scholarly journals Heart Failure Hospitalization by Race/Ethnicity, Gender and Age in California: Implications for Prevention

2016 ◽  
Vol 26 (3) ◽  
pp. 345 ◽  
Author(s):  
Baqar A. Husaini ◽  
Robert S. Levine ◽  
Keith C. Norris ◽  
Van Cain ◽  
Mohsen Bazargan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Primary Diagnosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Discharge Data ◽  
Chronic Heart Disease ◽  
Gender And Age ◽  
Hospitalization Costs ◽  
Race Ethnicity

<p><strong>Objective: </strong>We examined variation in rates of hospitalization, risk factors, and costs by race/ethnicity, gender and age among heart failure (HF) patients. <strong></strong></p><p><strong>Methods: </strong>We analyzed California hospital discharge data for patients in 2007 (n=58,544) and 2010 (n=57,219) with a primary diagnosis of HF (ICD-9 codes: 402, 404, 428). HF cases included African Americans (Blacks; 14%), Hispanic/Latinos (21%), and non-Hispanic Whites (65%). Age-adjusted prevalence rates per 100,000 US population were computed per CDC methodology. <strong></strong></p><p><strong>Results: </strong>Four major trends emerged: 1) Overall HF rates declined by 7.7% from 284.7 in 2007 to 262.8 in 2010; despite the decline, the rates for males and Blacks remained higher compared with others in both years; 2) while rates for Blacks (aged ≤54) were 6 times higher compared with same age Whites, rates for Hispanics were higher than Whites in the middle age category; 3) risk factors for HF included hypertension, chronic heart disease, chronic kidney disease, atrial fibrillation, and chronic obstructive pulmonary disease; and 4) submitted hospitalization costs were higher for males, Blacks, and younger patients compared with other groups. <strong></strong></p><p><strong>Conclusion: </strong>Health inequality in HF persists as hospitalization rates for Blacks remain higher compared with Whites and Hispanics. These findings reinforce the need to determine whether increased access to providers, or implementing proven hypertension and diabetes preventive programs among minorities might reduce subsequent hospitalization for HF in these populations. <em>Ethn Dis. </em>2016;26(3):345-354; doi:10.18865/ed.26.3.345 </p>

scholarly journals Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Manyun Tang ◽  
Yidan Wang ◽  
Mengjie Wang ◽  
Rui Tong ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p &lt; 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

scholarly journals Prevalence of Cardiovascular Events and Their Risk Factors in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Overlap Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Manyun Tang ◽  
Yunxiang Long ◽  
Shihong Liu ◽  
Xin Yue ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Partial Pressure ◽  
Cardiovascular Events ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Prevalence Rates ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Rationale: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been identified as independent risk factors for cardiovascular diseases. However, the impact of COPD and OSA overlap syndrome (OS) on cardiovascular outcomes remains to be elucidated.Objective: To determine the prevalence of cardiovascular events and their risk factors in OS patients.Methods: Seventy-four patients who had OS between January 2015 and July 2020 were retrospectively enrolled, and 222 COPD-only patients and 222 OSA-only patients were pair-matched for age and sex from the same period and served as the OS-free control group. The prevalence rates of coronary heart disease (CHD), arrhythmia, heart failure, and pulmonary arterial hypertension (PAH) were compared among the three groups, and multivariable logistic regression models were used to screen the risk factors for specific cardiovascular events.Results: OS patients had higher prevalence rates of heart failure (10.8 vs. 0.5 and 1.4%, respectively) and PAH (31.1 vs. 4.5 and 17.1%, respectively) than those with OSA alone or COPD alone (all P &lt; 0.01). The CHD prevalence was also significantly higher in the OS group than in the COPD-alone group (25.7 vs. 11.7%, P &lt; 0.01). There was no significant difference in the prevalence of arrhythmia among the three groups (20.3, 22.5, and 13.1%, respectively, P &gt; 0.05). In OS patients, risk factors for CHD included hypertension, diabetes, body mass index, lactate dehydrogenase level, and tidal volume; risk factors for heart failure included diabetes, partial pressure of oxygen, partial pressure of carbon dioxide, maximum ventilatory volume, and neutrophilic granulocyte percentage; and risk factors for PAH included minimum nocturnal oxygen saturation, partial pressure of carbon dioxide, and brain natriuretic peptide and lactate dehydrogenase levels.Conclusions: OS patients have a higher prevalence of cardiovascular events, which is associated with hypoxemia, hypercapnia, and impaired lung function in these patients.

