American heart journal plus : cardiology research and practice最新文献

{"title":"Medication optimization clinic decreases hospitalizations and mortality for patients with heart failure with reduced ejection fraction","authors":"James C. Coons ,&nbsp;Jennifer Kliner ,&nbsp;Michael A. Mathier ,&nbsp;Suresh Mulukutla ,&nbsp;Floyd Thoma ,&nbsp;Ahmet Sezer ,&nbsp;Mary Keebler","doi":"10.1016/j.ahjo.2024.100470","DOIUrl":"10.1016/j.ahjo.2024.100470","url":null,"abstract":"<div><h3>Study objective</h3><div>To evaluate the impact of a medication optimization clinic (MOC) on GDMT and outcomes for patients with HFrEF versus usual care.</div></div><div><h3>Design</h3><div>Retrospective evaluation of a multi-site MOC was conducted.</div></div><div><h3>Setting</h3><div>Large health system with academic and community hospitals.</div></div><div><h3>Participants</h3><div>Patients with HFrEF referred to MOC by their cardiologist versus usual care.</div></div><div><h3>Interventions</h3><div>GDMT use managed by an advanced practice provider or clinical pharmacist through weekly telemedicine visits.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was HF hospitalization. Cardiovascular hospitalization and all-cause mortality were also assessed. Kaplan−Meier Curve, Cumulative Incidence Function, and competing risk analysis with regression models were conducted.</div></div><div><h3>Results</h3><div>1419 patients in MOC group were compared to 5116 control patients. GDMT use was significantly higher in MOC: quadruple therapy (49 % vs. 19 %; p &lt; 0.0001), angiotensin-receptor neprilysin inhibitor (62 % vs. 45 %; p &lt; 0.0001), beta blocker (92 % vs. 88 %; p &lt; 0.0001), mineralocorticoid receptor antagonist (69 % vs. 45 %; p &lt; 0.0001), and sodium glucose cotransporter-2 inhibitor (68 % vs. 35 %; p &lt; 0.0001). Competing risk analyses showed that HF and CV hospitalizations were significantly lower at all times points (3, 6, and 12 months) for MOC vs. control (p &lt; 0.001). All-cause mortality was significantly lower at 6 months (p = 0.006) and 12 months (p &lt; 0.001), but did not differ at 3 months (p = 0.35), for MOC vs. control.</div></div><div><h3>Conclusions</h3><div>MOC was associated with improved GDMT and lower risks of hospitalizations due to HF and any cardiovascular cause, and all-cause mortality in patients with HFrEF.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100470"},"PeriodicalIF":1.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of door to extracorporeal cardiopulmonary resuscitation time on mortality and neurological outcomes among out-of-hospital cardiac arrest acute myocardial infarction patients treated by primary percutaneous coronary intervention","authors":"Taro Takeuchi ,&nbsp;Yasunori Ueda ,&nbsp;Shumpei Kosugi ,&nbsp;Kuniyasu Ikeoka ,&nbsp;Haruya Yamane ,&nbsp;Takuya Ohashi ,&nbsp;Takashi Iehara ,&nbsp;Kazuho Ukai ,&nbsp;Kazuki Oozato ,&nbsp;Satoshi Oosaki ,&nbsp;Masayuki Nakamura ,&nbsp;Tatsuhisa Ozaki ,&nbsp;Tsuyoshi Mishima ,&nbsp;Haruhiko Abe ,&nbsp;Koichi Inoue ,&nbsp;Yasushi Matsumura","doi":"10.1016/j.ahjo.2024.100473","DOIUrl":"10.1016/j.ahjo.2024.100473","url":null,"abstract":"<div><h3>Background</h3><div>Few previous studies evaluated the impact of time from the hospital arrival to the implementation of extracorporeal cardiopulmonary resuscitation (ECPR) (door to ECPR time) on outcomes among out-of-hospital cardiac arrest (OHCA) acute myocardial infarction (MI) patients.</div></div><div><h3>Methods</h3><div>50 patients with OHCA who received both ECPR and percutaneous coronary intervention (PCI) at Cardiovascular Division, NHO Osaka National Hospital were analyzed. Patients were divided into 2 groups according to the median of door to ECPR time. The primary outcome was all-cause death. Survival analyses were conducted to compare all-cause mortality at 90 days between 2 groups. Neurological outcome at 30 days was also compared between 2 groups using the Cerebral Performance Category (CPC).