scholarly journals Combination of Uric Acid and NT-ProBNP: A More Useful Prognostic Marker for Short-Term Clinical Outcomes in Patients with Acute Heart Failure

2010 ◽  
Vol 25 (3) ◽  
pp. 253 ◽  
Author(s):  
Hyoung-Seob Park ◽  
Hyungseop Kim ◽  
Ji-Hyun Sohn ◽  
Hong-Won Shin ◽  
Yun-Kyeong Cho ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Clinical Outcomes ◽  
Acute Heart Failure ◽  
Prognostic Marker ◽  
Short Term

scholarly journals Uric acid as a prognostic marker in acute heart failure - new expectations from an old molecule

2007 ◽  
Vol 9 (5) ◽  
pp. 437-439 ◽  
Author(s):  
Wolfram Doehner ◽  
Stephan von Haehling ◽  
Stefan D. Anker
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Acute Heart Failure ◽  
Prognostic Marker

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 Relationship between Uric Acid Levels and Diagnostic and Prognostic Outcomes in Acute Heart Failure

2012 ◽  
Vol 5 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Queen Henry-Okafor ◽  
Sean P. Collins ◽  
Cathy A. Jenkins ◽  
Karen F. Miller ◽  
David J. Maron ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Logistic Regression ◽  
Uric Acid ◽  
Clinical Outcomes ◽  
Acute Heart Failure ◽  
Natriuretic Peptide ◽  
Diagnostic Utility ◽  
Wilcoxon Rank Sum Test ◽  
Prognostic Utility

Objectives: We evaluated the association of plasma uric acid alone and in combination with b-type natriuretic peptide (BNP) for emergency department (ED) diagnosis and 30-day prognosis in patients evaluated for acute heart failure (AHF). Methods: We prospectively enrolled 322 adult ED patients with suspected AHF. Wilcoxon rank sum test, multivariable logistic regression and likelihood ratio (LR) tests were used for statistical analyses. Results: Uric acid's diagnostic utility was poor and failed to show significant associations with 30-day clinical outcomes. Uric acid also did not add significantly to BNP results. Conclusion: Among ED patients with suspected AHF, uric acid has poor diagnostic and prognostic utility

scholarly journals Short-Term Change in Gait Speed and Clinical Outcomes in Older Patients With Acute Heart Failure

2019 ◽  
Vol 83 (9) ◽  
pp. 1860-1867 ◽  
Author(s):  
Shinya Tanaka ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Ryota Matsuzawa ◽  
Kohei Nozaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Acute Heart Failure ◽  
Gait Speed ◽  
Older Patients ◽  
Short Term ◽  
Short Term Change ◽  
Term Change

scholarly journals Hemodynamic Congestion at Hospital Discharge Predicts Rehospitalization during Short Term Follow Up in Acute Heart Failure Patients

2019 ◽  
Vol 40 (3) ◽  
Author(s):  
Yoga Waranugraha ◽  
Mohammad Saifur Rohman ◽  
Setyasih Anjarwani
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Hospital Discharge ◽  
Acute Heart Failure ◽  
Optimal Dose ◽  
Left Ventricular ◽  
Short Term ◽  
Significant Difference ◽  
Β Blockers ◽  
Symptoms And Signs

