The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study

Calero-Molina, E; Hidalgo, E; Rosenfeld, L; Verdú-Rotellar, José María; Verdú-Soriano, José; Garay, Alberto; Alcoberro, L; Jiménez-Marrero, Santiago; Garcimartín, Paloma; Yun, Sergi; Guerrero, Carmen; Moliner, Pedro; Delso, C; Alcober, Laia; Enjuanes, Cristina; Comín‐Colet, Josep

doi:10.1093/eurjcn/zvab011

Cited by 21 publications

(23 citation statements)

References 33 publications

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“…The methodology of the DAMOCLES study has been published previously by our group. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Briefly, for inclusion, patients had to be diagnosed with chronic HF according to the European Society of Cardiology diagnostic criteria, had at least one recent acute decompensation of chronic HF requiring intravenous diuretic therapy (either hospitalized or in the day care hospital), and had to be in stable condition at the time of study entry. Exclusion criteria were: significant primary valvular disease, clinical signs of fluid overload, pericardial disease, restrictive cardiomyopathy, hypertrophic cardiomyopathy, haemoglobin (Hb) levels <8.5 g/dL, active malignancy, and chronic liver disease.…”

Section: Methodsmentioning

confidence: 99%

Psychosocial factors partially explain gender differences in health‐related quality of life in heart failure patients

et al. 2022

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Aims There is little information about the influence of gender on quality of life (QoL) in heart failure. The purpose of this study was to evaluate whether the health‐related QoL gap between men and women can be explained by the interaction between psychosocial factors and clinical determinants in a real‐word cohort of patients with chronic heart failure. Methods and results We conducted a single‐centre, observational, prospective cohort study of 1236 consecutive patients diagnosed with chronic heart failure recruited between 2004 and 2014. To assess QoL, we used the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Female gender was associated with worse global QoL compared to male gender (MLHFQ overall summary score: 49 ± 23 vs. 43 ± 24; P value <0.001, respectively) and similarly had poorer scores in physical and emotional dimensions but scored better on social dimension. In univariate models and in models adjusted for clinical determinants, female gender behaved as a predictor of worse global, physical and emotional QoL, and better social QoL compared with men. In models only including psychosocial determinants and in comprehensive models including all psychosocial and clinical factors, these differences according to gender were no longer significant. Conclusions In this study, we have shown that the gap in health‐related QoL between men and women with chronic heart failure can be partially explained by the interaction between biological and psychosocial factors. Biological factors are the main drivers of QoL in HF patients. However, the contribution of psychosocial factors is essential to definitively understand the role of gender in this field.

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Section: Methodsmentioning

confidence: 99%

Psychosocial factors partially explain gender differences in health‐related quality of life in heart failure patients

et al. 2022

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“…The methodology of the DAMOCLES study has been published previously by our group [ 6 , 15 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Briefly, for inclusion, patients had to be diagnosed with chronic HF according to the European Society of Cardiology diagnostic criteria, have had at least one recent acute decompensation of HF requiring intravenous diuretic therapy (either hospitalized or in the day-care hospital), and had to be in stable condition at the time of study entry.…”

Section: Methodsmentioning

confidence: 99%

Blood Differential Gene Expression in Patients with Chronic Heart Failure and Systemic Iron Deficiency: Pathways Involved in Pathophysiology and Impact on Clinical Outcomes

