Predictors of one-year outcome in patients hospitalised for heart failure: results from the Polish part of the Heart Failure Pilot Survey of the European Society of Cardiology

Balsam, Paweł; Tymińska, Agata; Kapłon‐Cieślicka, Agnieszka; Ozierański, Krzysztof; Peller, Michał; Galas, Michalina; Marchel, Michał; Dróżdż, Jarosław; Filipiak‬, Krzysztof J.; Opolski, Grzegorz

doi:10.5603/kp.a2015.0112

Cited by 26 publications

(26 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in our study the composite endpoint consisted only of death due to cardiovascular causes and/or hospitalisation for exacerbation of CHF, while the composite endpoint in Balsam's et al [27] work was composed of all-cause death and/or readmission for cardiac causes. Additionally, in our study the median ejection fraction was much higher at 58% (IQR = 46-64) than in the Heart Failure Pilot Survey -37% (IQR = 27-50).…”

Section: Discussionmentioning

confidence: 98%

“…In turn, the occurrence of composite endpoint in our studied geriatric population (32.7%) was quite low compared to Polish patients from the Heart Failure Pilot Survey of the European Society of Cardiology (55.3%) [27]. However, in our study the composite endpoint consisted only of death due to cardiovascular causes and/or hospitalisation for exacerbation of CHF, while the composite endpoint in Balsam's et al [27] work was composed of all-cause death and/or readmission for cardiac causes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Annual prognostic factors in chronic heart failure in patients over 80 years old

Cichocka-Radwan

Lelonek

2017

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c tBackground: In the elderly the most common cause of hospitalisation and the leading cause of death is heart failure (HF). Aim:The purpose was to determine prognostic factors in chronic HF (CHF) in octogenarians and nonagenarians.Methods: The analysis included 197 consecutive patients over 80 years old (mean age 83.63 ± 3.01 years; 46.19% men) hospitalised in 2010-2013 due to CHF. Sixty-two parameters were investigated, such as: age, gender, New York Heart Association functional class, body mass index, blood pressure, other comorbidities, the parameters of the 12-lead resting electrocardiography and the echocardiography, the results of basic laboratory tests, and selected biomarkers, including N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T (hs-TnT), and high-sensitive C-reactive protein. Participants remained in a prospective follow-up for 12 months. We defined the primary endpoint as death due to cardiovascular causes and the composite endpoint, which consisted of: death due to cardiovascular causes and/or hospitalisation for exacerbation of CHF. Follow-up concerning the deaths was performed in 189 patients, composite endpoint in 168 and hospitalisation in 166. The uni-and multivariate logistic regression stepwise analysis was performed for the entire population, according to left ventricular ejection fraction (LVEF < 45% and ≥ 45%) and in the group with glomerular filtration rate (GFR) < 60 mL/min. Results:Patients who died constituted 11.1% of the study population (21/189). In multivariate analysis four variables were independently associated with the primary endpoint: GFR (OR = 0.92), hypertension (OR = 0.19), lung diseases (OR = 9.36), and vascular diseases (OR = 6.07). In turn, in the group of patients who reached the composite endpoint (55/168; 32.7%), the only statistically significant independent variable was anaemia (OR = 4.71). In the subpopulation of patients with LVEF < 45% the prognostics for each endpoint were vascular diseases and lung diseases, and they increased the risk from 10-to 24-fold. In the subgroup of patients with LVEF ≥ 45% the independent variable associated with the composite endpoint was haemoglobin (OR = 0.61), in turn for death the prognostics were: white blood cell count, hs-TnT, and vascular diseases (respectively OR = 1.30; OR = 1.04; OR = 3.96). In the population with GFR < 60 mL/min variables with prognostic importance for the composite endpoint were red blood cell parameters: red blood cell distribution width (OR = 1.42) and anaemia (OR = 3.79), while for occurrence of death they were the same as for the entire population -vascular (OR = 5.16) and lung diseases (OR = 4.72). Conclusions:In patients over 80 years old with CHF, comorbidities are of important prognostic value for annual prognosis. The most aggravating factor in studied subgroups was lung disease.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Annual prognostic factors in chronic heart failure in patients over 80 years old

Cichocka-Radwan

Lelonek

2017

Kardiol Pol

View full text Add to dashboard Cite

show abstract

“…Patients with renal dysfunction during HF hospitalisation have higher in-hospital mortality rates, longer length of stay, and increased long-term mortality rates [21][22][23]. Urea also plays a basic and direct role in the fluid and sodium homeostasis, which is regulated by the neurohormonal system [24].…”

Section: Conflict Of Interest: None Declaredmentioning

confidence: 99%

Plasma osmolality predicts mortality in patients with heart failure with reduced ejection fraction

