介入治疗期间和出血事件的活化凝血时间

The American journal of cardiology Pub Date : 2023-03-03 DOI: 10.1101/2023.02.28.23286600

E. Shibahashi, T. Abe, K. Kamishima, S. Ebihara, T. Moriyama, K. Shimazaki, Katsumi Saito, Y. Uchigata, K. Jujo

{"title":"Direct Oral Anticoagulants Affect Activated Clotting Time During and Bleeding Events After Percutaneous Coronary Intervention","authors":"E. Shibahashi, T. Abe, K. Kamishima, S. Ebihara, T. Moriyama, K. Shimazaki, Katsumi Saito, Y. Uchigata, K. Jujo","doi":"10.1101/2023.02.28.23286600","DOIUrl":"https://doi.org/10.1101/2023.02.28.23286600","url":null,"abstract":"Background: Inappropriately high activated clotting time (ACT) during percutaneous coronary intervention (PCI) is associated with an increased risk of bleeding events. However, whether the prescription of direct oral anticoagulants (DOAC) affects ACT kinetics during heparin use and adverse clinical events in patients undergoing PCI remains unclear. To evaluate the ACT changes during and adverse clinical events after PCI in patients who were prescribed DOAC. Methods: This observational study included 246 patients undergoing PCI at the two cardiovascular centers who were not receiving warfarin and whose ACT was recorded immediately before and 30 min after injection of unfractionated heparin (UFH). Patients were divided into two groups according to DOAC prescription at the time of the index PCI: DOAC users (n=31) and non-users (n=215). Any bleeding and systemic thromboembolic events were investigated until 30 days after PCI. Results: The average age of this population was 70.5 years, and 66.3% were male. Average ACT was significantly higher in DOAC users than non-users both before and 30 min after UFH induction (157.2 {plus minus} 30.1 vs. 131.8 {plus minus} 25.1 sec, p<0.001; 371.1 {plus minus} 122.2 vs. 308.3 {plus minus} 82.2 sec, p<0.001; respectively). The incidence of post-PCI systemic thromboembolism was low and comparable between the two groups (0% vs. 3.7%, p=0.60). However, the rate of any bleeding event was significantly higher in DOAC users than non-users (16.1% vs. 4.7%, p=0.028). Conclusion: Patients receiving DOAC have higher ACTs during PCI and higher incidence of bleeding events than those not receiving DOAC.","PeriodicalId":443997,"journal":{"name":"The American journal of cardiology","volume":"514 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133634685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Outcomes of Acute Myocardial Infarction in Female Patients With Type 1 Diabetes Mellitus. 女性1型糖尿病患者急性心肌梗死的预后

The American journal of cardiology Pub Date : 2023-03-01 DOI: 10.1016/s0735-1097(23)02091-0

Julio C Santana, M. Dangl, M. Albosta, R. Colombo

引用次数: 0

Supervised Exercise Therapy Versus Percutaneous Transluminal Angioplasty for Claudication by Level of Disease: A Systematic Review and Meta-Analysis. 监督运动治疗与经皮腔内血管成形术治疗跛行不同疾病水平:系统回顾和荟萃分析。

The American journal of cardiology Pub Date : 2023-03-01 DOI: 10.1016/s0735-1097(23)02494-4

S. Kapadia, Haocheng Huang, H. Parise, Mahmoud Ismayl, Zain V. Ahmed, D. Tirziu, S. E. Altin

引用次数: 0

Association Between Pulmonary Vascular Volume and Cardiac Structure and Function in Patients With Atrial Fibrillation. 心房颤动患者肺血管容量与心脏结构和功能的关系

The American journal of cardiology Pub Date : 2023-03-01 DOI: 10.1016/s0735-1097(23)01792-8

A. Nielsen, K. Skaarup, Kasper Djernæs, L. S. Duus, C. Espersen, Samuel K. Sørensen, M. Ruwald, M. L. Hansen, R. Worck, A. Johannessen, J. Hansen, P. Nardelli, R. San José Estépar, R. San José Estépar, T. Biering-Sørensen

引用次数: 3

Predictors and Outcomes of Sudden Cardiac Arrest in Heart Failure With Preserved Ejection Fraction: A Nationwide Inpatient Sample Analysis. 保留射血分数的心力衰竭患者心脏骤停的预测因素和结局:一项全国住院患者样本分析。

The American journal of cardiology Pub Date : 2023-03-01 DOI: 10.1016/s0735-1097(23)01058-6

Mohil Garg, Mohak Gupta, Neel N. Patel, K. Bansal, F. Sheikh

引用次数: 1

Transthyretin cardiac amyloidosis disguised as light chain amyloidosis, or multiple myeloma? 转甲状腺素型心脏淀粉样变伪装成轻链淀粉样变，还是多发性骨髓瘤?