</div></div><div><h3>Results</h3><div>The multivariable Cox proportional-hazards model showed that all-cause mortality at 90 days was significantly higher among patients with door to ECPR time ≥ 25 min compared with those with door to ECPR time &lt; 25 min (adjusted hazard ratio [HR]: 3.14; 95 % confidence interval [CI]: 1.21–8.18). The proportion of patients with CPC at 30 days ≤ 2 was significantly higher among patients with shorter door to ECPR time (<em>P</em> = 0.048).</div></div><div><h3>Conclusion</h3><div>Among patients with OHCA due to acute MI who received ECPR and PCI, the shorter door to ECPR time was associated with the lower mortality and favorable neurological outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100473"},"PeriodicalIF":1.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of climate change and physical activity: Implications for cardiovascular health","authors":"Eloise J. Thompson ,&nbsp;Sarah E. Alexander ,&nbsp;Kegan Moneghetti,&nbsp;Erin J. Howden","doi":"10.1016/j.ahjo.2024.100474","DOIUrl":"10.1016/j.ahjo.2024.100474","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) is one of the top contributors to global disease burden. Meeting the physical activity guidelines can effectively control and prevent several CVD risk factors, including obesity, hypertension and diabetes mellitus. The effects of climate change are multifactorial and have direct impacts on cardiovascular health. Increasing ambient temperatures, worsening air and water quality and urbanisation and loss of greenspace will also have indirect effects of cardiovascular health by impacting the ability and opportunity to participate in physical activity. A changing climate also has implications for large scale sporting events and policies regarding risk mitigation during exercise in hot climates. This review will discuss the impact of a changing climate on cardiovascular health and physical activity and the implications for the future of organised sport.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100474"},"PeriodicalIF":1.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subsequent pregnancies in peripartum cardiomyopathy: Patient-level differences and decision-making","authors":"Olga Corazón Irizarry ,&nbsp;Jennifer Lewey ,&nbsp;Camille McCallister ,&nbsp;Nathanael C. Koelper ,&nbsp;Zoltan Arany ,&nbsp;Lisa D. Levine","doi":"10.1016/j.ahjo.2024.100472","DOIUrl":"10.1016/j.ahjo.2024.100472","url":null,"abstract":"<div><h3>Study objective</h3><div>To evaluate patient-level differences and decision making surrounding subsequent pregnancies (SSP) after peripartum cardiomyopathy (PPCM).</div></div><div><h3>Design</h3><div>Mixed methods approach to evaluate quantitative demographic and clinical differences between patients with and without a SSP and to qualitatively describe the decision-making regarding a SSP with a survey component.</div></div><div><h3>Setting/participants</h3><div>220 PPCM cases within the University of Pennsylvania Health System.</div></div><div><h3>Main outcome measures</h3><div>Demographic, clinical and obstetrical outcomes.</div></div><div><h3>Results</h3><div>73 patients (33 %) had a SSP, 37 with a live birth. Those with a SSP were more likely to self-identify as Black (70 % vs. 52 %; <em>p</em> = 0.04), be nulliparous in index pregnancy (68 % vs. 45 %, <em>p</em> = 0.02), were younger at diagnosis (24.3 vs. 30.5 years; <em>p</em> &lt; 0.01), and a higher left ventricular ejection fraction (LVEF) at diagnosis (35 % vs. 27.5 %; <em>p</em> = 0.03) compared to patients without a SSP. There was no difference in recovery rates of LVEF (62 % vs. 50 %, <em>p</em> = 0.17), or need for LVAD, transplant, or death. 22 patients completed the survey (representing 44 SSPs): 41 % of SSPs (<em>n</em> = 18) resulted in termination, 18 % (<em>n</em> = 8) in a first/s trimester loss, and 41 % (n = 18) in a live-born delivery. All patients who elected termination indicated risk of recurrence/worsening heart failure to be a motivating factor.