Díez‐López

Orduña

Grau

et al. 2021

JCM

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Background: Iron deficiency is a common disorder in patients with heart failure and is related with adverse outcomes and poor quality of life. Previous experimental studies have shown biological connections between iron homeostasis, mitochondrial metabolism, and myocardial function. However, the mechanisms involved in this crosstalk are yet to be unfolded. Methods: The present research attempts to investigate the intrinsic biological mechanisms between heart failure and iron deficiency and to identify potential prognostic biomarkers by determining the gene expression pattern in the blood of heart failure patients, using whole transcriptome and targeted TaqMan® low-density array analyses. Results: We performed a stepwise cross-sectional longitudinal study in a cohort of chronic heart failure patients with and without systemic iron deficiency. First, the full transcriptome was performed in a nested case-control exploratory cohort of 7 paired patients and underscored 1128 differentially expressed transcripts according to iron status (cohort1#). Later, we analyzed the messenger RNA levels of 22 genes selected by their statistical significance and pathophysiological relevance, in a validation cohort of 71 patients (cohort 2#). Patients with systemic iron deficiency presented lower mRNA levels of mitochondrial ferritin, sirtuin-7, small integral membrane protein 20, adrenomedullin and endothelin converting enzyme-1. An intermediate mitochondrial ferritin gene expression and an intermediate or low sirtuin7 and small integral membrane protein 20 mRNA levels were associated with an increased risk of all-cause mortality and heart failure admission ((HR 2.40, 95% CI 1.04–5.50, p-value = 0.039), (HR 5.49, 95% CI 1.78–16.92, p-value = 0.003), (HR 9.51, 95% CI 2.69–33.53, p-value < 0.001), respectively). Conclusions: Patients with chronic heart failure present different patterns of blood gene expression depending on systemic iron status that affect pivotal genes involved in iron regulation, mitochondrial metabolism, endothelial function and cardiovascular physiology, and correlate with adverse clinical outcomes.

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“…Suboptimal organization of care and poor patient self-care have been identified as factors that may partially explain the occurrence of major adverse events and limitations in patient-reported outcomes in the setting of HF [ 9 , 10 ]. Regarding this, multidisciplinary HF disease management programs have been established to improve results through a structured follow-up based on patient education, optimization of medical treatment and improved access to care.…”

Section: Introductionmentioning

confidence: 99%

Breaking the 30-day barrier: Long-term effectiveness of a nurse-led 7-step transitional intervention program in heart failure

et al. 2023

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Background and aims Heart failure (HF) programs successfully reduce 30-day readmissions. However, conflicting data exist about its sustained effects afterwards and its impact on mortality. We evaluated whether the impact of a new nurse-led coordinated transitional HF program extends to longer periods of time, including 90 and 180 days after discharge. Methods and results We designed a natural experiment to undertake a pragmatical evaluation of the implementation of the program. We compared outcomes between patients discharged with HF as primary diagnosis in Period #1 (pre-program; Jan 2017—Aug 2017) and those discharged during Period #2 (HF program; Sept 2017—Jan 2019). Primary endpoint was the composite of all-cause death or all-cause hospitalization 90 and 180 days after discharge. 440 patients were enrolled: 123 in Period #1 and 317 in Period #2. Mean age was 75±9 years. There were more females in Period #2 (p = 0.025), with no other significant differences between periods. The primary endpoint was significantly reduced in the HF program group, at 90 [adjusted OR 0.31 (0.18–0.53), p <0.001] and at 180 days [adjusted OR 0.18 (CI 0.11–0.32), p <0.001]. Such a decrease was due to a reduction in cardiovascular (CV) and HF hospitalization. All-cause death was reduced when a double check discharge planning was implanted compared to usual care [0 (0%) vs. 7 (3.8%), p = 0.022]. Conclusion A new nurse-led coordinated transitional bundle of interventions model reduces the composite endpoint of all-cause death and all-cause hospitalization both at 90 and 180 days after a discharge for HF, also in high-risk populations. Such a decrease is driven by a reduction of CV and HF hospitalization. Reduction of all-cause mortality was also observed when the full model including a more exhaustive discharge planning process was implemented.

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The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study

Cited by 21 publications

References 33 publications

Psychosocial factors partially explain gender differences in health‐related quality of life in heart failure patients

Psychosocial factors partially explain gender differences in health‐related quality of life in heart failure patients

Blood Differential Gene Expression in Patients with Chronic Heart Failure and Systemic Iron Deficiency: Pathways Involved in Pathophysiology and Impact on Clinical Outcomes

Breaking the 30-day barrier: Long-term effectiveness of a nurse-led 7-step transitional intervention program in heart failure

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