Kaya

Yücel

Ege³

et al. 2017

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c tBackground: Heart failure (HF) is a fatal disease. Plasma osmolality with individual impacts of sodium, blood urea nitrogen (BUN), and glucose has not been studied prognostically in patients with HF. Aim:This study aims to investigate the impact of serum osmolality on clinical endpoints in HF patients. Methods:A total of 509 patients (383 males, 126 females) with HF with reduced ejection fraction in three HF centres were retrospectively analysed between January 2007 and December 2013. Follow-up data were completed for 496 patients. Plasma osmolality was calculated as (2 × Na) + (BUN/2.8) + (Glucose/18). Quartiles of plasma osmolality were produced, and the possible relationship between plasma osmolality and cardiovascular mortality was investigated. Results:The mean follow-up was 25 ± 22 months. The mean age was 56.5 ± 17.3 years with a mean EF of 26 ± 8%. The mean levels of plasma osmolality were as follows in the quartiles: 1 st % = 280 ± 6, 2 nd % = 288 ± 1, 3 rd % = 293 ± 2 (95% confidence interval [CI] 292.72-293.3), and 4 th % = 301 ± 5 mOsm/kg. The EF and B-type natriuretic peptide levels were similar in the four quartiles. Univariate and multivariate analyses in the Cox proportional hazard model revealed a significantly higher rate of mortality in the patients with hypo-osmolality. The Kaplan-Meier plot showed graded mortality curves with the 1 st quartile having the worst prognosis, followed by the 4 th quartile and the 2 nd quartile, while the 3 rd quartile was shown to have the best prognosis. Conclusions:Our study results suggest that normal plasma osmolality is between 275 and 295 mOsm/kg. However, being close to the upper limit of normal range (292-293 mOsm/kg) seems to be the optimal plasma osmolality level in terms of cardiovascular prognosis in patients with HF.

show abstract

“…Under the assumption that death and rehospitalization are relatively common in patients with heart failure, we estimate the frequency of primary endpoint in the furosemide group as 60% [32]. Sample size calculation was performed for 5% type I error rate with 70% power.…”

Section: Methodsmentioning

confidence: 99%

The impact of torasemide on haemodynamic and neurohormonal stress, and cardiac remodelling in heart failure – TORNADO: a study protocol for a randomized controlled trial

Balsam

Ozierański

Tymińska

et al. 2017

Trials

Self Cite

View full text Add to dashboard Cite

BackgroundApproximately 50% of heart failure patients are readmitted to hospital within 6 months, owing to deterioration of their condition. Thus, symptomatic treatment of heart failure requires significant improvement. The aim of this study is to compare the effects of torasemide and furosemide on biochemical parameters of haemodynamic and neurohormonal compensation, myocardial remodelling, clinical outcomes and quality of life in patients with chronic heart failure.MethodsThis is a multicentre, randomized, open, blinded endpoint phase-IV trial. The study includes 120 heart failure patients in NYHA (New York Heart Association) functional class II–IV, treated with optimal heart failure therapy, with indications for use of loop diuretics. At enrolment, patients are stable, with a fixed dose of loop diuretics. Patients are randomized to treatment with furosemide or torasemide (randomization 1:1). After randomization, the current fixed dose of furosemide is continued or is replaced by an equipotential dose of torasemide (4:1). The study consists of two control visits (3 and 6 months after enrolment) with minimal follow-up of 6 months. Assessment involves clinical examination, Quality of Life Questionnaire, laboratory tests, echocardiography, electrocardiography, 24 h Holter-electrocardiography monitoring, 6 -min walk test and assessment of fluid retention. Any need for dose adjustment is assessed during the observation. The primary objective is to compare the effects of torasemide and furosemide on clinical and biochemical parameters of haemodynamic and neurohormonal compensation and myocardial remodelling. Secondary objectives include monitoring of: changes in signs and symptoms of heart failure, NYHA functional class, quality of life, dosage changes, rate of readmissions and mortality.DiscussionDespite decades of the diuretic’s history, knowledge about diuretic therapy is still unsatisfactory. The most widely used diuretic, furosemide, has a stormy pharmacokinetics and pharmacodynamics, and is associated with a high risk of mortality and hospitalization for worsening heart failure. Reports are very encouraging and suggest beneficial effects of torasemide. Hence, there is a need for further studies of the overall effect of torasemide, compared with furosemide. This can translate into improved quality of life and better prognosis of patients with heart failure.Trial registrationClinicalTrials.gov, NCT01942109. Registered on 24 August 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1760-z) contains supplementary material, which is available to authorized users.

show abstract

Predictors of one-year outcome in patients hospitalised for heart failure: results from the Polish part of the Heart Failure Pilot Survey of the European Society of Cardiology

Cited by 26 publications

References 20 publications

Annual prognostic factors in chronic heart failure in patients over 80 years old

Annual prognostic factors in chronic heart failure in patients over 80 years old

Plasma osmolality predicts mortality in patients with heart failure with reduced ejection fraction

The impact of torasemide on haemodynamic and neurohormonal stress, and cardiac remodelling in heart failure – TORNADO: a study protocol for a randomized controlled trial

Contact Info

Product

Resources

About