Journal of Geriatric Cardiology最新文献

{"title":"Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study.","authors":"Francisco Marín, Manuel Anguita Sánchez, Iñaki Lekuona, Marcelo Sanmartín Fernández, Vivencio Barrios, Carlos Perez Muñoz, Juan Cosín-Sales, Alejandro I Pérez Cabeza, Vanesa Roldán Schilling, Carles Rafols Priu, Esteban Orenes-Piñero, María Asunción Esteve-Pastor","doi":"10.26599/1671-5411.2024.07.003","DOIUrl":"10.26599/1671-5411.2024.07.003","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the clinical profile, adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial fibrillation (AF), taking rivaroxaban in clinical practice.</p><p><strong>Methods: </strong>Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before being included. Data were analyzed according to age (≥ 80 <i>vs</i>. < 80 years) at baseline.</p><p><strong>Results: </strong>Out of 1433 patients, 453 (31.6%) were octogenarians at baseline. Compared to younger patients, octogenarians had more comorbidities, higher CHA₂DS₂-VASc (4.5 ± 1.3 <i>vs</i>. 3.0 ± 1.4; <i>P</i> < 0.001) and HAS-BLED scores (2.0 ± 1.0 <i>vs.</i> 1.4 ± 1.0; <i>P</i> < 0.001). Overall, the dose of rivaroxaban was adequately prescribed in 83.4% of patients, but more frequently in the younger population (71.1% <i>vs.</i> 89.1%; <i>P</i> = 0.039). After a mean follow-up of 2.2 ± 0.6 years, annual rates of stroke + systemic embolism + transient ischemic attack, MACE, cardiovascular death and major bleeding were 1.03%, 1.24%, 1.03% and 1.75%, respectively, in octogenarian patients. Except for progressive heart failure death and major bleeding, rates of outcomes in octogenarians were similar compared to younger patients. In octogenarians, the concomitant use of antiplatelet agents and non-severe dementia were independently associated with the development of ischemic stroke, whereas previous coronary revascularization and heart failure with MACE, and higher HAS-BLED score with major bleeding.</p><p><strong>Conclusions: </strong>In clinical practice, around one third of patients taking rivaroxaban are octogenarians. These patients have many comorbidities and a high thromboembolic risk. Despite that, rates of adverse events remain low. Rivaroxaban is adequately prescribed in the majority of octogenarians.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"723-732"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in mortality among the geriatric population undergoing Surgical aortic valve replacement (SAVR) and potential racial disparities: a 20-year perspective via the National (Nationwide) Inpatient Sample.","authors":"Nomesh Kumar, Kamleshun Ramphul, Fnu Bawna, Nitish Behary Paray, Mansimran Singh Dulay, Jasninder Singh Dhaliwal, Shruti Aggarwal, Sebastian Mactaggart, Suma Sri Chennapragada, Shaheen Sombans, Renuka Verma, Hemamalini Sakthivel, Raheel Ahmed","doi":"10.26599/1671-5411.2024.07.002","DOIUrl":"10.26599/1671-5411.2024.07.002","url":null,"abstract":"<p><strong>Background: </strong>Racial disparities in cardiovascular conditions are well documented. Whether similar race-based discrepancies in health outcomes also exist among elderly patients undergoing surgical aortic valve replacement (SAVR) for aortic stenosis remains understudied.</p><p><strong>Methods: </strong>We abstracted data from the National (Nationwide) Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 codes. We included patients aged ≥ 60 and ≤ 80 years with races recorded as White, African American, or Hispanic at the time of their hospitalization for surgery. We analyzed and reported the baseline characteristics, risk-adjusted in-hospital mortality, and complications stratified by race.</p><p><strong>Results: </strong>Of 420,181 patients studied, 90.0% identified as White, 4.0% as African American and 6.0% as Hispanic. Despite a decrease in overall in-hospital mortality rates from 3.8% between 2001-2005 to 1.8% between 2016-2020, African Americans had higher odds of all-cause in-hospital deaths compared to Whites (aOR = 1.390, <i>P</i> < 0.001). Additionally, they were more likely to experience cardiogenic shock (aOR = 1.241, <i>P</i> < 0.001) and acute kidney injury (aOR = 1.314, <i>P</i> < 0.001) as well as more likely to require organ support such as IABP use (aOR = 1.336, <i>P</i> < 0.001) or invasive mechanical ventilation (aOR = 1.342, <i>P</i> < 0.001). Interestingly, African Americans were less likely to report events of acute ischemic stroke compared to Whites (aOR = 0.852, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Despite a reassuring reduction in overall in-hospital mortality rates of geriatric patients undergoing SAVR for aortic stenosis, racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital morbidity and mortality.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"716-722"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers.","authors":"Wei Wang, Hai-Bo Zhang, Jia-Min Liu, Yan Li, Na Tian, Lei Yan, Jin-Xiao Song, Mei-Li Li, Yue Peng, Jing Li","doi":"10.26599/1671-5411.2024.07.010","DOIUrl":"10.26599/1671-5411.2024.07.010","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness of a large-scale, web-based, in-service hypertension management training project among lay health workers (LHWs) at primary care health (PHC) settings in China, and to examine the factors contributing to the variations of effectiveness.