The American journal of cardiology Pub Date : 2023-03-01 DOI: 10.1016/s0735-1097(23)03979-7

A. Stein, Eldon Matthia, Stephen Petty, Brian D. Stewart, J. Vilaro, M. A. Al-Ani, Mustafa M. Ahmed, Juan M Aranda Jr, J. Hiemenz, Alex M. Parker

引用次数: 0

Cardiac Interventions in the Absence of Assent: An Ethical Dilemma. 未经同意的心脏干预:一个伦理困境。

The American journal of cardiology Pub Date : 2023-03-01 DOI: 10.1016/s0735-1097(23)04139-6

C. Kersey, Beteal Ashinne, J. Keenan, J. Kirkpatrick

引用次数: 0

Development of a Novel Score to Predict Urgent Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention 一种预测慢性全闭塞经皮冠状动脉介入治疗中紧急机械循环支持的新评分方法的发展

The American journal of cardiology Pub Date : 2023-02-07 DOI: 10.1101/2023.02.03.23285426

J. Karacsonyi, B. Okeson, K. Alaswad, F. Jaffer, Paul Poomipanit, Jaikirshan J Khatri, M. Patel, Robert F. Riley, A. Sheikh, Jason Wollmuth, R. Yeh, R. Chandwaney, A. ElGuindy, K. Tammam, N. A. Rafeh, D. Schimmel, M. N. Burke, Spyridon Kostantinis, Bahadir Simsek, Karen E. Deffenbacher, K. Benzuly, J. Flaherty, B. Rangan, I. Ungi, E. Brilakis

{"title":"Development of a Novel Score to Predict Urgent Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention","authors":"J. Karacsonyi, B. Okeson, K. Alaswad, F. Jaffer, Paul Poomipanit, Jaikirshan J Khatri, M. Patel, Robert F. Riley, A. Sheikh, Jason Wollmuth, R. Yeh, R. Chandwaney, A. ElGuindy, K. Tammam, N. A. Rafeh, D. Schimmel, M. N. Burke, Spyridon Kostantinis, Bahadir Simsek, Karen E. Deffenbacher, K. Benzuly, J. Flaherty, B. Rangan, I. Ungi, E. Brilakis","doi":"10.1101/2023.02.03.23285426","DOIUrl":"https://doi.org/10.1101/2023.02.03.23285426","url":null,"abstract":"Background: Estimating the likelihood of urgent mechanical circulatory support (MCS) can facilitate procedural planning and clinical decision making in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: We analyzed 2,784 CTO PCIs performed between 2012 and 2021 at 12 centers. The variable importance was estimated by a bootstrap applying a random forest algorithm to a propensity-matched sample (a ratio of 1:5 matching cases with controls on center). The identified variables were used to predict the risk of urgent MCS. The performance of the risk model was assessed in-sample as well as on 2411 out-of-sample procedures who did not require urgent MCS. Results: Urgent MCS was used in 62 (2.2%) of cases. Patients who required urgent MCS were older (70 [63, 77] vs. 66 [58, 73] years, p=0.003) compared with those who did not require urgent MCS. Technical (68% vs. 87%, p<0.001) and procedural successes (40% vs. 85%, p<0.001) were lower in the urgent MCS group compared with no urgent MCS cases. The risk model for urgent MCS use included retrograde crossing strategy, left ventricular ejection fraction, and lesion length. The resulting model demonstrated good calibration and discriminatory capacity with AUC (95%CI) of 0.79 (0.73, 0.86) and specificity and sensitivity of 86% and 52%, respectively. On the out-of-sample set, the specificity of the model was 87%. Conclusion: The PROGRESS CTO MCS score can help estimate the risk of urgent MCS use during CTO PCI.","PeriodicalId":443997,"journal":{"name":"The American journal of cardiology","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128408105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0