scholarly journals Comorbidity of chronic heart failure and chronic obstructive pulmonary disease: features of pathogenesis, clinic and diagnostics

2018 ◽  
Vol 17 (6) ◽  
pp. 62-68 ◽  
Author(s):  
R. E. Tokmachev ◽  
M. S. Mukhortova ◽  
A. V. Budnevsky ◽  
E. V. Tokmachev ◽  
E. S. Ovsyannikov
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Heart Failure ◽  
Pulmonary Disease ◽  
Research Methods ◽  
Clinical Symptoms ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Common Risk Factors

This article discusses the epidemiology of chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD). CHF and COPD are characterized by high prevalence and high mortality, especially when they are combined. The article analyzes the general mechanisms of formation of these diseases: the relationship of COPD with cardiovascular diseases is explained by common risk factors, including smoking, physical inactivity, improper feeding and genetic predisposition. The leading role in the pathogenesis of pathologies is played by the activation and maintenance of systemic inflammation. Article presents the features of the clinical picture and the direction of the diagnostics in case of suspected combined pathology, the possibilities of modern laboratory and instrumental research methods. Diagnostics of comorbidity of CHF and COPD may be difficult, given the above common risk factors, some common pathogenesis mechanisms and similar clinical symptoms. However the caution regarding the comorbidity of the studied conditions, as well as a thorough clinical examination and the appointment of the necessary additional research methods, can reduce the number of diagnostic mistakes and improve the prognosis in such patients.

scholarly journals Baseline and Outcome Characteristics of Multiple Valve Surgery Compared with Single Valve Procedures in Mainland China: A Multicenter Experience

2019 ◽  
Vol 22 (6) ◽  
pp. E486-E493
Author(s):  
Lei Jin ◽  
Guan-xin Zhang ◽  
Lin Han ◽  
Chong Wang
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Congestive Heart Failure ◽  
Mainland China ◽  
Valve Surgery ◽  
Chronic Obstructive ◽  
Class Iii ◽  
Obstructive Pulmonary Disease ◽  
Baseline Characteristics

Background: To compare baseline and outcome characteristics of multiple valve surgery with single-valve procedures in a multicenter patient population of mainland China. Methods: From January 2008 to December 2012, data from 14,322 consecutive patients older than 16 years who underwent heart valve surgery at five cardiac surgical centers (except pulmonary valve operations) were collected. The patients were divided into seven subgroups according to the type of valve procedures, and baseline characteristics and postoperative outcomes were contrasted between all seven combinations of single-valve and multiple-valve procedures involving aortic, mitral, and tricuspid valves. Two independent logistic regression analyses were performed and multivariable risk factors for mortality were compared, with emphasis on single-valve versus multiple-valve surgery. Results: Baseline characteristics for MUV procedures (n = 8945) shared many differences to those for single-valve procedures (n = 5377). Proportion of females, chronic obstructive pulmonary disease, cerebrovascular disease, renal impairment, congestive heart failure, NHYA class III-IV, atrial fibrillation, pulmonary hypertension, and decreased ejection fraction were more common in MUV subgroups, and smoker, hypertension, dyslipidemia, active infectious endocarditis, and coronary bypass graft was less frequent. In-hospital mortality was higher for MUV as compared with single-valve procedures (2.4% versus 1.6%, P = .007). Preoperative independent predictors for mortality of patients undergoing MUV procedures were age, chronic obstructive pulmonary disease, diabetes mellitus, renal dysfunction, dialysis, congestive heart failure, cardiogenic shock, NYHA class III-IV, mitral stenosis, tricuspid regurgitation, mitral valve replacement, and concomitant CABG. However, risk factors for mortality were relatively different between single-valve and MUV procedures. Conclusion: Baseline characteristics and epidemiology were different between MUV and single-valve procedures. The in-hospital mortality and postoperative complications for MUV procedures remained considerably higher and determinants of mortality were relatively different across procedures types. These findings serve as a benchmark for further studies, as well as suggest a continued search for explanations of MUV outcomes.

