Ischemic Etiology and Prognosis in Men and Women with Acute Heart Failure

Vicent, Lourdes; Guerra, José M.; Vázquez-García, Rafael; González-Juanàtey, José Ramón; Dolz, Luis Martínez; Segovia‐Cubero, Javier; Pascual-Figal, Domingo A.; Bover, Ramón; Worner, Fernando; Delgado, Juan; Fernández‐Avilés, Francisco; Martínez‐Sellés, Manuel

doi:10.3390/jcm10081713

Cited by 7 publications

(4 citation statements)

References 39 publications

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“…The non-ischaemic aetiology correlated with a higher risk of rehospitalisation and death, as observed in a comparative analysis between patients with AHF of ischaemic and non-ischaemic aetiology from the "OP-AHF" registry, a single-centre study enrolling 122 patients; similarly, the same was also observed in a subanalysis of the Spanish Network for the Study of Heart Failure II registry (REDINSCOR II), a multicentre study with a larger population sample (1830 patients with AHF) [28,29]. An elevated creatinine level and prior HF hospitalisation were associated with a poor outcome as observed by Ruigómez et al [30].…”

Section: Discussionmentioning

confidence: 55%

Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS)

Magaldi,

Nogue,

Molinari

et al. 2024

JCM

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Background: Acute heart failure (AHF) represents a leading cause of unscheduled hospital stays, frequent rehospitalisations, and mortality worldwide. The aim of our study was to develop a bedside prognostic tool, a multivariable predictive risk score, that is useful in daily practice, thus providing an early prognostic evaluation at admission and an accurate risk stratification after discharge in patients with AHF. Methods: This study is a subanalysis of the STADE HF study, which is a single-centre, prospective, randomised controlled trial enrolling 123 patients admitted to hospital for AHF. Here, 117 patients were included in the analysis, due to data exhaustivity. Regression analysis was performed to determine predictive variables for one-year mortality and/or rehospitalisation after discharge. Results: During the first year after discharge, 23 patients died. After modellisation, the variables considered to be of prognostic relevance in terms of mortality were (1) non-ischaemic aetiology of HF, (2) elevated creatinine levels at admission, (3) moderate/severe mitral regurgitation, and (4) prior HF hospitalisation. We designed a linear model based on these four independent predictive variables, and it showed a good ability to score and predict patient mortality with an AUC of 0.84 (95%CI: 0.76–0.92), thus denoting a high discriminative ability. A risk score equation was developed. During the first year after discharge, we observed as well that 41 patients died or were rehospitalised; hence, while searching for a model that could predict worsening health conditions (i.e., death and/or rehospitalisation), only two predictive variables were identified: non-ischaemic HF aetiology and previous HF hospitalisation (also included in the one-year mortality model). This second modellisation showed a more discrete discriminative ability with an AUC of 0.67 (95% C.I. 0.59–0.77). Conclusions: The proposed risk score and model, based on readily available predictive variables, are promising and useful tools to assess, respectively, the one-year mortality risk and the one-year mortality and/or rehospitalisations in patients hospitalised for AHF and to assist clinicians in the management of patients with HF aiming at improving their prognosis.

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Section: Discussionmentioning

confidence: 55%

Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS)

Magaldi,

Nogue,

Molinari

et al. 2024

JCM

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“…There are several sex differences in patients with HF previously reported, as traditional risk factors, pathophysiology and response to treatment differs between men and women ( 10 , 11 , 14 , 15 ). In a large multicentre study, including >80,000 hospitalized patients, Hsich et al described, more than a decade ago, that women with HF were usually older than men, more likely to have hypertension and depression and less likely to have coronary or peripheral artery disease.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the impact of frailty in elderly outpatients with heart failure

Díez‐Villanueva

Jiménez-Méndez

Bonanad

et al. 2022

Front. Cardiovasc. Med.