Background: Hemodynamic congestion is an increase in left ventricular diastolic pressure (LVEDP) without clinical symptoms and signs of congestion. Current acute heart failure (AHF) treatment goals only focused on improving clinical congestion. The purpose of this study was to investigate whether hemodynamic congestion measured by NT-proBNP level and ePCWP at hospital discharge could predict short term clinical outcomes in AHF patients. Method: This prospective cohort study was conducted at dr. Saiful Anwar General Hospital Malang from January to July 2018. All patients got AHF treatment according to the 2016 ESC guidelines for heart failure. All patients were discharged without symptoms and signs of clinical congestion. Hemodynamic congestion at hospital discharge was defined as failure of treatment during hospitalization to achieve a reduction in NT-proBNP level >30% and/or ePCWP at hospital discharge >16 mmHg. NT-proBNP level and ePCWP were measured at 0-12 hours after hospital admisssion and at hospital discharge. ePCWP was measured using echocardiography. The clinical outcomes assessed were AHF rehospitalization and cardiovascular mortality within 30 days after hospitral discharge. Subgroup analysis was performed to determine therapeutic regimens that are effective in improving hemodynamic congestion. Result: A total of 33 AHF patients were included in this study. 48% patients were discharged with hemodynamic congestion and 52% patients discharged without hemodynamic congestion. Patients with hemodynamic congestion at hospital discharge showed a higher rehospitalization within 30 days (8 [50%] vs 1 [5.9%]; P = 0.007). Mortality within 30 days in both groups did not show a significant difference (2 [12.5%] vs 0 [0%]; P = 0.277). Treatment regiment of optimal dose of ACEi/ARB, β-blockers, and diuretics was associated with improvement of hemodynamic congestion (P = 0.026; r = 0.454), a decrease in NT-proBNP> 66% (P = 0.02; r = 0,574), and achievement of ePCWP <16 (P = 0,013; r = 0,493) at hospital discharge in HFrEF patients. Conclusion: This study showed that hemodynamic congestion assessed with NT-proBNP level and ePCWP at hospital discharge increased 30 day rehospitalization in AHF patients. In HFrEF, improvements in hemodynamic congestion can be achieved by giving the treatment regiment of optimal dose of ACEi/ARB, β-blockers, and diuretics. Keyword: Acute heart failure, hemodynamic congestion, NT-proBNP, ePCWP

scholarly journals Preliminary results of the acute Heart Failure registry in the DELTA region of Egypt (DELTA-HF): a database and a quality initiative project

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Abdelfatah Elasfar ◽  
Sherif Shaheen ◽  
Wafaa El-Sherbeny ◽  
Hatem Elsokkary ◽  
Suzan Elhefnawy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Acute Heart Failure ◽  
Valvular Heart Disease ◽  
Beta Blockers ◽  
Left Ventricular Ejection ◽  
Systemic Hypertension ◽  
Delta Region ◽  
Device Therapy ◽  
Short Term

Abstract Background Data about heart failure in Egypt is scarce. We aimed to describe the clinical characteristics and diagnostic and treatment options in patients with acute heart failure in the Delta region of Egypt and to explore the gap in the management in comparison to the international guidelines. Results DELTA-HF is a prospective observational cohort registry for all consecutive patients with acute heart failure (AHF) who were admitted to three tertiary care cardiac centers distributed in the Delta region of Egypt. All patients were recruited in the period from April 2017 to May 2018, during which, data were collected and short-term follow-up was done. A total of 220 patients (65.5% were males with a median age of 61.5 years and 50.9% had acute decompensation on top of chronic heart failure) was enrolled in our registry. The risk factors for heart failure included rheumatic valvular heart disease (10.9%), smoking (65.3%), hypertension (48.2%), diabetes mellitus (42.7%), and coronary artery disease (28.2%). Left ventricular ejection fraction (LVEF) was less than 40% in 62.6%. Etiologies of heart failure included ischemic heart disease (58.1%), valvular heart disease (16.3%), systemic hypertension (9.1%), and dilated non-ischemic cardiomyopathy (15.5%). Exacerbating factors included infections (28.1%), acute coronary syndromes (25.5%), non-compliance to HF medications (19.6%), and non-compliance to diet (23.2%) in acute decompensated heart failure (ADHF) patients. None of our patients had been offered heart failure device therapy and only 50% were put on beta-blockers upon discharge. In-hospital, 30 days and 90 days all-cause mortality were 18.2%, 20.7%, and 26% respectively. Conclusions There is a clear gap in the management of patients with acute heart failure in the Delta region of Egypt with confirmed under-utilization of heart failure device therapy and under-prescription of guideline-directed medical therapies particularly beta-blockers. The short-term mortality is high if compared with Western and other local registries. This could be attributed mainly to the low-resource health care system in this region and the lack of formal heart failure management programs.