scholarly journals Risk factors for new-onset atrial fibrillation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10376
Author(s):  
Qiangru Huang ◽  
Huaiyu Xiong ◽  
Tiankui Shuai ◽  
Meng Zhang ◽  
Chuchu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Related Factors ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Potential Risk Factors ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background New-onset atrial fibrillation (AF) in patients with chronic obstructive pulmonary disease (COPD) is associated with an accelerated decline in lung function, and a significant increase in mortality rate. A deeper understanding of the risk factors for new-onset AF during COPD will provide insights into the relationship between COPD and AF and guide clinical practice. This systematic review and meta-analysis is designed to identify risk factors for new-onset AF in patients with COPD, and to formulate recommendations for preventing AF in COPD patients that will assist clinical decision making. Methods PubMed, Embase, Web of Science and Cochrane Library databases were searched for studies, which reported the results of potential risk factors for new-onset AF in COPD patients. Results Twenty studies involving 8,072,043 participants were included. Fifty factors were examined as potential risk factors for new-onset AF during COPD. Risk factors were grouped according to demographics, comorbid conditions, and COPD- and cardiovascular-related factors. In quantitative analysis, cardiovascular- and demographic-related factors with a greater than 50% increase in the odds of new-onset AF included age (over 65 years and over 75 years), acute care encounter, coronary artery disease, heart failure and congestive heart failure. Only one factor is related to the reduction of odds by more than 33.3%, which is black race (vs white). In qualitative analysis, the comparison of the risk factors was conducted between COPD-associated AF and non-COPD-associated AF. Cardiovascular-related factors for non-COPD-associated AF were also considered as risk factors for new-onset AF during COPD; however, the influence tended to be stronger during COPD. In addition, comorbid factors identified in non-COPD-associated AF were not associated with an increased risk of AF during COPD. Conclusions New-onset AF in COPD has significant demographic characteristics. Older age (over 65 years), males and white race are at higher risk of developing AF. COPD patients with a history of cardiovascular disease should be carefully monitored for new-onset of AF, and appropriate preventive measures should be implemented. Even patients with mild COPD are at high risk of new-onset AF. This study shows that risk factors for new-onset AF during COPD are mainly those associated with the cardiovascular-related event and are not synonymous with comorbid factors for non-COPD-associated AF. The pathogenesis of COPD-associated AF may be predominantly related to the cardiac dysfunction caused by the chronic duration of COPD, which increases the risk of cardiovascular-related factors and further increases the risk of AF during COPD. PROSPERO registration number CRD42019137758.

Abstract 14875: Chronic Obstructive Pulmonary Disease Negatively Affects In-hospital Outcomes in Patients With Takotsubo Cardiomyopathy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Pengyang Li ◽  
Catherine Teng ◽  
Mark Kranis ◽  
Peng Cai ◽  
Qiying Dai ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Propensity Score ◽  
Cardiogenic Shock ◽  
Takotsubo Cardiomyopathy ◽  
Primary Diagnosis ◽  
Chronic Obstructive ◽  
Inpatient Mortality ◽  
Hospital Outcomes ◽  
Obstructive Pulmonary Disease ◽  
Hospitalization Costs

