The definition of heart failure (HF) phenotypes is relatively new. There is scarce evidence on the true characteristics of patients with HF in the Polish population, which are classified into three categories. The presented study provides a broad characterization of the relevant phenotypes of patients hospitalized for HF. Furthermore, the information retrieved from the electronic database was validated for the diagnosis of HF, which makes a significant difference compared to studies based on the electronic registry. Furthermore, we identified predictors for each HF subtype. Conclusions: To our knowledge, this is the first publication on different subtypes of HF with a confirmed diagnosis, providing a broad description of hospitalized patients with HF of the Polish population.
1980-2010, an increasing number of deaths from HF was documented in a standardized population. 3 The same trend has been observed in an analysis of the Polish national database in subsequent years. 4 Furthermore, Pikala et al 5 analyzed the years 2000-2014, and found out a decreasing trend in the standard expected years of life lost per living person from cardiovascular diseases, for both men and women. This is also true for the main cardiovascular diseases, such as INTROduCTION Heart failure (HF) still remains a significant clinical, economic, and social problem. Although the incidence of HF decreases, its prevalence increases (partly due to improved survival), and the number of deaths attributable to HF rises. 1 Furthermore, in recent decades, cardiovascular disease has been recognized as the leading cause of death at the population level, 2 and HF is one of the main contributors to this trend. In a previous publication, covering the years
Introduction: Heart failure (HF) is a prothrombotic state that is also associated with the progression of renal dysfunction. However, it is unknown whether coagulation abnormalities are associated with progressive cardiorenal syndrome. Aim of the research:To evaluate activators and inhibitors of coagulation and fibrinolysis and their relationship with renal failure in HF patients. Material and methods: Coagulation biomarkers such as thrombin-antithrombin III, human tissue-type plasminogen activator, human plasminogen activator inhibitor, von Willebrand factor (vWF), soluble thrombomodulin (sTM), human prothrombin fragments (F1+F2), and protein C were evaluated in 36 consecutive HF patients without anticoagulation and in 19 controls matched in age and gender. Results: HF patients, compared to controls, had lower levels of C protein (p = 0.04) and F1 + F2 (p < 0.001) but higher levels of vWF (p < 0.001) and borderline sTM (p = 0.07). Similarly, haemoglobin (p < 0.001) and glomerular filtration rate (GFR) (p = 0.004) were lower in HF, while INR (p < 0.001), NT-proBNP (p < 0.001), and asymmetric dimethylarginine (ADMA) (p < 0.001) were higher. Most of the echocardiographic parameters differed between the 2 groups. From coagulation biomarkers, sTM (r = -0.66; p < 0.001) and vWF (r = -0.41; p = 0.002) were associated with eGFR. Most of the echocardiographic and laboratory parameters were also related to eGFR. After classifying all variables into 5 categories; laboratory tests, echocardiographic parameters, vascular reactivity, haemodynamics, and coagulation parameters, multivariable linear regression showed that coagulation parameters were the most strongly associated with eGFR (r 2 = 0.48, p < 0.001). Conclusions: In the study population, coagulation disorders were most strongly associated with impaired renal function, independently of other parameters. StreszczenieWprowadzenie: Niewydolność serca (HF) jest stanem zwiększonej gotowości zakrzepowej, z często współwystępującą dysfunkcją nerek. Jednak dotąd nie wykazano związku zaburzeń w obrębie biomarkerów zakrzepowych z postępującym zespołem sercowo-nerkowym. Cel pracy: Ocena związku biomarkerów zakrzepowych z upośledzeniem funkcji nerek u chorych z niewydolnością serca. Materiał i metody: Biomarkery zakrzepowe, takie jak kompleksy trombina-antytrombina III, tkankowy aktywator plazminogenu, czynnik von Willenbranda (vWF), rozpuszczalna trombomodulina (sTM), fragmenty protrombiny (F1 + F2) oraz białko C, zostały ocenione u 36 chorych z niewydolnością serca nieleczonych przeciwzakrzepowo oraz u 19 zdrowych ochotników w grupie kontrolnej, dobranej pod względem wieku i płci. Wyniki: Pacjenci z niewydolnością serca w porównaniu z grupą kontrolną mieli niższą aktywność białka C (p = 0,04), ale wyższe stężenia vWF (p < 0,001) i graniczną istotność dla sTM (p = 0,07). Hemoglobina (p < 0,001) oraz przesączanie kłębuszkowe (eGFR) (p = 0,004) były niższe w grupie z HF, podczas gdy INR (p < 0,001), NT-proBNP (p < 0.001) i asymetryczna Coagulation abnormalities as predictors of re...
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