Abstract 256: The Effect Of Credentialed Cardiovascular Pharmacists On Process Measures And Outcomes In Myocardial Infarction And Heart Failure

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Michael P Dorsch ◽  
Jennifer Lose ◽  
Robert J DiDomenico
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Process Of Care ◽  
Cross Sectional ◽  
Process Measures ◽  
Matched Case ◽  
Improved Performance ◽  
The Individual ◽  
Hospital Compare ◽  
Control Study

Background: Although cardiology pharmacist credentialing is strongly advocated, there is little to no evidence suggesting board certification improves patient outcomes. The purpose of this study is to determine if institutions with inpatient cardiology credentialed pharmacists exhibit improved quality measure performance for myocardial infarction and heart failure compared to institutions without inpatient cardiology credentialed pharmacists. Methods: This is a multicenter, retrospective, cross-sectional, matched case-control study. The cardiology credentialing studied was the Board of Pharmaceutical Specialties (BPS) Added Qualification in Cardiology (AQCV). A list of AQCV pharmacists was derived from publically available data on the BPS website in July 2011 for inclusion in the study. Each case AQCV pharmacist hospital was matched to a hospital without an AQCV pharmacist in a 1 to 3 manner. Control hospitals were matched by geographical region, number of cardiovascular discharges, and the type of hospital. The proportion of patients meeting HF and AMI process of care measures, 30-day readmission rate, and 30 day mortality for each hospital were determined from the website Hospital Compare. Results: The 34 AQCV hospitals were matched to 102 non-AQCV hospitals. Hospitals that employed inpatient AQCV pharmacists performed better on a composite of 5 medication-related process of care measures compared to hospitals that do not employ inpatient AQCV pharmacists (OR 1.41, 95% CI 1.25-1.58, p <0.0001, p<0.001 for heterogeneity). The individual measures that were improved were aspirin on discharge for AMI and ACEi/ARB on discharge for HF. Thirty day readmission and mortality for HF and AMI were not different in hospitals that employed inpatient AQCV pharmacists compared to those that do not. Conclusions: Hospitals that employ inpatient AQCV credentialed pharmacists have improved performance on process of care measures compared to those that do not employ AQCV credentialed pharmacists. This analysis did not demonstrate that inpatient AQCV credentialed pharmacists improve readmissions or mortality for AMI and HF.

scholarly journals Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study

2021 ◽  
Author(s):  
Arjola Bano ◽  
Nicolas Rodondi ◽  
Jürg H. Beer ◽  
Giorgio Moschovitis ◽  
Richard Kobza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Unique Identifier ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
History Of

Background Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF. Methods and Results Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities. Conclusions Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02105844.

Does Absolute Neutrophilia Predict Early Congestive Heart Failure After Acute Myocardial Infarction? A Cross-Sectional Study

2008 ◽  
Vol 101 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Farid Rashidi ◽  
Arash Rashidi ◽  
Ali Golmohamadi ◽  
Eslam Hoseinzadeh ◽  
Behzad Mohammadi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Congestive Heart Failure ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Serum osteoprotegerin in young survivors of myocardial infarction

2006 ◽  
Vol 95 (05) ◽  
pp. 881-885 ◽  
Author(s):  
Ellen Brodin ◽  
Trond Børvik ◽  
Baldur Sveinbjørnsson ◽  
John-Bjarne Hansen ◽  
Anders Vik
Keyword(s):  
Myocardial Infarction ◽  
Positive Association ◽  
Coagulation Factors ◽  
Significant Negative Correlation ◽  
Young Survivors ◽  
Matched Case ◽  
The Relationship ◽  
Matched Case Control Study ◽  
Necrosis Factor ◽  
Control Study

SummaryOsteoprotegerin (OPG) is a member of the tumour necrosis factor superfamily and is involved in the regulation of bone metabolism and vascular calcification. Increased serum OPG levels have been reported in patients with stable angina pectoris and survivors of myocardial infarction with heart failure. The purpose of the present study was to determine serum OPG levels in young survivors of acute myocardial infarction (MI), and the relationship between OPG, homocysteine, sCD40L and coagulation factors in blood. Fifty-eight patients with verified MI, 40–60 years of age, were recruited 1–4 years after the acute event into an age- and sex- matched case control study with controls recruited from the general population. Serum OPG levels were similar in cases (2.41 ng/ml, 2.11–2.77 ng/ml) (mean, 95% CI) and controls (2.43 ng/ml, 2.11–2.79 ng/ml) (p= 0.92). Significant correlation between OPG and homocysteine was found in patients (r=0.30, p=0.02) and controls (r=0.35, p=0.007). A significant negative correlation was found between OPG and sCD40L in patients (r=-0.51, p<0.001), but not in controls (r=0.001, p=0.96). No associations were found between serum OPG and markers of coagulation activation. The present study shows that serum OPG level was not increased in young survivors of uncomplicated myocardial infarction. Serum OPG levels were not associated with thrombin generation assessed by thrombin-antithrombin complexes (TAT), but a positive association between serum OPG and homocysteine was found.

scholarly journals Cognitive and self-care changes in patients with heart failure in the Amazon Region

2020 ◽  
Vol 9 (6) ◽  
pp. e98963321
Author(s):  
Adriana de Oliveira Lameira Veríssimo ◽  
Juniel Pereira Honorato ◽  
Silvio Douglas Medeiros Costa ◽  
João Victor Moura Garcia ◽  
Isis Jaspe Reis da Silva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Public Health Problem ◽  
Clinical Aspects ◽  
Digit Symbol Substitution Test ◽  
Cognitive Changes ◽  
Cross Sectional ◽  
Significance Level ◽  
Symbol Substitution ◽  
The Individual