Introduction: Chronic obstructive pulmonary disease (COPD) is a known comorbidity of takotsubo cardiomyopathy (TCM), and COPD exacerbation is a potential trigger of TCM. The association between COPD and in-hospital outcomes and complications in TCM patients is not well established. Aim: We aimed to assess the effect of COPD on hospitalized patients with a primary diagnosis of TCM. Methods: Using the latest National Inpatient Sample from 2016-2017, we conducted a retrospective cohort study in patients with a primary diagnosis of TCM with or without COPD. The diagnosis was identified by the ICD-10-CM coding system. We identified 3,139 patients admitted with a primary diagnosis of TCM; 684 of those patients also had a diagnosis of COPD. We performed propensity score matching in a 1:2 ratio (n=678 patients, matched COPD group; n=1,070, matched non-COPD group) and compared in-hospital outcomes and complications between TCM patients with and without a COPD diagnosis. Results: Before matching, the COPD group had worse outcomes compared with the non-COPD group in inpatient death (2.9% vs. 1.3%, p=0.006), length of stay (LOS) (4.02±2.99 days vs. 3.27±3.39 days, p<0.001), hospitalization costs ($55,242.68±47,637.40 vs. $48,316.97±47,939.84, p=0.001), and acute respiratory failure (ARF) (22.5% vs. 7.7%, p<0.001), respectively. After propensity score matching, the matched COPD group, compared with the matched non-COPD group, had a higher inpatient mortality rate (2.9% vs.1.0%, p=0.005), longer LOS (4.02±3.00 days vs. 3.40±3.54 days, p<0.001), higher hospitalization costs ($55,409.23±47,809.13 vs. $44,6469.60±42,209.10, p<0.001), and a higher incidence of ARF (22.6% vs. 8.2%, p<0.001) and cardiogenic shock (5.6% vs. 3.3%, p=0.024), respectively. Conclusions: Patients who are hospitalized for TCM and have COPD have higher rates of inpatient mortality, ARF, and cardiogenic shock, as well as a longer LOS and a higher cost of stay than TCM patients without COPD. Prospective studies are warranted to examine the effect of early intervention or treatment of COPD on short and long-term outcomes of TCM.

scholarly journals Clinical risk factors for mortality in an analysis of 1375 patients admitted for COVID treatment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sean A. P. Clouston ◽  
Benjamin J. Luft ◽  
Edward Sun
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Clinical Risk Factors ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinical Risk ◽  
History Of

AbstractThe goal of the present work was to examine clinical risk factors for mortality in 1375 COVID + patients admitted to a hospital in Suffolk County, NY. Data were collated by the hospital epidemiological service for patients admitted from 3/7/2020 to 9/1/2020. Time until final discharge or death was the outcome. Cox proportional hazards models were used to estimate time until death among admitted patients. In total, all cases had resolved leading to 207 deaths. Length of stay was significantly longer in those who died as compared to those who did not (p = 0.007). Of patients who had been discharged, 54 were readmitted and nine subsequently died. Multivariable-adjusted Cox proportional hazards regression revealed that in addition to older age, male sex, and a history of chronic heart failure, chronic obstructive pulmonary disease, and diabetes, that a history of premorbid depression was a risk factors for COVID-19 mortality (aHR = 2.42 [1.38–4.23] P = 0.002), and that this association remained after adjusting for age and for neuropsychiatric conditions as well as medical comorbidities including cardiovascular disease and pulmonary conditions. Sex-stratified analyses revealed that associations between mortality and depression was strongest in males (aHR = 4.45 [2.04–9.72], P < 0.001), and that the association between heart failure and mortality was strongest in participants aged < 65 years old (aHR = 30.50 [9.17–101.48], P < 0.001). While an increasing number of studies have identified several comorbid medical conditions including chronic heart failure and age of patient as risk factors for mortality in COVID + patients, this study confirmed several prior reports and also noted that a history of depression is an independent risk factor for COVID-19 mortality.

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