</p><p><strong>Methods: </strong>We used data from a web-based national hypertension management training project implemented in 2018, it was designed to facilitate LHWs to learn, understand, and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards. All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge. We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups. Afterwards, we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.</p><p><strong>Results: </strong>There were 1,208,610 LHWs who completed training and were certificated. Nationally, the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43 (95% confidence interval [CI]: 25.40-25.47). Training contents involved in antihypertensive medication showed the lowest score (54.36) in the pre-test and soared the most after training, up to 84.22 by 54.94%. Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training, which included sex, age, education, practice type, professional level, and hierarchy of working institutions. Geographical variations were shown at the provincial level, with the majority of them being explained by factors at the regional level.</p><p><strong>Conclusions: </strong>Accessible web-based training modality, government efforts, accompanied with experiences derived from the training, could be generalized to other low- and middle-income countries in facilitating the hypertension management capacity of LHWs. Localization and evaluation is warranted on the way to its further application.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"733-750"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life's essential 8 and risk of subclinical atherosclerosis progression: a prospective cohort study.","authors":"Shi-Yu Zhou, Fang-Chao Liu, Shu-Feng Chen, Jian-Xin Li, Jie Cao, Ke-Yong Huang, Zheng-Hao Tang, Feng-Chao Liang, Dong-Sheng Hu, Lian-Cheng Zhao, Ying Li, Jian-Feng Huang, Xiang-Feng Lu, Bin Lu, Dong-Feng Gu","doi":"10.26599/1671-5411.2024.07.005","DOIUrl":"10.26599/1671-5411.2024.07.005","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated the benefits of ideal cardiovascular health (CVH) in reducing cardiovascular risk. However, its role in subclinical atherosclerosis (SA) progression remains unclear. We aim to examine the association of CVH, estimated by the American Heart Association's new Life's Essential 8 (LE8), with the progression of SA.</p><p><strong>Methods: </strong>This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for 5.7 years. The LE8 score (range, 0-100) consisted of blood pressure, lipids, glucose, body mass index, smoking status, diet health, physical activity and sleep health was evaluated in 1998 and 2008-2009. Progression of SA was determined by carotid plaque and coronary artery calcification (CAC) in 2008-2009 and 2013-2014. Log-binomial regression model was used to estimate the association of LE8 score with SA progression.</p><p><strong>Results: </strong>Each 10 points increment in LE8 score was associated with 15.2% (RR: 0.848, 95% CI: 0.797-0.902), 17.7% (RR: 0.823, 95% CI: 0.766-0.884) and 12.0% (RR: 0.880, 95% CI: 0.845-0.916) lower risks of carotid plaque, CAC and overall SA progression, respectively. Compared with participants with non-ideal CVH at both visits, the participants with ideal CVH at both visits had 39.1% (RR: 0.609, 95% CI: 0.494-0.752), 41.0% (RR: 0.590, 95% CI: 0.456-0.764) and 29.7% (RR: 0.703, 95% CI: 0.598-0.825) lower risks of carotid plaque, CAC and overall SA progression, respectively.</p><p><strong>Conclusions: </strong>Higher LE8 scores were associated with lower risks of SA progression. Besides, long-term maintenance of optimal CVH was more beneficial to prevent SA progression.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"751-759"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretation of Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients with Statin Intolerance: A guiding file for helping to lipid management for Chinese population.","authors":"Jian-Jun Li","doi":"10.26599/1671-5411.2024.07.006","DOIUrl":"10.26599/1671-5411.2024.07.006","url":null,"abstract":"<p><p>It is well-known that elevated low-density lipoprotein cholesterol (LDL-C) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD), statins are cornerstone drugs for the cause-based treatment of ASCVD, which has created a new era for ASCVD therapy. However, statin intolerance is not clinically uncommon, which there are several issues with confusion and misunderstandings. Hence, a file named Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients With Statin Intolerance, like a navigator, has recently been published written by a team of experts from the Cardiovascular Metabolic Medicine Professional Committee, Expert Committee of the National Center for Cardiovascular Diseases aiming to enhance the standardized clinical application of statins and improve the prevention and clinical outcome. In this article, author briefly summarized the key points of above consensus in order to helping to comprehending the content of the consensus suggestions.