</div></div><div><h3>Conclusions</h3><div>Less than 20 % of patients in this single-center, multi-racial cohort had a SSP and delivery after PPCM with fear of recurrence as a large driver in this decision. Patients with a SSP were younger with a higher EF at diagnosis but ultimately had similar cardiac outcomes as patients without a SSP.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100472"},"PeriodicalIF":1.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cholesterol crystals and ocular crystal emboli in retinal pathology","authors":"Nicholas G. Medawar ,&nbsp;Tim F. Dorweiler ,&nbsp;George S. Abela ,&nbsp;Julia V. Busik ,&nbsp;Maria B. Grant","doi":"10.1016/j.ahjo.2024.100475","DOIUrl":"10.1016/j.ahjo.2024.100475","url":null,"abstract":"<div><div>Cholesterol crystals (CC) can be responsible for a range of clinical syndromes in the retina from asymptomatic plaques to retinal artery occlusion with clinical trials providing evidence for the efficacy in lipid lowering therapies in preventing ocular pathology. Much of the literature has focused on CC in retinal circulation as a marker of poor systemic health and have attempted to use them to categorize risk of mortality and stroke. More recently cholesterol accumulation and CC formation have been linked to development of diabetic retinopathy with CC formation in the retina due to aberrant retinal cholesterol homeostasis and not simply systemic dyslipidemia.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100475"},"PeriodicalIF":1.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional and non-traditional cardiovascular risk factor profiles in young patients with coronary artery disease","authors":"Anish Adhikari ,&nbsp;Sasha DeJesus ,&nbsp;Nyein Swe ,&nbsp;Georgeta Vaidean ,&nbsp;Rachel Nahrwold ,&nbsp;John Joshua ,&nbsp;Monique Carrero-Tagle ,&nbsp;Caleb Wutawanashe ,&nbsp;Roland Hentz ,&nbsp;Martin Lesser ,&nbsp;Eugenia Gianos","doi":"10.1016/j.ahjo.2024.100471","DOIUrl":"10.1016/j.ahjo.2024.100471","url":null,"abstract":"<div><h3>Study objective</h3><div>There is an increasing trend in myocardial infarction (MI) hospitalizations in young individuals. The prevalence of modifiable cardiovascular risk factors is high in this population. This study aims to assess the prevalence of traditional and non-traditional cardiovascular risk factors among young patients with coronary artery disease (CAD) including novel lipid and dietary biomarkers with a focus on potential gender differences.</div></div><div><h3>Design</h3><div>The Young Heart study is a prospective, single-center pilot cohort study. Baseline data included medical history, medications, and lifestyle factors. We also collected blood samples for lipid profile, lipoprotein (a), high-sensitivity C-reactive protein (hsCRP), and trimethylamine N-oxide (TMAO).</div></div><div><h3>Participants</h3><div>A total of 60 patients aged &lt;60 years with CAD (on coronary CT or invasive angiogram) were included in the study.</div></div><div><h3>Results</h3><div>The median age was 51 years and predominantly male (70 %). Baseline assessment revealed a high prevalence of hypertension (76.7 %), hyperlipidemia (91.7 %), and obstructive CAD (88.3 %). 36.7 % had diabetes, 28.3 % had prediabetes, and 38.3 % had prior MI. Uncontrolled risk factors were prevalent, including increased waist circumference (54.6 %), metabolic syndrome (60.0 %), and LDL ≥70 mg/dL (47.5 %), Lp(a) ≥75 nmol/L (47.5 %). Furthermore, 41.7 % had hsCRP ≥2 mg/L, and 28.3 % had suboptimal TMAO levels. 70.0 % of patients were on guideline-directed doses of statins.</div></div><div><h3>Conclusion</h3><div>Young patients with CAD demonstrated a substantial burden of traditional and non-traditional cardiovascular risk factors. The study findings highlight the need for targeted interventions to improve risk factor control and optimize lifestyle behaviors. Further investigation is warranted to assess the impact of these interventions on cardiovascular outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100471"},"PeriodicalIF":1.