Psychosocial Working Environment and Risk of Adverse Cardiac Events in Patients Treated for Coronary Heart Disease

Background: Heart failure (HF) is considered one of the most common complications of coronary heart disease (CHD), with a higher incidence of readmission and mortality. Thus, exploring the risk factors related to the prognosis is necessary. Moreover, the effect of the waist-to-hip ratio (WHR) on HF patients with revascularized CHD is still unclear. Thus, we aimed to assess the influence of WHR on the prognosis of HF patients with revascularized CHD.Methods: We collected data of HF patients with revascularized CHD who were referred to the Cardiac Rehabilitation Clinic of PLA Hospital from June 30, 2015, to June 30, 2019. Cox proportional hazard regression analysis was used to determine the relationship between WHR and prognosis of HF patients with revascularized CHD. Patients were divided into higher and lower WHR groups based on the cutoff WHR value calculated by the X-tile software. Cox regression analysis was used to analysis the two groups. We drew the receiver operating characteristic curve (ROC) of WHR and analyzed the differences between the two groups. Endpoints were defined as major adverse cardiac events (MACE) (including all-cause mortality, non-fatal myocardial infarction, unscheduled revascularization, and stroke).Results: During the median follow-up of 39 months and maximum follow-up of 54 months, 109 patients were enrolled, of which 91.7% were males, and the mean age was 56.0 ± 10.4 years. WHR was associated with the incidence of MACE in the Cox regression analysis (p = 0.001); an increase in WHR of 0.01 unit had a hazard ratio (HR) of 1.134 (95%CI: 1.057–1.216). The WHR cutoff value was 0.93. Patients in the higher WHR group had a significantly higher risk of MACE than those in the lower WHR group (HR = 7.037, 95%CI: 1.758–28.168). The ROC area under the curve was 0.733 at 4 years. Patients in the higher WHR group had a higher body mass index (BMI; 26.7 ± 3.5 vs. 25.4 ± 2.4, P = 0.033) than patients in the lower WHR group.Conclusions: WHR is an independent risk factor of the long-term prognosis of Chinese HF patients with revascularized CHD. Patients with WHR ≥ 0.93 require intensified treatment. Higher WHR is related to higher BMI and ΔVO2/ΔWR.

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Perinatal outcomes in pregnant women with heart disease: Hospital General León experience

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185288 ◽

2018 ◽

Vol 8 (1) ◽

pp. 54

Author(s):

Edgar Ruiz Treviño ◽

Gabriela Tecayehuatl Delgado ◽

Junior Joel Araiza Navarro

Keyword(s):

Heart Disease ◽

Perinatal Outcomes ◽

Adverse Outcomes ◽

Morbidity And Mortality ◽

Fetal Mortality ◽

Outpatient Basis ◽

Cardiac Events ◽

Maternal Risk ◽

Adverse Cardiac Events ◽

Disease Hospital

Background: Pregnancies in patients with heart disease are often complicated. The prevalence in our country is at 0.1 to 4%. An increase in the morbidity and mortality of pregnant patients with heart disease was observed, so it is recommended to evaluate the maternal risk with the WHO Classification. The objective of the study was to determine adverse outcomes; cardiac, obstetric and fetal/neonatal.Methods: We retrospectively studied all pregnancies of women with heart disease that were presented on an outpatient basis in the period of 4 years at the General Hospital of León and maternal, obstetric and fetal/ neonatal outcomes were reviewed.Results: In our study population, no maternal or fetal mortality was observed. Of 16 pregnancies of patients with heart disease were complicated by adverse cardiac events (2 of 16), obstetric (9 of 16), fetal/ neonatal (6 of 16). Hospitalization was required during the pregnancy of 11 patients. WHO class IV was the only group in which there were adverse cardiac events. 12 pregnancies were interrupted abdominally. Low fetal growth curve was observed in 6 of the 16 patients.Conclusions: Pregnancies in patients with heart disease have a high risk of cardiac, obstetric and fetal / neonatal complications. Therefore, preconceptionally counseling and specialized multidisciplinary management should be offered to reduce perinatal morbidity and mortality.

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Perioperative cardiothoracic surgical management

Drugs in Cardiology ◽

10.1093/med/9780199557462.003.0109 ◽

2010 ◽

pp. 257-276

Author(s):

Juan Carlos Kaski

Keyword(s):

Coronary Artery Disease ◽

Cardiac Surgery ◽

Heart Disease ◽

Cardiac Arrhythmias ◽

Perioperative Management ◽

Perioperative Risk ◽

Cardiac Patients ◽

Cardiac Events ◽

Adverse Cardiac Events ◽

Artery Disease

Perioperative management of cardiac patients undergoing non-cardiac surgery 258 Risk stratification of cardiac patients undergoing non-cardiac surgery 260 Management of cardiac conditions associated with increased perioperative risk 262 Perioperative management of patients undergoing cardiac surgery 272 Pre-existing CVD is associated with a significant increase in morbidity and mortality in patients undergoing non-cardiac surgery. Coronary artery disease accounts for the vast majority of adverse cardiac events associated with non-cardiac surgery. Other conditions associated with increased perioperative risk include HF, valvular heart disease, and cardiac arrhythmias....

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