scholarly journals Procalcitonin (PCT) Predicts Worse Outcome in Patients with Chronic Heart Failure with Reduced Ejection Fraction (HFrEF)

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
J. Banach ◽  
Ł. Wołowiec ◽  
D. Rogowicz ◽  
L. Gackowska ◽  
I. Kubiszewska ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Roc Analysis ◽  
Diagnostic Marker ◽  
Lower Probability ◽  
Reduced Ejection Fraction ◽  
Probability Of Survival ◽  
Kaplan Meier

Introduction. Procalcitonin (PCT) is an excellent marker of sepsis but was not extensively studied in cardiology. The present study investigated PCT plasma concentration in patients with chronic heart failure with reduced ejection fraction (HFrEF) and its prognostic value during 24-month follow-up. Material and Methods. Study group consisted of 130 patients with HFrEF (LVEF ≤ 45%) and 32 controls. PCT level was assessed on admission in all patients. Telephone follow-up was performed every three months over a period of 2 years. Endpoints were death of all causes and readmission for HFrEF exacerbation. Results. HFrEF patients had significantly higher PCT concentration than controls (166.95 versus 22.15 pg/ml; p<0.001). Individuals with peripheral oedema had increased PCT comparing to those without oedema (217.07 versus 152.12 pg/ml; p<0.02). In ROC analysis, PCT turned out to be a valuable diagnostic marker of HFrEF (AUC 0.91; p<0.001). Kaplan-Meier survival curves revealed that patients with PCT in the 4th quartile had significantly lower probability of survival than those with PCT in the 1st and 2nd quartiles. In univariate, but not multivariate, analysis, procalcitonin turned out to be a significant predictor of death during 24-month follow-up. (HR 1.002; 95% CI 1.000–1.003; p<0.03). Conclusions. Elevated PCT concentration may serve as another predictor of worse outcome in patients with HFrEF.

scholarly journals Right ventricular recovery during follow-up is associated with improved survival in patients with chronic heart failure with reduced ejection fraction

2016 ◽  
Vol 18 (12) ◽  
pp. 1462-1471 ◽  
Author(s):  
Frank Lloyd Dini ◽  
Erberto Carluccio ◽  
Anca Simioniuc ◽  
Paolo Biagioli ◽  
Gianpaolo Reboldi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Reduced Ejection Fraction

scholarly journals Participation in a Heart Failure Clinical Trial: Perspectives and Opportunities From the VICTORIA Trial and VICTORIA Simultaneous Registry

2021 ◽  
Author(s):  
Justin Ezekowitz ◽  
Robert J. Mentz ◽  
Cynthia M. Westerhout ◽  
Nancy K. Sweitzer ◽  
Michael M. Givertz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Risk Score ◽  
Meta Analysis ◽  
The United States ◽  
Unique Identifier ◽  
Eligibility Criteria ◽  
Reduced Ejection Fraction

Background: Randomized controlled trials (RCTs) often target enrollment of patients with demographics and outcomes less representative of the broader population of interest. To provide context for the VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), we designed a registry of hospitalized patients with worsening heart failure to characterize their clinical profile, outcomes, and reasons for their nonparticipation in a RCT. Methods: Fifty-one RCT sites in Canada and the United States participated. Eligible patients included those with chronic heart failure, hospitalized for heart failure, and an ejection fraction <45%; no other exclusions were applied. Sites identified patients between 2017 and 2019 during the RCT enrollment period. RCT eligibility criteria were applied, and non–mutually exclusive reasons for nonenrollment were captured. Mortality at 1 year was estimated via the Meta-Analysis Global Group in Chronic Heart Failure risk score or as observed in the RCT. Results: Overall, 2056 patients were enrolled in the registry; 61% (n=1256) were ineligible for the RCT, 37% (n=766) were eligible but not enrolled, and 2% (n=34) were also enrolled in the RCT. Registry participants had a median age of 70, 33% were women, and 63% were White. The median risk score predicted a 20.9% 1-year mortality, higher than in the RCT (predicted 14.7% and observed 11.5%). Major reasons for ineligibility in the RCT included the use of nitrates (23%), systolic blood pressure <100 mm Hg (12%), and substance use (11%) with other exclusion criteria <10%. For eligible patients, reasons for nonparticipation in the RCT included lack of interest in participating (28%), poor compliance (25%), inability to complete follow-up (23%), too sick (20%), unable to provide consent (17%), and distance from site (15%). Conclusions: Patients with worsening heart failure in routine clinical practice exhibit high-risk features, and approximately one-third were eligible for an RCT but excluded. The majority of these nonparticipating patients had modifiable reasons. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02861534.

scholarly journals Soluble ST2 protein and hospitalizations due to worsening chronic heart failure during a one-year follow-up in a population with reduced ejection fraction

2017 ◽  
Vol 26 (6) ◽  
pp. 931-938 ◽  
Author(s):  
Karolina Wojtczak-Soska ◽  
Agata Sakowicz ◽  
Tadeusz Pietrucha ◽  
Kamil Janikowski ◽  
Malgorzata Lelonek
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Soluble St2 ◽  
Reduced Ejection Fraction ◽  
One Year

Exercise Dynamic of Patients with Chronic Heart Failure and Reduced Ejection Fraction

2021 ◽  
Vol 23 (7) ◽  
Author(s):  
Sara Rovai ◽  
Irene Mattavelli ◽  
Elisabetta Salvioni ◽  
Ugo Corrà ◽  
Gaia Cattadori ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Reduced Ejection Fraction

scholarly journals Effect of frailty on treatment, hospitalisation and death in patients with chronic heart failure

2021 ◽  
Author(s):  
S. Sze ◽  
P. Pellicori ◽  
J. Zhang ◽  
J. Weston ◽  
I. B. Squire ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Frailty Scale ◽  
Mineralocorticoid Receptor Antagonist ◽  
Reduced Ejection Fraction ◽  
Frail Patients ◽  
History Of ◽  
Poor Outcomes ◽  
To Receive

Abstract Background Frailty is common in patients with chronic heart failure (CHF) and is associated with poor outcomes. The natural history of frail patients with CHF is unknown. Methods Frailty was assessed using the clinical frailty scale (CFS) in 467 consecutive patients with CHF (67% male, median age 76 years, median NT-proBNP 1156 ng/L) attending a routine follow-up visit. Those with CFS > 4 were classified as frail. We investigated the relation between frailty and treatments, hospitalisation and death in patients with CHF. Results 206 patients (44%) were frail. Of 291 patients with HF with reduced ejection fraction (HeFREF), those who were frail (N = 117; 40%) were less likely to receive optimal treatment, with many not receiving a renin–angiotensin–aldosterone system inhibitor (frail: 25% vs. non-frail: 4%), a beta-blocker (16% vs. 8%) or a mineralocorticoid receptor antagonist (50% vs 41%). By 1 year, there were 56 deaths and 322 hospitalisations, of which 25 (45%) and 198 (61%), respectively, were due to non-cardiovascular (non-CV) causes. Most deaths (N = 46, 82%) and hospitalisations (N = 215, 67%) occurred in frail patients. Amongst frail patients, 43% of deaths and 64% of hospitalisations were for non-CV causes; 58% of cardiovascular (CV) deaths were due to advancing HF. Among non-frail patients, 50% of deaths and 57% of hospitalisations were for non-CV causes; all CV deaths were due to advancing HF. Conclusion Frailty in patients with HeFREF is associated with sub-optimal medical treatment. Frail patients are more likely to die or be admitted to hospital, but whether frail or not, many events are non-CV. Graphical abstract

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