Abstract 18183: Short-term Impact of Defibrillation Testing on Heart Failure Admission

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Baris Akdemir ◽  
Balaji Krishnan ◽  
Venkatakrishna Tholakanahalli ◽  
David Benditt ◽  
Jian-Ming Li
Keyword(s):  
Heart Failure ◽  
Retrospective Study ◽  
Short Term ◽  
Primary Endpoints ◽  
Significant Difference ◽  
Heart Failure Admission ◽  
The Mean ◽  
Demographic Features ◽  
Long Term Mortality

Introduction: SIMPLE trial showed that defibrillation testing (DT) is safe but does not improve shock efficacy or mortality. However, impact of DT on heart failure (HF) admission at 30 days is unclear. Objectives: The aim of this study was to compare mortality and HF admission of ICD recipients who underwent DT (DT+) compared with those who did not (DT-). Methods: In this retrospective study, we analyzed consecutive patients who received an ICD ( new implant or generator change ) with DT+ and DT- between January 2008 and May 2014 from our ICD registry. Primary endpoints were death ( 30 days and 1 year ) and HF admission ( 30 days) . Results: Of the 501 patients, 311 patients (62,1%) were in DT+ group vs 190 (37,9%) were in DT- group. The mean ages in DT+ and DT- were 66 ± 10 and 70 ± 10 respectively (p<0.0001). DT- group had more generator change than DT+ group ( 61,1% versus 30,9%, p < 0.0001). Other demographic features were not significantly different between two groups (Table 1). No significant difference in mortality was found between two groups at 30 days and 1 year. HF admission at 30 days was significantly higher in DT+ group than in DT- group ( 17,4 % versus 4,7%, p < 0.0001) (Table 2). Conclusion: No short-term and long-term mortality were associated with DT, but DT was associated with increased HF admission at 30 days. Future prospective studies are needed to prove this association.

scholarly journals Evaluation of Thyroid Function in Patients Hospitalized for Acute Heart Failure

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ana Rita Leite ◽  
João Sérgio Neves ◽  
Marta Borges-Canha ◽  
Catarina Vale ◽  
Madalena von Hafe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Clinical Outcomes ◽  
Acute Heart Failure ◽  
Thyroid Function ◽  
Short Term ◽  
Cardiovascular Parameters ◽  
Adjusted Model ◽  
Long Term Mortality

Background. Thyroid hormones (TH) are crucial for cardiovascular homeostasis. Recent evidence suggests that acute cardiovascular conditions, particularly acute heart failure (AHF), significantly impair the thyroid axis. Our aim was to evaluate the association of thyroid function with cardiovascular parameters and short- and long-term clinical outcomes in AHF patients. Methods. We performed a single-centre retrospective cohort study including patients hospitalized for AHF between January 2012 and December 2017. We used linear, logistic, and Cox proportional hazard regression models to analyse the association of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) with inpatient cardiovascular parameters, in-hospital mortality, short-term adverse clinical outcomes, and long-term mortality. Two models were used: (1) unadjusted, and (2) adjusted for age and sex. Results. Of the 235 patients included, 59% were female, and the mean age was 77.5 (SD 10.4) years. In the adjusted model, diastolic blood pressure was positively associated with TSH [β = 2.68 (0.27 to 5.09); p = 0.030 ]; left ventricle ejection fraction (LVEF) was negatively associated with FT4 [β = -24.85 (-47.87 to -1.82); p = 0.035 ]; and a nonsignificant trend for a positive association was found between 30-day all-cause mortality and FT4 [OR = 3.40 (0.90 to 12.83); p = 0.071 ]. Among euthyroid participants, higher FT4 levels were significantly associated with a higher odds of 30-day all-cause death [OR = 4.40 (1.06 to 18.16); p = 0.041 ]. Neither TSH nor FT4 levels were relevant predictors of long-term mortality in the adjusted model. Conclusions. Thyroid function in AHF patients is associated with blood pressure and LVEF during hospitalization. FT4 might be useful as a biomarker of short-term adverse outcomes in these patients.

scholarly journals QT prolongation predicts short-term mortality independent of comorbidity

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1254-1260 ◽  
Author(s):  
Charlotte Gibbs ◽  
Jacob Thalamus ◽  
Doris Tove Kristoffersen ◽  
Martin Veel Svendsen ◽  
Øystein L Holla ◽  
...  
Keyword(s):  
Main Diagnosis ◽  
Short Term ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Short Term Mortality ◽  
Comorbidity Index ◽  
Short And Long Term ◽  
Mortality Hazard Ratio ◽  
Long Term Mortality