scholarly journals Plasma natriuretic peptide level is an independent determinant of major clinical outcomes in atrial fibrillation patients without heart failure: the Fushimi AF Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Hamatani ◽  
M Iguchi ◽  
Y Aono ◽  
K Ishigami ◽  
S Ikeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Prognostic Marker ◽  
Oral Anticoagulants ◽  
Systemic Embolism ◽  
The Mean

Abstract Background Atrial fibrillation (AF) increases the risk of death, stroke/systemic embolism and heart failure (HF). Plasma natriuretic peptide (NP) level is an important prognostic marker in HF patients. However, little is known regarding the prognostic significance of plasma NP level in AF patients without HF. Purpose The aim of this study is to investigate the relationship between plasma NP level and clinical outcomes such as all-cause death, stroke/systemic embolism and HF hospitalization during follow-up period in AF patients without HF. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in our city. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,466 patients by the end of November 2019. From the registry, we excluded 1,220 patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction &lt;40%). Among 3,246 AF patients without HF, we investigated 1,189 patients with the data of plasma BNP (n=401) or N-terminal pro-BNP (n=788) level at the enrollment. We divided the patients according to the quartile of each plasma BNP or NT-pro BNP level and compared the backgrounds and outcomes between these 4 groups stratified by plasma NP level. Results Of 1,189 patients, the mean age was 72.1±10.2 years, 454 (38%) were female and 684 (58%) were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc score were 1.6±1.1 and 2.9±1.5, respectively. Oral anticoagulants were prescribed in 671 (56%) at baseline. The median (interquartile range) BNP and N-terminal pro-BNP level were 84 (38, 176) and 500 (155, 984) pg/ml, respectively. Patients with high plasma NP level were older, and demonstrated lower prevalence of paroxysmal AF, higher CHADS2 and CHA2DS2-VASc scores and higher prevalence of chronic kidney disease and oral anticoagulants prescription (all P&lt;0.01). A total of 165 all-cause death, 114 stroke/systemic embolism and 103 HF hospitalization occurred during the median follow-up period of 5.0 years. Kaplan-Meier curves demonstrated that higher plasma NP level was significantly associated with the incidences of all-cause death, stroke/systemic embolism and HF hospitalization in AF patients without HF (Figure 1A). Multivariable Cox regression analysis revealed that plasma NP level could stratify the risk of clinical outcomes even after adjustment by type of AF, CHA2DS2-VASc score, chronic kidney disease and oral anticoagulant prescription (Figure 1B). Conclusion Plasma NP level is a significant prognostic marker for all-cause death, stroke/systemic embolism and HF hospitalization in AF patients without HF, suggesting the importance of measuring plasma NP level in AF patients even without HF. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Comparative Assessment of Short-Term Adverse Events in Acute Heart Failure With Cystatin C and Other Estimates of Renal Function

2015 ◽  
Vol 3 (1) ◽  
pp. 40-49 ◽  
Author(s):  
W.H. Wilson Tang ◽  
Matthias Dupont ◽  
Adrian F. Hernandez ◽  
Adriaan A. Voors ◽  
Amy P. Hsu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Adverse Events ◽  
Acute Heart Failure ◽  
Cystatin C ◽  
Comparative Assessment ◽  
Short Term

Limited value of brain natriuretic peptide as a prognostic marker in acute heart failure — A meta-analysis

2010 ◽  
Vol 145 (3) ◽  
pp. 540-541 ◽  
Author(s):  
Andrew Binder ◽  
Ignacio M. Seropian ◽  
Michael C. Kontos ◽  
Benjamin W. Van Tassell ◽  
Giuseppe G.L. Biondi-Zoccai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Acute Heart Failure ◽  
Natriuretic Peptide ◽  
Prognostic Marker ◽  
Meta Analysis
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