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of atrial fibrillation on pulmonary embolism hospitalization: Nationwide analysis","authors":"Mubarak Hassan Yusuf ,&nbsp;Akanimo Anita ,&nbsp;Olayiwola Akeem Bolaji ,&nbsp;Faridat Moyosore Abdulkarim ,&nbsp;Chibuike Daniel Onyejesi ,&nbsp;Maryam Yusuf ,&nbsp;Utku Ekin ,&nbsp;Arham Syed Hazari ,&nbsp;Mourad Ismail","doi":"10.1016/j.ahjo.2024.100465","DOIUrl":"10.1016/j.ahjo.2024.100465","url":null,"abstract":"<div><h3>Introduction</h3><div>Atrial fibrillation (AF) is the most common type of arrythmia affecting approximately 1–2 % of the adult population. Patients with an underlying history of atrial fibrillation have a greater chance of developing venous thromboembolism (VTE). Likewise, patients with VTE are at increased risk for AF. There has been conflicting evidence on the prognostic impact of AF in acute pulmonary embolism (PE) patients. The aim of this retrospective cohort study was to estimate the impact of AF on the clinical outcomes of hospitalization for PE.</div></div><div><h3>Method</h3><div>The 2016–2021 National Inpatient Sample database was searched for adult patients hospitalized with PE with associated history of AF as the principal discharge diagnosis. The primary outcome was inpatient mortality, while the secondary outcomes were length of stay (LOS), total hospital charge (THC), cardiogenic shock, acute respiratory failure, in-hospital cardiac arrest (IHCA). The outcomes were analyzed using multivariable logistic and linear regression analyses.</div></div><div><h3>Results</h3><div>A total of 1,128,269 patients were admitted for PE, 12.4 % of whom had underlying AF. The AF and non-AF cohorts had a mean age of 73.6 years and 61.6 years, respectively. PE patient with AF had significantly higher mortality compared to non-AF patients with PE (6.05 % vs 2.75 %, adjusted odds ratio of 1.67 [95 % CI 1.56–1.79; <em>p</em> &lt; 0.0001]). The PE with AF cohort had increased odds of cardiac arrest, cardiogenic shock, respiratory failure requiring intubation, higher average length of stay (5.66 days vs 4.18 days, <em>P</em> &lt; 0.001) and a higher total hospital cost (65,235 vs 50,118, P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>AF was associated with increased inpatient mortality and worse clinical outcomes in hospitalization for acute PE.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"46 ","pages":"Article 100465"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142359117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and outcomes of different mechanical circulatory support modalities for acute myocardial infarction associated cardiogenic shock in patients undergoing early revascularization","authors":"Shafaqat Ali ,&nbsp;Manoj Kumar ,&nbsp;Irisha Badu ,&nbsp;Faryal Farooq ,&nbsp;Thannon Alsaeed ,&nbsp;Muhammad Sultan ,&nbsp;Lalitsiri Atti ,&nbsp;Sanchit Duhan ,&nbsp;Pratik Agrawal ,&nbsp;Vijaywant Brar ,&nbsp;Tarek Helmy ,&nbsp;Taher Tayeb","doi":"10.1016/j.ahjo.2024.100468","DOIUrl":"10.1016/j.ahjo.2024.100468","url":null,"abstract":"<div><h3>Background</h3><div>The use of Mechanical Circulatory Support (MCS) devices in cardiogenic shock (CS) is growing. However, the recent trends in using different MCS modalities and their outcomes in acute myocardial infarction associated CS (AMI-CS) are unknown.</div></div><div><h3>Methods</h3><div>The national readmission database (2016–2020) was used to identify AMI-CS requiring MCS. Cohorts were stratified as ECMO compared to Impella. Propensity score matching (PSM) was used to remove confounding factors. Pearson's x2 test was applied to matched cohorts to compare outcomes. We used multivariate regression and reported predictive margins for adjusted trend analysis.