Abstract Aims A prolonged corrected QT interval (QTc) ≥500 ms is associated with high all-cause mortality in hospitalized patients. We aimed to explore any difference in short- and long-term mortality in patients with QTc ≥500 ms compared with patients with QTc <500 ms after adjustment for comorbidity and main diagnosis. Methods and results Patients with QTc ≥500 ms who were hospitalized at Telemark Hospital Trust, Norway between January 2007 and April 2014 were identified. Thirty-day and 3-year all-cause mortality in 980 patients with QTc ≥500 ms were compared with 980 patients with QTc <500 ms, matched for age and sex and adjusting for Charlson comorbidity index (CCI), previous admissions, and main diagnoses. QTc ≥500 ms was associated with increased 30-day all-cause mortality [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.38–2.62; P < 0.001]. There was no significant difference in mortality between patients with QTc ≥500 ms and patients with QTc <500 ms who died between 30 days and 3 years; 32% vs. 29%, P = 0.20. Graded CCI was associated with increased 3-year all-cause mortality (CCI 1–2: HR 1.62, 95% CI 1.34–1.96; P < 0.001; CCI 3–4: HR 2.50, 95% CI 1.95–3.21; P < 0.001; CCI ≥5: HR 3.76, 95% CI 2.85–4.96; P < 0.001) but was not associated with 30-day all-cause mortality. Conclusion QTc ≥500 ms is a powerful predictor of short-term mortality overruling comorbidities. QTc ≥500 ms also predicted long-term mortality, but this effect was mainly caused by the increased short-term mortality. For long-term mortality, comorbidity was more important.

scholarly journals Comparing the effect of cardiac biomarkers on the outcome of normotensive patients with acute pulmonary embolism

2017 ◽  
Vol 87 (1) ◽  
Author(s):  
Yaser Jenab ◽  
Marzieh Pourjafari ◽  
Maryam Sotoudeh ◽  
Masoumeh Lotfi-tokaldany ◽  
Nasrin Etesamifard ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Adverse Outcome ◽  
Mean Value ◽  
Cardiac Biomarkers ◽  
Short Term ◽  
Fatty Acid Binding ◽  
The Mean ◽  
Long Term Mortality

Acute pulmonary embolism (PE) is a cardiovascular challenge with potentially fatal consequences. This study was designed to observe the association of novel cardiac biomarkers with outcome in this setting. In this prospective study, from 86 patients with a confirmed diagnosis of PE, 59 patients met the inclusion criteria (22 men, 37 women; mean age, 63.36±15.04 y).The plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15), heart-type fatty acid-binding protein (H-FABP), tenascin-C, and D-dimer were measured at the time of confirmed diagnosis. The endpoints of the study were defined as the short-term adverse outcome and long-term all-cause mortality. Totally, 11.8% (7/59) of the patients had the short-term adverse outcome. The mean value of logNT-proBNP was 6.40±1.66 pg/ml. Among all the examined biomarkers, only the mean value of logNT-proBNP was significantly higher in the patients with the short-term adverse outcome (7.88±0.67 vs. 6.22± 1.66 pg/ml; OR, 2.359; 95% CI, 1.037 to 5.367; P=0.041). After adjustment, a threefold increase in the short-term adverse outcome was identified (OR, 3.239; 95% CI, 0.877 to 11.967; P=0.078).Overall, 18.64% (11/59) of the patients had expired by the long-term follow-up. Moreover, adjustment revealed an evidence regarding association between increased logNT-proBNP levels and long-term mortality (HR, 2.163; 95%CI, 0.910 to 5.142; P=0.081). Our study could find evidences on association between increased level of NT-proBNP and short-term adverse outcome and/or long-term mortality in PE. This biomarker may be capable of improving prediction of outcome and clinical care in non-high-risk PE.

Telemedicine reduces long term mortality in patients with heart failure with reduced ejection fraction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
G Koulaouzidis ◽  
D Charisopoulou
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Care Quality ◽  
Aldosterone Antagonists ◽  
Reduced Ejection Fraction ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
Long Term Mortality

