Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co‐morbidities Aggravating Heart Failure (SICA‐HF)

Saitoh, Masakazu; Santos, Marcelo Rodrigues dos; Emami, Amir; Ishida, Junichi; Ebner, Nicole; Valentová, Miroslava; Bekfani, Tarek; Sandek, Anja; Lainščak, Mitja; Doehner, Wolfram; Anker, Stefan D.; Haehling, Stephan von

doi:10.1002/ehf2.12209

Cited by 59 publications

(51 citation statements)

References 57 publications

(112 reference statements)

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“…4 Overall HF costs were estimated to represent 2.1% of the country's total health expenditure, of which 69% were direct costs, which was slightly more than was estimated globally per annum (60%). 5,6 The health status of the European population has been measured regularly, showing that self-reported health status is worse in the lowest-income groups compared with the highest-income groups in all countries within the Organisation for Economic Co-operation and Development (OECD). 4 Chronic HF results in worsening physical and functional capacities and is characterized by unpredictable and lifethreatening exacerbations and symptoms that often result in hospital admissions.…”

Section: Introductionmentioning

confidence: 99%

Self‐reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross‐sectional study

2018

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AimsThere are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio‐economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio‐economic factors were associated with patient‐reported outcome measures (PROMs).Methods and resultsIn this cross‐sectional survey, PROMs were measured with seven validated instruments, as follows: self‐care (the 12‐item European Heart Failure Self‐Care Behaviour scale), HF‐related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care—‘Patients' evaluation’), health status (EQ‐5D visual analogue scale), health‐related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status.The patients' (n = 124, mean age 73 ± 14.9, 69% male) self‐care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF‐specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients' sense of security was high (>70% had a mean score of 5 or 6, scale 1–6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ‐5D) on average at 65.5 (scale 0–100), and 33% had poor or very bad HRQoL. The monthly income per household was <€3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care‐related items, and >90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out‐of‐pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out‐of‐pocket expenses after the crisis, income, or whether patients lived alone or with others.ConclusionsThis Icelandic patient population reported similar health‐related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.

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Section: Introductionmentioning

confidence: 99%

Self‐reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross‐sectional study

2018

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“…60,61,63,201 They were all shown to have a major impact on clinical presentation, response to treatment and outcomes. [202][203][204][205] , It is well-established that frailty has a key role in HF. The only exception are SGLT2 inhibitors whose administration to diabetic patients at high risk of CV events was associated with a lower rate of the primary outcomes and HF hospitalizations.…”

Section: Comorbiditiesmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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“…On the other hand, decreased exercise capacity and decreased physical activity act hand in hand in aggravating skeletal muscle loss, in itself accelerated by an imbalance in protein senescence and degradation. 34 In patients with dilated cardiomyopathy, an even higher prevalence has been established. 30 The human skeletal muscle proteome project is currently underway to characterize muscle proteins and the way they change during ageing and disease.…”

Section: Screening and Diagnosing Sarcopeniamentioning

confidence: 99%

Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co‐morbidities Aggravating Heart Failure (SICA‐HF)

Cited by 59 publications

References 57 publications

Self‐reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross‐sectional study

Self‐reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross‐sectional study

Highlights in heart failure

Muscle wasting and sarcopenia in heart failure: a brief overview of the current literature

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