Non-cardiovascular disorders in a contemporary cardiovascular intensive care unit in Japan

Abstract

Background: In the modern US cardiovascular intensive care unit (CICU), the incidence of noncardiovascular disorders has increased and non-cardiovascular disorders are associated with an increase in morbidity and mortality. In Japan, however, data regarding the association between non-cardiovascular disorders and outcomes in the CICU are limited.Methods: This study examined 490 consecutive admissions to a closed CICU at the Nippon Medical School Hospital from January to December 2017. Characteristics, diagnoses, treatments, and outcomes of admitted patients were identified. Results:The most common primary diagnosis was acute coronary syndrome (50.4%), followed by acute heart failure (20.0%), arrhythmia (6.7%), and non-cardiovascular diseases (3.7%). The mortality rate and median length of stay (LOS) in the CICU were 4.7% and 4 (interquartile range, 2-8) days, respectively. Of all patients, 42.2% ( n = 207) developed non-cardiovascular complications such as acute respiratory failure, acute kidney injury, or sepsis during CICU stay. Multivariate logistic regression analysis revealed that acute respiratory failure and sepsis were significantly associated with mortality in the CICU (odds ratio, 11.014 and 25.678, respectively; both p < 0.05). The multiple linear regression analysis showed that acute kidney injury was significantly associated with LOS in the CICU ( β= 0.144, p = 0.002). Conclusions:Approximately half of patients admitted to the CICU had non-cardiovascular disorders including non-cardiovascular disease and non-cardiovascular complications, which were significantly associated with mortality and LOS in the CICU.

Timing and Degree of Acute Kidney Injury in Patients Requiring Non-Surgical Intensive Care

“…Worsening renal function (new-onset AKI after admission and AKI with an increase in RIFLE class during hospitalization) is common in patients with cardiovascular disease (mainly ACS and AHF). 24, 25 In the present study, 934 patients (increased renal afterload) and increased renal interstitial pressure (intrinsic renal compromise) may play an important role in the development of AKI in patients with cardiovascular disease. 21 A recent study reported that persistent venous congestion, as well as arterial and organ hypoperfusion, reflected by a lower arterial pressure and cardiac index, are associated with both the incidence and severity of AKI.…”

Bioengineering and Biotechnology Approaches in Cardiovascular Regenerative Medicine, Volume II

“…Nevertheless, these studies have elucidated important relationships between cells and biochemical and biophysical forces and highlighted the capabilities of in vitro cultures in recapitulating aspects of the neurovascular microenvironment. Moving forward, the CO vascularization field Wnt signaling directs human pluripotent stem cells into vascularized cardiac organoids with chamber-like structures Introduction Cardiovascular disorders, including congenital heart defects and cardiovascular disease, remain as a global health issue due to their high mortality worldwide (Balakumar and Kaur, 2009;Kadooka et al, 2021;. Developing new therapies is also challenging, since few drug candidates succeed to pass pre-or clinical trials and many of them are removed from the market due to severe cardiac toxicity (Balakumar and Kaur, 2009;Matoba and Egashira, 2011).…”

Wnt signaling directs human pluripotent stem cells into vascularized cardiac organoids with chamber-like structures

“…Cardiovascular disorders, including congenital heart defects and cardiovascular disease, remain as a global health issue due to their high mortality worldwide (Balakumar and Kaur, 2009;Kadooka et al, 2021;Zhao et al, 2021). Developing new therapies is also challenging, since few drug candidates succeed to pass pre-or clinical trials and many of them are removed from the market due to severe cardiac toxicity (Balakumar and Kaur, 2009;Matoba and Egashira, 2011).…”