</div></div><div><h3>Results</h3><div>Among 20,950 AMI-CS hospitalizations requiring MCS, 19,628 (93.7 %) received Impella vs 1322 (6.3 %) were placed only on ECMO. ECMO group was younger (median age: 61 vs. 68 years, <em>p</em> &lt; 0.001) and had a lower comorbidity burden. On propensity-matched cohorts (N 742), the ECMO cohort had higher adverse events, including mortality (51.6 % vs. 41.5 %), sudden cardiac arrest (SCA) (40.9 % vs. 31.8 %), acute stroke (9.2 % vs. 4.6 %) and major bleeding (16 % vs 12.2 %) [<em>p</em> &lt; 0.05]. However, comparing ECPELLA (ECMO + Impella) to Impella alone, mortality (46.2 % vs. 39.4 %) and SCA (44 % vs. 36.4 %) rates were similar, though major bleeding was higher (18.2 % vs. 9.8 %). From 2016 to 2020, mortality trends for AMI-CS in the U.S. showed no significant change (p-trend: 0.071).</div></div><div><h3>Conclusion</h3><div>Despite advances in MCS modalities, the overall mortality rate for AMI-CS remains unchanged. ECMO use without LV unloading showed higher mortality and adverse events compared to Impella. Prospective studies are needed to verify these findings.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"46 ","pages":"Article 100468"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/ethnic disparities, artificial intelligence, and cutting-edge research: Proceedings from the 2023 Florida cardio-oncology symposium","authors":"Katelyn A. Bruno ,&nbsp;Michael G. Fradley ,&nbsp;Sherry-Ann Brown ,&nbsp;Avirup Guha ,&nbsp;Lakeshia Cousin ,&nbsp;Yi Guo ,&nbsp;Walter G. O'Dell ,&nbsp;Ashely J. Smuder ,&nbsp;Shuang Yang ,&nbsp;Dejana Braithwaite ,&nbsp;Carl J. Pepine ,&nbsp;Yan Gong","doi":"10.1016/j.ahjo.2024.100469","DOIUrl":"10.1016/j.ahjo.2024.100469","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"46 ","pages":"Article 100469"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlap of frailty and malnutrition as prognosticators in older patients with heart failure","authors":"Takuro Abe ,&nbsp;Kentaro Jujo ,&nbsp;Yudai Fujimoto ,&nbsp;Daichi Maeda ,&nbsp;Yuki Ogasahara ,&nbsp;Kazuya Saito ,&nbsp;Hiroshi Saito ,&nbsp;Kentaro Iwata ,&nbsp;Masaaki Konishi ,&nbsp;Takeshi Kitai ,&nbsp;Takatoshi Kasai ,&nbsp;Hiroshi Wada ,&nbsp;Shin-ichi Momomura ,&nbsp;Nobuyuki Kagiyama ,&nbsp;Kentaro Kamiya ,&nbsp;Emi Maekawa ,&nbsp;Yuya Matsue","doi":"10.1016/j.ahjo.2024.100467","DOIUrl":"10.1016/j.ahjo.2024.100467","url":null,"abstract":"<div><h3>Background</h3><div>Physical frailty and malnutrition coexist in older patients with heart failure (HF) and form a vicious cycle exacerbating each other and can cause poor clinical outcomes. We aimed to clarify the association of prevalence of physical frailty and malnutrition and clinical outcomes in hospitalized patients with HF.</div></div><div><h3>Methods</h3><div>A total of 862 hospitalized patients aged ≥65 years with HF decompensation were included in this FRAGILE-HF post-hoc sub-analysis. Patients were categorized into Neither, Either, or Both groups based on the prevalence of physical frailty and malnutrition. The primary outcome was all-cause mortality within 1 year after discharge. Prognoses among the groups were compared in the entire cohort and in subgroups with preserved ejection fraction (pEF) and reduced/mildly reduced left ventricular ejection fractions (rEF/mrEF).</div></div><div><h3>Results</h3><div>The Neither, Either, and Both groups comprised 32 %, 40 %, and 28 % respectively. During a 1-year follow-up period, 101 (12 %) patients died. Kaplan–Meier analysis showed significant differences in the primary outcomes among the groups (<em>P</em> &lt; 0.001). The Both group had a higher risk of mortality (HR: 2.47, 95 % CI: 1.38–4.42) than the Neither group, while the Either group showed insignificant risk increase (HR: 1.58, 95 % CI: 0.86–2.90). Similar trends were observed in the pEF and rEF/mrEF subgroups (<em>P</em> = 0.60).</div></div><div><h3>Conclusions</h3><div>Physical frailty and malnutrition coexist in approximately one-quarter of hospitalized older patients with HF and are associated with an increased risk of mortality. Assessing both conditions is crucial for risk stratification and interventions to mitigate their interplay.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"46 ","pages":"Article 100467"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}