Anaemia profile in heart failure with reduced ejection fraction patients with or without anaemia- A single center observational study

Introduction: Heart failure(HF) is a clinical syndrome that is widely prevalent affecting approximately 6.5 million people in the United States. It accounts for the ever-rising health care costs in the US due to recurrent hospitalizations. Despite advancements in medical management, the mortality and the rate of hospitalizations continues to be high with geographic variations and racial disparities. Through this descriptive study, we sought to analyze the health disparities among Hispanic, African American (AA) and Caucasian population in a single-center. Methods: We identified a total of 178 patients with HF with reduced ejection fraction from our outpatient clinic by utilizing the ICD-10 codes. Patients with ejection fraction >50% have been excluded. A retrospective chart review of their ethnic background, medications, and number of heart failure exacerbations per year has been performed. Results: 178 patients (mean age 62 years, 35.56% of females) including Hispanics (n=102), AA(n=44), and Caucasians (n=32) were included in the study. Although all patients were started on Beta-blockers, only 76.4% and 37.2% of Hispanics were started on ACEi/ARBs and spironolactone respectively. Similarly, 72.7% and 45.4% of AA were started on ACEi/ARBs and spironolactone respectively. This is in contrast to Caucasians population, where a majority of patients were on started on GDMT; 90% and 75% were started on ACEi/ARBs and spironolactone respectively. This was also reflected by the number of admissions due to HF exacerbations which ranged from 2-4/year for Hispanics and AA populations and 0-1/year for Caucasians. Conclusions: GDMT for HF is known to reduce heart failure exacerbations, mortality and the ever rising cost of the healthcare system. We have observed that despite recommendations to initiate GDMT in all patients with HF with reduced ejection fraction, racial disparities exist. Physicians should be mindful of initiating GDMT in all patients.

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Influence of nutrition support therapy on readmission among patients with acute heart failure in the intensive care unit: A single-center observational study

Clinical Nutrition ◽

10.1016/j.clnu.2019.01.010 ◽

2020 ◽

Vol 39 (1) ◽

pp. 174-179

Author(s):

Isao Miyajima ◽

Tomoaki Yatabe ◽

Hajime Kuroiwa ◽

Takahiko Tamura ◽

Masataka Yokoyama

Keyword(s):

Heart Failure ◽

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Acute Heart Failure ◽

Nutrition Support ◽

Single Center ◽

Single Center Observational Study

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450 Palliative Care in End Stage Heart Failure: A Single Center Observational Study

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2012.01.461 ◽

2012 ◽

Vol 31 (4) ◽

pp. S159

Author(s):

M.I. Owen ◽

B.D. DeMoss ◽

D. Gupta

Keyword(s):

Heart Failure ◽

Palliative Care ◽

Observational Study ◽

Single Center ◽

End Stage Heart Failure ◽

End Stage ◽

Single Center Observational Study

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A Novel Lipid Biomarker Panel for the Detection of Heart Failure with Reduced Ejection Fraction

Clinical Chemistry ◽

10.1373/clinchem.2016.257279 ◽

2017 ◽

Vol 63 (1) ◽

pp. 267-277 ◽

Cited By ~ 11

Author(s):

Matthias Mueller-Hennessen ◽

Hans-Dirk Düngen ◽

Matthias Lutz ◽

Tobias Daniel Trippel ◽

Michael Kreuter ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Left Ventricular ◽

Healthy Controls ◽

Single Center ◽

Reduced Ejection Fraction ◽

Biomarker Panel ◽

Analytical Protocol ◽

Single Center Study ◽

Center Study

Abstract OBJECTIVES In this study we aimed to identify novel metabolomic biomarkers suitable for improved diagnosis of heart failure with reduced ejection fraction (HFrEF). METHODS We prospectively recruited 887 individuals consisting of HFrEF patients with either ischemic (ICMP, n = 257) or nonischemic cardiomyopathy (NICMP, n = 269), healthy controls (n = 327), and patients with pulmonary diseases (n = 34). A single-center identification (n = 238) was followed by a multicenter confirmation study (n = 649). Plasma samples from the single-center study were subjected to metabolite profiling analysis to identify metabolomic features with potential as HFrEF biomarkers. A dedicated analytical protocol was developed for the routine analysis of selected metabolic features in the multicenter cohort. RESULTS In the single-center study, 92 of 181 metabolomic features with known chemical identity (51%) were significantly changed in HFrEF patients compared to healthy controls (P <0.05). Three specific metabolomic features belonging to the lipid classes of sphingomyelins, triglycerides, and phosphatidylcholines were selected as the cardiac lipid panel (CLP) and analyzed in the multicenter study using the dedicated analytical protocol. The combination of the CLP with N-terminal pro–B-type natriuretic peptide (NT-proBNP) distinguished HFrEF patients from healthy controls with an area under the curve (AUC) of 0.97 (sensitivity 80.2%, specificity 97.6%) and was significantly superior compared to NT-proBNP alone (AUC = 0.93, sensitivity 81.7%, specificity 88.1%, P <0.001), even in the subgroups with mildly reduced left ventricular EF (0.94 vs 0.87; P <0.001) and asymptomatic patients (0.95 vs 0.91; P <0.05). CONCLUSIONS The new metabolomic biomarker panel has the potential to improve HFrEF detection, even in mild and asymptomatic stages. The observed changes further indicate lipid alterations in the setting of HFrEF.

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