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"713-715"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of being in the COVID-19 pandemic on in-hospital mortality of non-infected patients aged 80 years and older with ST-elevation myocardial ınfarction.","authors":"Mustafa Ebik, Muhammet Gürdoğan, Uğur Özkan","doi":"10.26599/1671-5411.2024.07.008","DOIUrl":"10.26599/1671-5411.2024.07.008","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"768-774"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to manage the malposition of deep vein catheterization into the artery?","authors":"Jun-Na Sun, Hai Dong, Peng Chen, Zi-Qi Li, Li-You Sui, Bin Qi, Quan-Min Jing","doi":"10.26599/1671-5411.2024.06.007","DOIUrl":"10.26599/1671-5411.2024.06.007","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 6","pages":"682-685"},"PeriodicalIF":1.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged asystole following adenosine. Was it necessary?","authors":"Yuval Avidan, Amir Aker, Vsevolod Tabachnikov","doi":"10.26599/1671-5411.2024.06.005","DOIUrl":"10.26599/1671-5411.2024.06.005","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 6","pages":"686-688"},"PeriodicalIF":1.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between stress hyperglycemia ratio and in-hospital outcomes: findings from the improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) Project.","authors":"Wen-Jie Wang, Ke-Xin Wang, Jia-Long Niu, Yi-Xuan Liu, Hai-Long Ge, Hua Shen","doi":"10.26599/1671-5411.2024.06.006","DOIUrl":"10.26599/1671-5411.2024.06.006","url":null,"abstract":"<p><strong>Background: </strong>Stress hyperglycemia ratio (SHR) could provide accurate information on the acute status of hyperglycemia. The relationship between SHR and acute coronary syndrome (ACS) prognosis remains unclear. This study was conducted to identity the association between SHR and in-hospital outcomes in patients with ACS.</p><p><strong>Methods: </strong>A total of 12,010 patients were eventually enrolled in the study. The relationship between SHR and in-hospital major adverse cardiovascular events (MACEs) was then modeled by restricted cubic spline (RCS) curves, and all patients were divided into three groups according to the results. The multivariate logistic regression analysis was used to determine the associations between the SHR and in-hospital outcomes, described as odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were also performed on different diseases.</p><p><strong>Results: </strong>The median age of this cohort was 63 (54, 71) years old, and 8942 (74.5%) were male. Group 1 was defined as SHR < 0.6 (<i>n</i> = 426), Group 2 was defined as SHR between 0.6 and 1 (<i>n</i> = 5821), and Group 3 was defined as SHR > 1 (<i>n</i> = 5763). Compared with Group 2, Group 1 (OR = 1.891, 95% CI: 1.028-3.479, <i>P</i> < 0.001) and Group 3 (OR = 1.868, 95% CI: 1.434-2.434, <i>P</i> < 0.001) had higher risks of suffering from in-hospital MACEs. SHR was associated with higher risks of in-hospital MACEs in the subgroups of DM [OR = 2.282, 95% CI: 1.477-3.524).</p><p><strong>Conclusions: </strong>Both low and high SHR levels were independently associated with in-hospital MACEs. Young males with DM, hypertension, and decreased renal function had much higher risks of suffering from SHR-correlated MACEs.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 6","pages":"658-668"},"PeriodicalIF":1.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure in China: epidemiology and current management.","authors":"Sheng-Shou Hu","doi":"10.26599/1671-5411.2024.06.008","DOIUrl":"10.26599/1671-5411.2024.06.008","url":null,"abstract":"<p><p>The <i>Annual Report on Cardiovascular Health and Diseases in China</i> (2022) intricate landscape of cardiovascular health in China. In connection with the previous section, this sixth section of the report offers a comprehensive analysis of heart failure (HF) in China. HF is one of the most important cardiovascular disease in the 21^st century. Its mortality is equivalent to that of cancer. It is an important public health problem that seriously affects the health of Chinese residents. In recent years, with the deepening of understanding, the change of treatment principles, the innovation of treatment methods and the update of treatment guidelines, the in-hospital mortality of HF patients has declined, and the long-term prognosis is also improving. However, there are still differences in the management level of HF among different hospitals in China. How to improve the standardized diagnosis and treatment level of HF in China remains an important challenge.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 6","pages":"631-641"},"PeriodicalIF":1.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}