Heart failure is characterized as the lack of blood pumping capacity performed by the heart, which is considered a public health problem worldwide. Due to HF, the individual can develop clinical aspects that impact cognitive function and, consequently, self-care. Therefore, this study aimed to investigate cognitive changes and self-care in patients affected by HF and compare it with the cognitive and self-care changes of healthy participants. This is a quantitative, epidemiological, cross-sectional case-control study carried out at an institution in the city of Belém, Pará, Brazil. The following tests were used for data collection: Montreal Cognitive Assessment, Digit Symbol Substitution Test, European Heart Failure Self-care Behavior Scale (EHFScBS). Data were tabulated in Microsoft Excel 2010 and statistically treated by Epi Info version 3.5.2 with a 5% significance level and considering a 95% confidence interval in all analyzes. It was observed that patients with HF have slightly better self-care compared to patients without HF with scores obtained by EHFScBS equal to 29.7 ± 6.9 and 31.8 ± 8.2, respectively. Additionally, patients with HF showed impairments in the three cognitive domains, and women with HF demonstrated greater cognitive impairment compared to the other participants. The present study provides data to help build new approaches to interventions by the multidisciplinary team to promote better self-care and avoid cognitive impairments in patients with HF.

scholarly journals Value of miR-30d and miR-146a as Prognostic Biomarkers for Heart Failure Development Post Myocardial Infarction

2021 ◽  
pp. 1-7
Author(s):  
Ana S. Holley ◽  
Ana S. Holley ◽  
Kirsty M. Danielson ◽  
Scott A. Harding ◽  
Peter D. Larsen
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricular ◽  
Post Myocardial Infarction ◽  
Regulatory Function ◽  
Roc Curve Analysis ◽  
Markers Of Inflammation ◽  
Early Predictors ◽  
Inflammatory Processes ◽  
Control Study

Introduction: The development of heart failure (HF) following an acute myocardial infarction (AMI) is common and associated with poor clinical outcomes. In this context, the early identification of left ventricular remodelling that ultimately leads to HF remains challenging, with current biomarkers underperforming, and plasma microRNAs (miRs) have been proposed as functional biomarkers. Fibrotic and inflammatory processes are implicated in pathogenic remodelling, and miR-30d and miR-146a are reported to have regulatory function in these processes. This study aimed to determine if circulating levels of these miRs could be early predictors of HF development post myocardial infarction. Method: We conducted a case-control study with 46 AMI patients who developed HF within 1 year (cases) matched with control AMI patients (1:2 ratio) who did not develop HF and measured plasma miRs via quantitative reverse transcription polymerase chain reaction. Results: miR-30d was significantly upregulated in cases compared to controls (p<0.05), whereas miR-146a was not significantly different (p=0.57). ROC curve analysis for miR-30d demonstrated a modest sensitivity and specificity for this prediction (AUC=0.61, p<0.05). However, once adjusted for confounding factors such as atrial fibrillation and markers of inflammation, miR-30d was not found to be independently associated with HF development post myocardial infarction (OR 1.12 95% CI 0.99-1.27, p=0.08). Conclusion: miR-30d and markers of inflammation were significantly elevated in patients who developed HF within 1 year of their AMI. Further research is needed to determine the regulatory role that miR-30d may play in HF and the utility it may have as a prognostic marker in this setting.

scholarly journals Diabetes is associated with atrial fibrillation phenotype, cardiac and neurological comorbidities: insights from the Swiss-AF study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Bano ◽  
N Rodondi ◽  
J Beer ◽  
G Moschovitis ◽  
R Kobza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Cross Sectional ◽  
Funding Sources ◽  
Patients With Diabetes ◽  
History Of

Abstract Background Diabetes mellitus is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between AF patients with and without diabetes. Purpose To investigate the association of diabetes with AF phenotype, cardiac and neurological comorbidities in patients with documented AF. Methods Participants of the multicenter Swiss-AF study with available data on diabetes and AF phenotype were eligible. The primary outcomes were parameters of AF phenotype, including AF type (paroxysmal vs non-paroxysmal), AF symptoms (yes vs no), and quality of life (assessed by EQ-5D score). The secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, heart failure) and neurological comorbidities (ie, history of stroke, cognitive impairment). The cross-sectional association of diabetes with these outcomes was assessed using logistic and linear regression. Results were adjusted for age, sex, and cardiovascular risk factors. Results We included 2411 AF patients (27.4% women; median age, 73.6 years). Diabetes was not associated with non-paroxysmal AF (odds ratio [OR]=1.01; 95% confidence interval [CI]=0.81 to 1.27). Patients with diabetes less often perceived AF symptoms (OR=0.73; CI=0.59 to 0.91), but had worse quality of life (predicted mean difference in EQ-5D score: β=−4.54; CI=−6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac comorbidities [history of hypertension (OR=3.04; CI=2.19 to 4.22), myocardial infarction (OR=1.55; CI=1.18 to 2.03), heart failure (OR=1.99; CI=1.57 to 2.51)] and neurological comorbidities [history of stroke (OR=1.39; CI=1.03 to 1.87), cognitive impairment (OR=1.75; CI=1.39 to 2.21)]. Conclusions In the Swiss-AF cohort population, patients with diabetes less often perceived AF symptoms, but had worse quality of life, more cardiac and neurological comorbidities than those without diabetes. These findings have significant clinical implications. The reduced perception of AF symptoms in patients with diabetes might result in a delayed AF diagnosis and consequently more adverse events, especially cardioembolic stroke. This raises the question whether patients with diabetes should be systematically screened for silent AF. Moreover, patients with concomitant AF and diabetes have increased likelihood of comorbidities and therefore deserve more attentive care. FUNDunding Acknowledgement Type of funding sources: None.

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