Trends in long-term cardiovascular mortality and morbidity in men and women with heart failure of ischemic versus non-ischemic aetiology in Western Australia between 1990 and 2005

Introduction: Bucindolol is a nonselective beta-adrenergic blocker with potent sympatholytic properties. The Beta-blocker Evaluation of Survival Trial (BEST) reported that the administration of bucindolol resulted in a nonsignificant decrease in total mortality (HR = 0.89 (0.78, 1.02), unadjusted p=0.10) in patients with advanced, NYHA Class III-IV heart failure (HF). Recent observations from that trial also reported that the amino acid arginine (Arg/Arg) or glycine (any Gly) in position 389 of the beta-1 receptor plays a significant role on the clinical response to bucindolol. The impact of bucindolol on cardiovascular mortality and morbidity (cardiovascular hospitalizations) has been incompletely investigated, because hospitalizations had been evaluated from case report forms (CRFs) only, and never adjudicated by the endpoints committee (EPC). Methods: The BEST data base consists of 2708 patients with a mean follow-up of 2.0 years. Cardiovascular (CV) mortality and hospitalizations have now been evaluated by EPC, which further subclassified total hospitalizations into cardiovascular (CV) and those due to worsening heart failure (HF). The impacts of Arg or Gly encoded at amino acid position 389 on endpoints were further investigated in the 1040 patient substudy. Results: Time to event results for adjudicated CV endpoints are presented below. Conclusions: Chronic administration of bucindolol results in a significant reduction in cardiovascular hospitalizations and mortality. Effects on either are strikingly beta-1 389 Arg/Gly specific, with the higher functioning, Arg/Arg version of the receptor associated with large treatment effects and Gly carriers exhibiting little or no evidence of efficacy. Genetic targeting of the β 1 -ΑR 389 polymorphism may improve the clinical responses to bucindolol for CV mortality and morbidity.

Download Full-text

Effects of Spironolactone on Long-term Mortality and Morbidity in Patients With Heart Failure and Mild or No Symptoms

The American Journal of the Medical Sciences ◽

10.1097/maj.0b013e31829dd6b1 ◽

2014 ◽

Vol 347 (4) ◽

pp. 271-276 ◽

Cited By ~ 12

Author(s):

Enrico Vizzardi ◽

Savina Nodari ◽

Giorgio Caretta ◽

Antonio D'Aloia ◽

Natalia Pezzali ◽

...

Keyword(s):

Heart Failure ◽

Mortality And Morbidity ◽

Patients With Heart Failure ◽

Long Term Mortality

Download Full-text

Relationship between worsening renal function and long-term cardiovascular mortality in heart failure patients

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.12.101 ◽

2017 ◽

Vol 230 ◽

pp. 47-52 ◽

Cited By ~ 5

Author(s):

Toshitaka Okabe ◽

Tadayuki Yakushiji ◽

Takehiko Kido ◽

Yuji Oyama ◽

Wataru Igawa ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Cardiovascular Mortality ◽

Heart Failure Patients ◽

Worsening Renal Function

Download Full-text

5951The impact of regulatory T lymphocytes on long-term survival in patients with ischemic heart failure with reduced ejection fraction

European Heart Journal ◽

10.1093/eurheartj/ehz746.0101 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

P Sulzgruber ◽

L Koller ◽

S Blum ◽

A Hammer ◽

N Kazem ◽

...

Keyword(s):

Heart Failure ◽

T Lymphocytes ◽

Ejection Fraction ◽

Cellular Immunity ◽

Cardiovascular Mortality ◽

Left Ventricular Ejection ◽

Term Survival ◽

Long Term Survival ◽

Regulatory T Lymphocytes

Abstract Background Heart failure with reduce ejection fraction (HFrEF) constitutes a global health issue representing a prevalent clinical syndrome. While pro-inflammatory cytokines proved to have a pivotal role in the development and progression of HFrEF, less attention has been paid to the cellular immunity. Regulatory T lymphocytes (Tregs) seem to have an important role in the induction and maintenance of immune homeostasis especially in patients after acute coronary syndrome and coronary vessel disease. Therefore, we aimed to investigate the impact of Tregs on the outcome of patients presenting with ischemic HFrEF. Methods We prospectively enrolled 112 patients with HFrEF defined by New York Heart Association (NYHA) functional class >II and left ventricular ejection fraction (LVEF) <40%. Patients were stratified in ischemic (iHFrEF, n=57) and dilated etiology (dHFrEF, n=55). Cells from fresh heparinized blood were stained and analyzed using BD FACS Canto II flow cytometry. Cox regression hazard analysis was used to assess the influence of Tregs on survival. The multivariate model was adjusted forage and gender. Results Comparing patients with iHFrEF to dHFrEF we found a significantly lower fraction of Tregs within lymphocytes in the ischemic subgroup (0.42% vs. 0.56%; p=0.009). After a mean follow-up time of 4.5 years 32 (28.6%) patients died due to cardiovascular causes. We found that Tregs were significantly associated with cardiovascular survival in the entire study cohort with an adjusted HR per one standard deviation (1-SD) of 0.60 (95% CI 0.39–0.92; p=0.017). Interestingly while there was no association with cardiovascular survival independently in the dHFrEFsubgroup (adj. HR per 1-SD of 0.62 (95% CI 0.17–2.31); p=0.486), we found a significant inverse association of Tregs and cardiovascular survival in patients with iHFrEFwith an adj. HR per 1-SD of 0.59 (95% CI 0.36–0.96; p=0.034). Figure 1. Survival Curves of Cardiovascular Mortality. Kaplan-Meier plots showing survival free of cardiovascular mortality in the total study collective (A) and patients stratified in ischemic CMP (B) as well dilative CMP (C) according to tertiles of frequencies of regulatory T cells. Tertile 1 = high; Tertile 2 = mid; Tertile 3 = low. Conclusion Our results indicate a potential influence of Tregs in the pathogenesis and progression of iHFrEF, fostering the implication of cellular immunity in iHFrEF pathophysiology and proving Tregs as a predictor for long-term survival among iHFrEF -patients.

