Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden

Abstract Objectives: To determine the case-fatality rate (CFR) of coronavirus disease 2019 (COVID-19) and its associated determinants in order to understand the true magnitude of the problem during ongoing conflict in Yemen. Methods: The CFR among confirmed COVID-19 cases in Yemen was calculated. The data was retrieved from national COVID-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020. Results: A total of 419 confirmed COVID-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of total cases, 95 deaths were reported, giving CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly compared to young adults and varied between governorates. Mortality was associated with preexisting hypertension (OR: 2.30; 95%CI: 1.58, 3.54) and diabetes (OR: 1.68; 95%CI: 1.08, 2.61). Conclusions: Elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.

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THU0442 GOUT AND HEART FAILURE IN THE US: A NATIONAL PERSPECTIVE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3905 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 458.2-458

Author(s):

G. Singh ◽

M. Sehgal ◽

A. Mithal

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Confidence Intervals ◽

Burden Of Illness ◽

Average Length ◽

Private Insurance ◽

Significant Risk ◽

Case Fatality ◽

The United States ◽

The Us

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared

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Abstract 16010: Congestive Heart Failure and Coronavirus Disease 2019 Illness Severity

Circulation ◽

10.1161/circ.142.suppl_3.16010 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Max Ruge ◽

Joanne Michelle D Gomez ◽

Gatha G Nair ◽

Setri Fugar ◽

Jeanne du Fay de Lavallaz ◽

...

Keyword(s):

Heart Failure ◽

At Risk ◽

Congestive Heart Failure ◽

Case Fatality ◽

Severity Of Illness ◽

Severe Infection ◽

Severe Illness ◽

Increased Risk ◽

History Of ◽

Male Sex

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has killed hundreds of thousands worldwide. Those with cardiovascular disease represent a vulnerable population with higher risk for contracting COVID-19 and worse prognosis with higher case fatality rates. Congestive heart failure (CHF) may lead to worsening COVID-19 symptoms. However, it is unclear if CHF is an independent risk factor for severe COVID-19 infection or if other accompanying comorbidities are responsible for the increased risk. Methods: From March to June 2020, data was obtained from adult patients diagnosed with COVID-19 infection who were admitted in the Rush University System for Health (RUSH) in Illinois. Heart failure patients, determined by ICD code assignments extracted from the electronic medical records, were identified. Multivariable logistic regression was performed between predictor variables and a composite outcome of severe infection consisting of Intensive Care Unit (ICU) admission, intubation, or in-hospital mortality. Results: In this cohort (n=1136), CHF [odds ratio (OR) 1.02] alone did not predict a more severe illness. Prior myocardial infarction [(MI), OR 3.55], history of atrial fibrillation [(AF), OR 2.14], and male sex (OR 1.55) were all significantly (p<0.001) associated with more severe COVID-19 illness course when controlling for CHF (Figure 1). In the 178 CHF patients, more advanced age (68.8 years vs. 63.8 years; p<0.05) and female sex (54.5% vs. 39.1%; p<0.05) were associated with increased severity of illness. Conclusions: Prior MI, history of AF, and male sex predicted more severe COVID-19 illness course in our cohort, but pre-existing heart failure alone did not. However, CHF patients who are females and older in age are at risk for severe infection. These findings help clinicians identify patients with comorbidities early at risk for severe COVID-19 illness.

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Young adults with heart failure: Who are they? What is their clinical profile?

Heart & Lung ◽

10.1016/j.hrtlng.2015.10.012 ◽

2015 ◽

Vol 44 (6) ◽

pp. 549

Author(s):

Connie M. Lewis ◽

Zachary L. Cox ◽

Pikki Lai ◽

Rainy Valerio ◽

Daniel J. Lenihan

Keyword(s):

Heart Failure ◽

Young Adults ◽

Clinical Profile

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Significant mortality, morbidity and resource utilization associated with advanced heart failure in congenital heart disease in children and young adults

American Heart Journal ◽

10.1016/j.ahj.2018.11.010 ◽

2019 ◽

Vol 209 ◽

pp. 9-19 ◽

Cited By ~ 12

Author(s):

Danielle S. Burstein ◽

Pirouz Shamszad ◽

Dingwei Dai ◽

Christopher S. Almond ◽

Jack F. Price ◽

...

Keyword(s):

Heart Failure ◽

Congenital Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Resource Utilization ◽

Congenital Heart ◽

Advanced Heart Failure ◽

Children And Young Adults ◽

Significant Mortality

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Life Threatening Acute Heart Failure in Two Young Adults Treated with Antidepressant Medication

Journal of Pharmacovigilance ◽

10.4172/2329-6887.1000154 ◽

2014 ◽

Vol 02 (06) ◽

Author(s):

Gerhard Wikstrom

Keyword(s):

Heart Failure ◽

Young Adults ◽

Acute Heart Failure ◽

Antidepressant Medication ◽

Life Threatening

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Triglyceride-Glucose Index and HOMA-IR in Young Adulthood and Risk of Incident Congestive Heart Failure: The CARDIA Study

10.21203/rs.3.rs-960362/v1 ◽

2021 ◽

Author(s):

Xianghui Zeng ◽

Haobin Zhou ◽

Yuting Xue ◽

Xiao Wang ◽

Qiong Zhan ◽

...

Keyword(s):

Heart Failure ◽

Insulin Resistance ◽

Congestive Heart Failure ◽

Young Adults ◽

Young Adulthood ◽

Surrogate Marker ◽

Model Assessment ◽

Tyg Index ◽

Triglyceride Glucose Index ◽

Increased Risk

Abstract Background: Triglyceride-glucose (TyG) index and homeostasis model assessment-insulin resistance (HOMA-IR) are related to insulin resistance (IR). The aim of this study was to assess the association between triglyceride-glucose index / HOMA-IR within young adults and congestive heart failure (CHF), and to explore whether triglyceride-glucose index can replace HOMA-IR as a surrogate marker for insulin resistance in predicting the risk of CHF.Methods：A total of 4992 participants between the ages of 18 and 30 were enrolled from the Coronary Artery Risk Development in Young Adults (CARDIA) investigation (from 1985 to 1986 [year 0]). Cox proportional hazard regression analysis was conducted for assessing correlations between baseline TyG index / HOMA-IR and congestive heart failure events, together with Receiver Operating Characteristic (ROC) Curve employed for scrutinizing TyG index / HOMA-IR and he risk of CHF.Results: During the 31-year follow-up period, 64 (1.3%) out of the 4992 participants developed congestive heart failure. In multivariable Cox proportional hazards models, adjusted for confounding factors for CHF, increased risk of CHF was associated with per-unit increase in TyG index (hazard ratio [HR] 2.8; 95% confidence interval [CI], 1.7-4.7) and HOMA-IR (HR 1.2; 95%CI, 1.1-1.3). Kaplan-Meier curve analysis showed that participants in the TyG index and HOMA-IR index Q4 group had a higher risk of congestive heart failure than those in the Q1 group. The area under curve (AUC) for TyG index and HOMA-IR consisted of 0.67 (95% CI, 0.6-0.742) and 0.675 (95%CI, 0.604-0.746), respectively. There were no significant differences between TyG index and HOMA-IR for AUC (P = 0.986).Conclusions: TyG index and HOMA-IR are independent risk factors for CHF. The TyG index can replace HOMA-IR in young adulthood as a surrogate marker for IR to predict the risk of CHF.

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