Abstract Funding Acknowledgements Type of funding sources: None. Background Telemonitoring was introduced with the potential to improve the medical care, quality of life and prognosis of patients with heart failure (HF). The aim of the study was to assess the effect of home telemedicine (HTM) in long-term mortality in patients with heart failure with reduced ejection fraction (HFrEF). Methods This is a retrospective study of 452 consecutive subjects with HFrEF  who were referred to  HTM service. The HTM service was offered to HFrEF patients who: a) have been recently diagnosed with HF, b) have been recently hospitalized due to HF, c) have worsening HF, d) need frequent medication changes, e) are NYHA class II or III. Most patients (n= 352) accepted HTM (HTM-group), but 100 patients refused and received the usual care (UC-group). The HTM group were assessed daily by body weight, blood pressure and heart rate using electronic devices with automatic transfer of data to an online database. A nurse practitioner evaluated the measurements every day using a dedicated clinical user interface. Clinical alerts are dealt with by the HTM nurse calling the patient and then, if necessary, a clinical responder; either a community HF nurse with prescribing qualifications or a cardiologist if long-term changes in therapy are required. Patients in both groups were seen at a specialist HF clinic and the frequency of clinical follow-up was at the discretion of the HF team. The same cardiologists reviewed the patients in both groups. Follow-up period was 60 months. Higher prevalence of male gender was seen in the UC-group (78% vs 67%, p = 0.03). Otherwise there was no significant difference in the demographic characteristics or primary cause of HF between the two groups. Also no differences were seen between the two groups in the treatment with beta blockers, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers and aldosterone antagonists. Results The mean follow-up period for survivors was significantly higher in HTM-group compared with UC-group (50.6 ± 18.2 vs. 37.8 ± 25.2, p &lt; 0.001). After 3 month of follow-up, the all-cause mortality was significantly lower in HTM-group than in UC-group (2.8% vs. 14%; p &lt;0.01). This significantly lower mortality in HTM-group compared to UC-group was further observed in 6 months follow-up ( 4.5% vs. 22%, p &lt; 0.0009); in 12 months follow-up (9% vs. 31.2%,  p &lt; 0.0002); in 18 months follow-up (13.4% vs. 38.2%, p &lt; 0.0001); in 24 months follow-up (15.1% vs. 42%, p &lt; 0.0001); in 36 months follow-up (19% vs. 44.5%, p &lt; 0.0002); in 48 months follow-up (23% vs. 46%, p &lt; 0.001); and finally in 60 months follow-up (25.3% vs. 46%, p &lt; 0.003). Conclusion HTM was associated with improved survival. This was observed from the first months of the study and remained present until the end of the study.The reduced mortality in the HTM patients may reflect the fact that HTM improves patient HF knowledge and self-care behaviors.

scholarly journals Rationale for and design of the TRUE-AHF trial: the effects of ularitide on the short-term clinical course and long-term mortality of patients with acute heart failure

2016 ◽  
Vol 19 (5) ◽  
pp. 673-681 ◽  
Author(s):  
Milton Packer ◽  
Richard Holcomb ◽  
William T. Abraham ◽  
Stefan Anker ◽  
Kenneth Dickstein ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Clinical Course ◽  
Short Term ◽  
Long Term Mortality

Postinflammatory medial meatal fibrosis: early and late surgical outcomes

2013 ◽  
Vol 127 (12) ◽  
pp. 1160-1168 ◽  
Author(s):  
A Ghani ◽  
M C F Smith
Keyword(s):  
Retrospective Study ◽  
Standard Deviation ◽  
Outcome Measures ◽  
Surgical Outcomes ◽  
Common Complication ◽  
Significant Difference ◽  
High Prevalence ◽  
The Mean ◽  
Over Time

AbstractObjectives:To evaluate the primary and long-term surgical outcomes of patients with postinflammatory medial meatal fibrosis.Methods:A retrospective study was conducted of 14 ears (in 12 patients) with postinflammatory medial meatal fibrosis managed surgically. Outcome measures were primary (i.e. less than six months) and long-term (i.e. greater than five years) closure of the air–bone gap, and the incidence of otorrhoea and restenosis.Results:At primary review, the mean air–bone gap ± standard deviation had decreased from 29.9 ± 11.6 dB to 12 ± 8.4 dB (p < 0.0006). Seven (50 per cent) ears had closure of the air–bone gap to within 10 dB. However, for the 9 ears receiving long-term review, the mean air–bone gap ± standard deviation increased to 19.3 ± 15.2 dB; there was no significant difference between this result and pre-operative values (p = 0.06). Of the 9 long-term review ears, 3 (33 per cent) showed closure of the air–bone gap to within 10 dB. Recurrent otorrhoea was the most common complication, occurring in 5 of the 9 long-term review ears (56 per cent); in addition, 3 (33 per cent) of these 9 ears developed restenosis.Conclusion:Over time, the success of surgery for postinflammatory medial meatal fibrosis diminishes. This was demonstrated in the present study by progressive post-operative hearing decline and a high prevalence of otorrhoea and restenosis.

Short-term weight loss after hospitalization predicts long-term survival in patients with chronic heart failure

2006 ◽  
Vol 31 (03) ◽  
Author(s):  
M Lainscak ◽  
S von Haehling ◽  
A Sandek ◽  
I Keber ◽  
M Kerbev ◽  
...  
Keyword(s):  
Heart Failure ◽  
Weight Loss ◽  
Chronic Heart Failure ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival

Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 9 (04) ◽  
Author(s):  
Shivananda B Nayak ◽  
Dharindra Sawh ◽  
Brandon Scott ◽  
Vestra Sears ◽  
Kareshma Seebalack ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Biomarkers ◽  
Double Blind Study ◽  
Short Term ◽  
Double Blind ◽  
Reduced Ejection Fraction ◽  
The Mean ◽  
Design And Methods ◽  
The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

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