Serum metabolic characteristics and biomarkers of early-stage heart failure

2020 ◽  
Vol 14 (2) ◽  
pp. 119-130
Author(s):  
Siqi Guo ◽  
Jing Kong ◽  
Danya Zhou ◽  
Minchao Lai ◽  
Yirun Chen ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Early Stage ◽  
Heart Association ◽  
Class Ii ◽  
Class I ◽  
Metabolic Characteristics ◽  
Diagnostic Potential ◽  
Association Class ◽  
New York Heart Association

Aim: We aimed to identify metabolic characteristics of early-stage heart failure (HF) and related biomarkers. Patients & methods: One hundred and forty-three patients with New York Heart Association class I–IV HF and 34 healthy controls were recruited. Serum metabolic characteristics of class I HF were analyzed and compared with those of class II–IV HF. Potential biomarkers of class I HF with normal N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level were screened and validated in additional 72 subjects (46 class I patients and 26 controls). Results & conclusion: Eleven metabolites were found disturbed in class I HF, and five of which were also disturbed in class II–IV HF. Glutamine and tyrosine showed high value to identify class I HF with normal NT-proBNP level. The diagnostic potential of glutamine was partially confirmed in the validate set, holding a promise to detect early HF with normal NT-proBNP level.

Outpatient Costs of Medications for Patients with Chronic Heart Failure

2002 ◽  
Vol 11 (5) ◽  
pp. 474-478 ◽  
Author(s):  
Leslie C. Hussey ◽  
Sonya Hardin ◽  
Christopher Blanchette
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Web Sites ◽  
Heart Association ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Ability To Pay ◽  
New York Heart Association

• Background The outpatient costs of medications prescribed for chronic heart failure are high and are often borne by individual patients. Lack of financial resources may force noncompliance with use of medications. • Objective To compare the outpatient costs of medications for patients with different New York Heart Association classifications of chronic heart failure. • Methods The charts of 138 patients with chronic heart failure were reviewed retrospectively. Outpatient costs of medications were obtained from the Web sites of commercial pharmacies. Medications were classified by type according to the system of the American Heart Association. A mean cost for each classification of medication was used for analysis. • Results The overall mean monthly cost of medications for chronic heart failure was $438. Patients with class II and class III chronic heart failure had the highest costs: $541 and $514, respectively. Analysis of variance indicated that the differences in monthly costs of medications between the patients with the 4 stages of chronic heart failure were significant (F = 4.86, P = .003). A post hoc Scheffé test revealed significant differences in costs between patients with class I and patients with class II heart failure (P=.02) and between patients with class I and those with class III heart failure (P=.02). • Conclusions The outpatient costs of medications for chronic heart failure are significant. Ability to pay for prescribed medications must be determined. Healthcare professionals must maintain an awareness of the costs of medications and patients’ ability to pay.

scholarly journals Quantifying Benefit-Risk Preferences for Heart Failure Devices: A Stated-Preference Study

2021 ◽  
Author(s):  
Shelby D. Reed ◽  
Jui-Chen Yang ◽  
Timothy Rickert ◽  
F. Reed Johnson ◽  
Juan Marcos Gonzalez ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Stated Preference ◽  
Academic Medical Center ◽  
Heart Association ◽  
Class Ii ◽  
York Heart Association Class ◽  
Health Technologies ◽  
Association Class ◽  
New York Heart Association

Background: Regulatory and clinical decisions involving health technologies require judgements about relative importance of their expected benefits and risks. We sought to quantify heart-failure patients’ acceptance of therapeutic risks in exchange for improved effectiveness with implantable devices. Methods: Individuals with heart failure recruited from a national web panel or academic medical center completed a web-based discrete-choice experiment survey in which they were randomized to one of 40 blocks of 8 experimentally controlled choice questions comprised of 2 device scenarios and a no-device scenario. Device scenarios offered an additional year of physical functioning equivalent to New York Heart Association class III or a year with improved (ie, class II) symptoms, or both, with 30-day mortality risks ranging from 0% to 15%, in-hospital complication risks ranging from 0% to 40%, and a remote adjustment device feature. Logit-based regression models fit participants’ choices as a function of health outcomes, risks and remote adjustment. Results: Latent-class analysis of 613 participants (mean age, 65; 49% female) revealed that two-thirds were best represented by a pro-device, more risk-tolerant class, accepting up to 9% (95% CI, 7%–11%) absolute risk of device-associated mortality for a one-year gain in improved functioning (New York Heart Association class II). Approximately 20% were best represented by a less risk-tolerant class, accepting a maximum device-associated mortality risk of 3% (95% CI, 1%–4%) for the same benefit. The remaining class had strong antidevice preferences, thus maximum-acceptable risk was not calculated. Conclusions: Quantitative evidence on benefit-risk tradeoffs for implantable heart-failure device profiles may facilitate incorporating patients’ views during product development, regulatory decision-making, and clinical practice.

Abstract 2848: Medication Knowledge And Assistance In Older Chronic Heart Failure Patients.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robyn Gallagher ◽  
Judith Donoghue ◽  
Lynn Chenoweth ◽  
Jane Stein-Parbury
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Self Efficacy ◽  
Heart Association ◽  
Post Discharge ◽  
Medication Knowledge ◽  
Moderate Heart Failure ◽  
Association Class ◽  
New York Heart Association

Medication knowledge and assistance in older chronic heart failure (CHF) patients. Medication adherence is central to the optimal management of CHF. Little is known about older patients’ knowledge of their medications or the factors that contribute to this knowledge. Aim: To describe and identify the predictors of medication knowledge in older CHF patients. Method: Subjects ( n = 62) aged over 55 years with moderate heart failure (New York Heart Association Class II and III) who identified as self-managing were recruited from hospital or rehabilitation. Interviews occurred at home four weeks post-discharge using a medication checklist and the Self-Efficacy in Chronic Illness Scale (Lorig et al, 2001). Multiple regression analysis determined the predictors of medication knowledge. Results: Patients were aged mean 78.4 years (sd 8.54 years), mostly male (57%) and had an average 8 (median, range 3–22) medications to take daily, of which 6 (median, range 3–14) were for CHF. Most managed their own medications (54%) but more than a quarter (28%) were assisted by reminding, dispensing and supervision. Compliance with medications was high (84%), although only half (53%) knew the name, main purpose and side effect of their medications. Patients with better self-efficacy (β = 2.88) and no help with medication (β = -21.05) had better medication knowledge (model F = 13.6, p = .000, R = .61, r 2 = .37). Conclusion: Older CHF patients have poor knowledge of their medications, which may be improved by promoting overall self-efficacy for disease management. Less knowledgeable patients received appropriate assistance with medications, but the consequence may be less knowledge and thus warrants further investigation.

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