scholarly journals Effect of diabetes mellitus on long-term outcomes of surgical revascularization in patients with ischemic heart failure surgical revascularization

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Meng Liu ◽  
Hua-Jun Zhang ◽  
Han Song ◽  
Nan Cheng ◽  
Yuan-Bin Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Ischemic Heart ◽  
Ischemic Heart Failure ◽  
Long Term Outcomes ◽  
Surgical Revascularization

scholarly journals Sex Difference in Patients With Ischemic Heart Failure Undergoing Surgical Revascularization

Circulation ◽  
2018 ◽  
Vol 137 (8) ◽  
pp. 771-780 ◽  
Author(s):  
Ileana L. Piña ◽  
Qi Zheng ◽  
Lilin She ◽  
Hanna Szwed ◽  
Irene M. Lang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sex Difference ◽  
Ischemic Heart ◽  
Ischemic Heart Failure ◽  
Surgical Revascularization

scholarly journals Angina Severity at the Time of Revascularization in Patients With Diabetes Mellitus and Its Association With Long-term Outcomes: A Multicenter Cohort Study.

2021 ◽  
Author(s):  
Nozomi Niimi ◽  
Satoshi Shoji ◽  
Mitsuaki Sawano ◽  
Nobuhiro Ikemura ◽  
Yasuyuki Shiraishi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Contributing Factors ◽  
Long Term Outcomes ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Patients With Diabetes

Abstract Background: While angina severity is pertinent in determining the management strategy for patients with stable ischemic heart disease (SIHD), its contributing factors and prognostic effect remain unclear, particularly in patients with diabetes mellitus (DM). Methods: From a multicenter percutaneous coronary intervention (PCI) registry, 1,911 consecutive SIHD patients without previous revascularization or heart failure between 2008 and 2015 were analyzed. Angina severity was assessed by the Canadian Cardiovascular Society (CCS) functional classification at the time of PCI. We assessed the contributing factors of CCS III/IV angina. Further, the association between CCS III/IV angina and subsequent occurrence of major adverse cardiac and cerebrovascular events (MACCE: all-cause death, acute coronary syndrome, heart failure, and stroke) within 2 years were analyzed in patients with DM and without DM.Results: A total of 771 SIHD patients (40.3% of all SIHD patients) had DM at the time of revascularization. In the total cohort, 52.4% had CCS I/II, and 13.0% had CCS III/IV angina, with less prevalence of CCS III/IV angina in patients with DM than in those without DM (11.3% vs. 14.2%, P<0.001). In patients with DM, the prevalence of unprotected left main coronary trunk lesions and proximal left anterior descending lesion increased with angina severity. The presence of severe angina at the time of PCI was associated with MACCE in patients with DM (adjusted hazard ratio 1.93; [95% CI 1.01, 3.71]; P=0.047), while no significant difference in those without DM (adjusted hazard ratio 0.82; [95% CI 0.42, 1.59]; P=0.55).Conclusions: In SIHD patients with DM that underwent PCI, severe angina at the time of revascularization was associated with complex coronary anatomies and long-term outcomes. These findings underscore the importance of evaluating angina-related health status while considering revascularization in SIHD patients with DM.

P577Effect of adding an implantable cardioverter defibrillator on long-term survival in non-ischemic CRT patients stratified by Goldenberg risk score

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Kosztin ◽  
W R Schwertner ◽  
A Behon ◽  
E Merkel ◽  
E Zima ◽  
...  
Keyword(s):  
Heart Failure ◽  
Implantable Cardioverter Defibrillator ◽  
Risk Score ◽  
Cardiac Risk ◽  
Ischemic Heart ◽  
Ischemic Heart Failure ◽  
Mortality Benefit ◽  
Cardioverter Defibrillator ◽  
All Cause Mortality

Abstract Background There are limited and incomprehensive long-term data on the effects of adding an implantable cardioverter defibrillator (ICD) to cardiac resynchronization therapy (CRT) in patients with non-ischemic heart failure.  Purpose We compared the long-term all-cause mortality and relative risk reduction in mortality of non-ischemic patients after CRT-P vs. CRT-D implantation stratified by their Goldenberg risk score. Methods In our retrospective registry, data of 1196 non-ischemic patients who underwent CRT implantation between 2000 to 2018 were collected. Goldenberg sudden cardiac risk score was calculated by the presence of atrial fibrillation, NYHA class &gt; 2, age &gt; 70 years, blood urea nitrogen &gt; 26mg/dl and QRS width.  Results In our registry from 1196 CRT implanted patients with non-ischemic heart failure, 716 patients had all the required data to calculate the Goldenberg score. From this cohort 379 (53%) had CRT-P and 337 (47%) CRT-D implantation. The mean value of the Goldenberg score was 2.7 in the total cohort, while a significantly higher score was found in the CRT-P group (CRT-P 2.9 ± 1.1 vs. CRT-D 2.5 ± 1.1 p &lt; 0.001). During the median follow-up time of 4.9 years, 345 (48%) patients reached the primary endpoint, 220 patients (64%) with CRT-P and 125 patients (36%) with CRT-D. After comparing patients by low (≤3) and high (&gt;3) Goldenberg score, we found that CRT-D patients with lower risk score showed mortality benefit compared to CRT-P (HR 0.69; 95%, CI 0.53-0.89; p = 0.001). In the contrary there was no apparent mortality benefit in CRT-D patients compared to CRT-P when high Goldenberg score subgroup was analyzed (HR 0.99; 95%, CI 0.67-1.45; p = 0.95). Conclusions In non-ischemic heart failure patients, Goldenberg sudden cardiac risk score can be also applied. In CRT-D patients those with less co-morbidities and lower (≤3) Goldenberg risk score showed mortality benefit compared to CRT-P patients, while among patients with higher score (&gt;3) adding an ICD had no additional effect on all-cause mortality.

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