Predictors of Long-Term Adverse Outcomes in Elderly Patients Over 80 Years Hospitalized With Heart Failure  - A Report From the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) -

Hamaguchi, Sanae; Kinugawa, Shintaro; Goto, Daisuke; Tsuchihashi-Makaya, Miyuki; Yokota, Takashi; Yamada, Satoshi; Yokoshiki, Hisashi; Takeshita, Akira; Tsutsui, Hiroyuki; Investigators, Jcare-Card

doi:10.1253/circj.cj-11-0267

Cited by 84 publications

(61 citation statements)

References 27 publications

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“…Furthermore, it is assumed that the prognosis of elderly patients who develop heart failure is even worse; therefore, it seems prudent to consider surgery at an early stage. 9,10) According to various reports, in-hospital mortality after AVR for aortic stenosis ranges from 3.2% to 9% for patients 80 years or older and from 2.9% to 7.4% for younger patients or patients of all ages; therefore, the difference between these rates is minimal. [11][12][13][14] Even in patients undergoing AVR combined with CABG, shortterm and long-term outcomes do not vary greatly 13) ; moreover, there was no difference in mortality, incidence of acute cerebrovascular events and postoperative myocardial infarction, postoperative dialysis rate, frequency of pacemaker placement, and incidence of major cardiovascular events including mediastinitis.…”

Section: Discussionmentioning

confidence: 99%

“…Sporadic reports have also described older age among cardiovascular surgery patients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] For elderly patients, the indications for surgery should be considered while accounting for various risks, which differ from those for younger patients. Cardiovascular surgery for elderly patients aged ≥85 years is associated with very high risk, and we have to carefully consider surgical treatment for these patients.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Quality of Life after Cardiac and Thoracic Aortic Surgery for Very Elderly Patients 85 Years or Older

Yokose

Miura

Hashizume

et al. 2016

ATCS

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Purpose: We evaluated the outcomes of open heart surgery and long-term quality of life for patients 85 years and older. Methods: We enrolled 46 patients 85 years and older who underwent cardiac and thoracic aortic surgery between May 1999 and November 2012. Long-term assessment was performed for 43 patients; three patients who died in the hospital were excluded. Patient conditions were assessed before surgery, 6 months and 12 months after surgery, and during the late period regarding the need for nursing care, degree of independent living, and living willingness. Results: Three patients (6.5%) died during hospitalization and 22 (51%) died during the follow-up period. The 1-, 3-, 5-year survival rates were 74%, 49%, and 36%. During the late period, of 21 surviving patients, 18 patients (85%) were living at home. The need for nursing care was comparable before and after surgery. The degree of independent living decreased after surgery. Living willingness was similar before and after surgery. Conclusion: Among patients 85 years or older who underwent open heart surgery, 85% were living at home. All patients could perform activities of daily living without any assistance while maintaining living willingness.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Quality of Life after Cardiac and Thoracic Aortic Surgery for Very Elderly Patients 85 Years or Older

Yokose

Miura

Hashizume

et al. 2016

ATCS

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“…[22][23][24] Concordant with the present study, Hamaguchi, et al reported that the rehospitalization rate was significantly higher in Japanese elderly HF patients. 25) Our country has the highest proportion of elderly citizens in the world. Therefore, improving the management of HF in elderly patients is quite important in Japanese clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients

et al. 2015

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SummaryRepeated hospitalization due to acute decompensated heart failure (HF) is a pandemic health problem in Japan. However, it is difficult to predict rehospitalization after discharge for acute decompensated HF. We used a single hospital-based cohort from the Shinken Database 2004Database -2012 who visited the Cardiovascular Institute Hospital. A total of 282 patients discharged after their first acute HF admission were included in the analysis. The median follow-up period was 908 ± 865 days. Of these patients, rehospitalization due to worsening HF occurred in 55 patients. The cumulative rate of rehospitalization was 17.5% at 1 year, 21.4% at 2 years, and 25.5% at 3 years. Patients with rehospitalization were older than those without rehospitalization. Prevalence of diabetes mellitus (DM) was more common in patients with rehospitalization. Average heart rate (HR) tended to be higher in patients with rehospitalization. Loop diuretics were more commonly used at hospital discharge in patients with rehospitalization. Multivariate Cox regression analysis revealed that age ≥ 75 years, DM, HR ≥ 75 bpm at discharge, and use of loop diuretics at discharge were independent predictors for rehospitalization. The number of these independent risk factors could be used to clearly discriminate between the HF rehospitalization low-, middle-and high-risk patients. HF rehospitalization commonly occurred in patients who were discharged after their first acute HF admission. Older age, DM, increased HR, and loop diuretics use at discharge were independently associated with HF rehospitalization. By simply counting these risk factors, we might be able to predict the risk of HF rehospitalization after discharge. (Int Heart J 2015; 56: 219-225)

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“…These 2 parameters both are significant predictors of CVD, ESRD, and mortality. 53, 54 As an established risk factor for progressive renal function loss, 55 proteinuria or albuminuria is a target in treatment of diabetic kidney disease. 56 In the general population, proteinuria is an important marker of endothelial injury and an independent risk factor for cardiovascular morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Effects of Rosuvastatin and Atorvastatin on Renal Function

Wu¹,

Yan²,

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp hronic kidney disease (CKD) and renal replacement treatment are important global public health problems associated with a high risk of cardiovascular disease (CVD) and high health-care costs. 1,2 Dyslipidemia is one of the risk factors (the others are hypertension, diabetes, and smoking) associated with the development and progression of CKD. 3,4 Clinical trials have indicated the powerful effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) on lipid lowering, which is independently associated with the decrease of all cause mortality and cardiovascular mortality. 5,6 Several studies and meta-analyses have shown the renoprotective effects of statins. 7-12 The roles of 2 strong statins (rosuvastatin [RSV] and atorvastatin [ATV]) on renal function, however, still need to be clarified considering the conflicting results.In the PLANET 1 and PLANET 2 trials, diabetic and nondiabetic patients with moderate proteinuria were assigned to RSV or ATV for 1 year. 13,14 It was found that ATV significantly reduced proteinuria without affecting glomerular filtration rate (GFR), whereas RSV was associated with a significant decline in GFR and had no effect on proteinuria. In contrast, Abe et al reported that RSV reduced proteinuria significantly in patients with diabetic nephropathy, 15 and another study by Sawara et al showed that RSV had beneficial roles both on GFR and proteinuria in CKD patients. 16 The previous meta-analysis by Sandhu et al reported significant decrease in the rate of GFR reduction by a mean of 1.22 ml · min -1 · year -1 and meta-regression showed that ATV was associated with a significantly larger beneficial effect on the rate of decline in GFR than other statins. 9 A Cochrane systematic review by Navaneethan et al, however, showed that statins did not improve the decline in renal function as measured by cre- Background: Several clinical trials have reported inconsistent findings for the effects of rosuvastatin (RSV) and atorvastatin (ATV) on renal function. The aim of this meta-analysis was to investigate the effects of these 2 statins on glomerular filtration rate (GFR) and proteinuria respectively, and determine which is better.

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Predictors of Long-Term Adverse Outcomes in Elderly Patients Over 80 Years Hospitalized With Heart Failure - A Report From the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) -

Cited by 84 publications

References 27 publications

Long-Term Quality of Life after Cardiac and Thoracic Aortic Surgery for Very Elderly Patients 85 Years or Older

Long-Term Quality of Life after Cardiac and Thoracic Aortic Surgery for Very Elderly Patients 85 Years or Older

Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients

Effects of Rosuvastatin and Atorvastatin on Renal Function

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