scholarly journals Prognostic Impact of Sleep Patterns and Related-Drugs in Patients with Heart Failure

2021 ◽  
Vol 10 (22) ◽  
pp. 5387
Author(s):  
François Bughin ◽  
Isabelle Jaussent ◽  
Bronia Ayoub ◽  
Sylvain Aguilhon ◽  
Nicolas Chapet ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Impact ◽  
Sleep Patterns ◽  
Patients With Heart Failure ◽  
Cns Drugs

Sleep disturbances are frequent among patients with heart failure (HF). We hypothesized that self-reported sleep disturbances are associated with a poor prognosis in patients with HF. A longitudinal study of 119 patients with HF was carried out to assess the association between sleep disturbances and the occurrence of major cardiovascular events (MACE). All patients with HF completed self-administered questionnaires on sleepiness, fatigue, insomnia, quality of sleep, sleep patterns, anxiety and depressive symptoms, and central nervous system (CNS) drugs intake. Patients were followed for a median of 888 days. Cox models were used to estimate the risk of MACE associated with baseline sleep characteristics. After adjustment for age, the risk of a future MACE increased with CNS drugs intake, sleep quality and insomnia scores as well with increased sleep latency, decreased sleep efficiency and total sleep time. However, after adjustment for left ventricular ejection fraction and hypercholesterolemia the HR failed to be significant except for CNS drugs and total sleep time. CNS drugs intake and decreased total sleep time were independently associated with an increased risk of MACE in patients with HF. Routine assessment of self-reported sleep disturbances should be considered to prevent the natural progression of HF.

Abstract 13309: Soluble Fibrin Monomer Complex is Associated With Cardio- and Cerebro-vascular Events in Patients With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yusuke KIMISHIMA ◽  
Akiomi YOSHIHISA ◽  
Yasuhiro Ichijo ◽  
Koichiro Watanabe ◽  
Yu Hotuki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Independent Predictor ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Impact ◽  
Vascular Events ◽  
Soluble Fibrin ◽  
Fibrin Monomer ◽  
Patients With Heart Failure ◽  
All Cause Mortality

Background: The soluble fibrin monomer complex (SFMC) is a biomarker of fibrin formation, and has been shown to be abnormally elevated in various clinical situations of hypercoagulability. However, the association between SFMC and cardiovascular events in patients with heart failure (HF) remains uncertain. We aimed to examine the prognostic impact of SFMC concerning increased risk of major cardio- and cerebro-vascular events (MACCE) and all-cause mortality in patients with HF. Methods and Results: We conducted a prospective observational study. We analyzed data on 723 hospitalized patients with HF who discharged alive and measured SFMC at stable condition in prior to discharge. Patients were divided into tertiles based on levels of SFMC: 1 st (SFMC <1.7 μg/ml, n = 250), 2 nd (1.8 ≤ SFMC <2.9 μg/ml, n = 233), and 3 rd (3.0 μg/ml ≤ SFMC, n = 240) tertiles. We compared baseline patients’ characteristics and their post-discharge MACCE and mortality. Prevalence of chronic kidney disease (CKD) and anemia was significantly higher in the 3 rd tertile than in the 1 st and 2 nd tertiles. In contrast, age, sex, CHADS 2 -Vasc score, left ventricular ejection fraction, and prevalence of hypertension, diabetes and atrial fibrillation did not differ among the tertiles. During the median follow-up period of 422 days, 61 patients experienced MACCE, and 82 patients died. In the Kaplan-Meier analysis ( Figure ), accumulated event rates of both MACCE and all-cause mortality progressively increased from the 1 st to the 3 rd tertiles (MACCE, 4.8%, 8.6% and 12.1%, log-rank P=0.014; all-cause mortality, 6.4%, 9.4% and 18.3%, log-rank P<0.001). In the multivariable Cox proportional hazard analysis, the 3 rd tertile was found to be an independent predictor of MACCE (HR 2.608, 95%CI 1.331-5.113, P=0.005) and all-cause mortality (HR 2.938, 95%CI 1.657-5.207, P<0.001). Conclusion: SFMC is an independent predictor of adverse prognosis in patients with HF.

scholarly journals Association between platelet distribution width and prognosis in patients with heart failure

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244608
Author(s):  
Yu Sato ◽  
Akiomi Yoshihisa ◽  
Koichiro Watanabe ◽  
Yu Hotsuki ◽  
Yusuke Kimishima ◽  
...  
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptide ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Impact ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure

Background The prognostic impact of platelet distribution width (PDW), which is a specific marker of platelet activation, has been unclear in patients with heart failure (HF). Methods and results We conducted a prospective observational study enrolling 1,746 hospitalized patients with HF. Patients were divided into tertiles based on levels of PDW: 1st (PDW < 15.9 fL, n = 586), 2nd (PDW 15.9–16.8 fL, n = 617), and 3rd (PDW ≥ 16.9, n = 543) tertiles. We compared baseline patients’ characteristics and post-discharge prognosis: all-cause death; cardiac death; and cardiac events. The 3rd tertile showed the highest age and levels of B-type natriuretic peptide compared to other tertiles (1st, 2nd, and 3rd tertiles; age, 69.0, 68.0, and 70.0 years old, P = 0.038; B-type natriuretic peptide, 235.2, 171.9, and 241.0 pg/mL, P < 0.001). Left ventricular ejection fraction was equivalent among the tertiles. In the Kaplan-Meier analysis, rates of all endpoints were the highest in the 3rd tertile (log-rank P < 0.001, respectively). The Cox proportional hazard analysis revealed that the 3rd tertile was associated with adverse prognosis (all-cause death, hazard ratio [HR] 1.716, P < 0.001; cardiac death, HR 1.919, P < 0.001; cardiac event, HR 1.401, P = 0.002). Conclusions High PDW is a novel predictor of adverse prognosis in patients with HF.

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