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IntroductionFrailty is common among patients with heart failure (HF). Our aim was to address the role of frailty in the management and prognosis of elderly men and women with HF.Methods and resultsProspective multicenter registry that included 499 HF outpatients ≥75 years old. Mean age was 81.4 ± 4.3 years, and 193 (38%) were women. Compared with men, women were older (81.9 ± 4.3 vs. 81.0 ± 4.2 years, p = 0.03) and had higher left ventricular ejection fraction (46 vs. 40%, p < 0.001) and less ischemic heart disease (30 vs. 57%, p < 0.001). Women had a higher prevalence of frailty (22 vs. 10% with Clinical Frailty Scale, 34 vs. 15% with FRAIL, and 67% vs. 46% with the mobility visual scale, all p-values < 0.001) and other geriatric conditions (Barthel index ≤90: 14.9 vs. 6.2%, p = 0.003; malnutrition according to Mini Nutritional Assessment Short Formulary ≤11: 55% vs. 42%, p = 0.007; Pfeiffer cognitive test's errors: 1.6 ± 1.7 vs. 1.0 ± 1.6, p < 0.001; depression according to Yesavage test; p < 0.001) and lower comorbidity (Charlson index ≥4: 14.1% vs. 22.1%, p = 0.038). Women also showed worse self-reported quality of life (6.5 ± 2.1 vs. 6.9 ± 1.9, on a scale from 0 to 10, p = 0.012). In the univariate analysis, frailty was an independent predictor of mortality in men [Hazard ratio (HR) 3.18, 95% confidence interval (CI) 1.29–7.83, p = 0.012; HR 4.53, 95% CI 2.08–9.89, p < 0.001; and HR 2.61, 95% CI 1.23–5.43, p = 0.010, according to FRAIL, Clinical Frailty Scale, and visual mobility scale, respectively], but not in women. In the multivariable analysis, frailty identified by the visual mobility scale was an independent predictor of mortality (HR 1.95, 95% CI 1.04–3.67, p = 0.03) and mortality/readmission (HR 2.06, 95% CI 1.05–4.04, p = 0.03) in men.ConclusionsIn elderly outpatients with HF frailty is more common in women than in men. However, frailty is only associated with mortality in men.

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“…The last decades witnessed an improvement in CAD-treatment modalities, with reduced its associated mortality and increasing survival after myocardial infarction [MI]. However, the incidence of CAD continued to increase, as a result of the increased percentages of aging population [2] .…”

Section: Introductionmentioning

confidence: 99%

Immediate versus Deferred Stenting for Patients Undergoing Primary Percutaneous Coronary Intervention

Almorsy

Altahan

Attia

2021

International Journal of Medical Arts

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Background: Deferred stenting are proposed to be associated with better clinical outcome than early stenting. However, the evidence is consistent. Aim of the work:This study aimed to identify the effectiveness, safety, and outcomes of immediate versus deferred stenting in patients undergoing primary percutaneous intervention [PCI].Patients and Methods: This study included 400 adult patients scheduled for primary PCI. All were evaluated by full history taking, clinical, electrocardiography and echo-cardiography examination, on admission, and at 60 minutes' post PCI. Additionally, an electrocardiographic study was completed for all patients before and after PCI. Patients were categorized according to treatment protocol, 200 for immediate stenting, and 200 for stenting 12 to 24 hours later. Patients follow up was achieved during the procedure, immediately after their return to the CCU and till their discharge. The follow included clinical, laboratory, echocardiographic assessment, and adverse cardiac events.Results: Both groups were comparable regarding patient demographics, pre-interventional comorbidities, or thrombolysis in myocardial infarction [TIMI] flow before PCI. The majority were males in their sixties. The commonest location of infarction was the anterior location [45.75%]. The femoral access was the main approach [among 96.0%]. The procedure related complications was reported among 1.75%, and transfusion was reported among 0.50%. TIMI flow was significantly better among differed than early stenting. After six and twelve months after PCI, there was significant increase of ejection fraction delayed than early stenting [55±4.9, 57±2.6 vs 53±3.1 and 55±3.7, respectively]. Conclusion:Results of the current work are in favor of delayed than early stenting in primary PCI. Especially, for clinical outcome at 6 and 12 months after primary PCI.

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Ischemic Etiology and Prognosis in Men and Women with Acute Heart Failure

Cited by 7 publications

References 39 publications

Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS)

Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS)

Sex differences in the impact of frailty in elderly outpatients with heart failure

Immediate versus Deferred Stenting for Patients Undergoing Primary Percutaneous Coronary Intervention

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