Download Full-text

Long-term all-cause and cardiovascular mortality following incident myocardial infarction in men and women with and without diabetes: Temporal trends from 1998 to 2009

European Journal of Preventive Cardiology ◽

10.1177/2047487316634279 ◽

2016 ◽

Vol 23 (12) ◽

pp. 1273-1281 ◽

Cited By ~ 6

Author(s):

Lee Nedkoff ◽

Matthew Knuiman ◽

Joseph Hung ◽

Tom G Briffa

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Mortality ◽

Temporal Trends ◽

Men And Women

Download Full-text

Elevated Depression Symptoms Predict Long-Term Cardiovascular Mortality in Patients With Atrial Fibrillation and Heart Failure

Circulation ◽

10.1161/circulationaha.109.851675 ◽

2009 ◽

Vol 120 (2) ◽

pp. 134-140 ◽

Cited By ~ 129

Author(s):

Nancy Frasure-Smith ◽

François Lespérance ◽

Martine Habra ◽

Mario Talajic ◽

Paul Khairy ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Cardiovascular Mortality ◽

Depression Symptoms

Download Full-text

Distance covered during a six-minute walk test predicts long-term cardiovascular mortality and hospitalisation rates in men with systolic heart failure: an observational study

Journal of Physiotherapy ◽

10.1016/s1836-9553(13)70182-6 ◽

2013 ◽

Vol 59 (3) ◽

pp. 177-187 ◽

Cited By ~ 22

Author(s):

Kinga Wegrzynowska-Teodorczyk ◽

Eliza Rudzinska ◽

Malgorzata Lazorczyk ◽

Katarzyna Nowakowska ◽

Waldemar Banasiak ◽

...

Keyword(s):

Heart Failure ◽

Observational Study ◽

Cardiovascular Mortality ◽

Systolic Heart Failure ◽

Walk Test ◽

Six Minute Walk Test ◽

Minute Walk

Download Full-text

Predictive Value of the Serum Cystatin C/Prealbumin Ratio in Combination With NT-proBNP Levels for Long-Term Prognosis in Chronic Heart Failure Patients: A Retrospective Cohort Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.684919 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chuanhe Wang ◽

Su Han ◽

Fei Tong ◽

Ying Li ◽

Zhichao Li ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Cystatin C ◽

Cardiovascular Mortality ◽

Retrospective Cohort ◽

Serum Cystatin C ◽

Serum Cystatin ◽

All Cause Mortality ◽

Long Term Prognosis

Aim: The present study was established to investigate the use of the serum cystatin C/prealbumin (Cys-C/PAB) ratio as a predictive factor for long-term prognosis in patients with chronic heart failure.Methods: We divided our retrospective cohort of 6,311 patients admitted to hospital due to an episode of heart failure (HF) into three groups according to the Cys-C/PAB ratio. The endpoints were cardiovascular and all-cause mortality. Median follow-up time were 3.3 years (2–8 years), during which 2,945 (46.7%) patients died.Results: The Cys-C/PAB ratio was revealed to be an independent predictor of cardiovascular mortality (HR: 1.12, 95% CI: 1.15–1.23, P < 0.01) and all-cause mortality (HR: 1.19, 95% CI: 1.13–1.24, P < 0.01) by multivariable Cox analysis. Integrated discrimination improvement (IDI) showed that the Cys-C/PAB ratio in conjunction with the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) conferred a significant improvement in predicting individual risks of cardiovascular (P = 0.023) and all-cause (P = 0.028) mortality. For those with a high Cys-C/PAB ratio in combination with a high NT-proBNP level, the long-term cardiovascular mortality risk ratio was 8.6-times higher than for those with low values, and 7.51-times for all-cause mortality. Our study also showed that Cys-C/PAB and NT-proBNP in combination displayed higher value for the prediction of cardiovascular and all-cause in-hospital mortality in patients with HF.Conclusions: The Cys-C/PAB ratio is valuable for predicting cardiovascular and all-cause mortality in patients with HF and offers additional information to that provided by NT-proBNP.

Download Full-text