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Congestive heart failure cardiogenic shock

Anissa C Dallmann, Asa Wilks, Soeren Mattke
The Medicare Readmissions Reduction Program penalizes hospitals with higher than expected readmission rates after discharge for congestive heart failure (CHF). This exploratory study analyzed whether categorizing readmissions by event severity might have implications for the program. The authors used the 5% MedPAR (Medicare Provider and Analysis Review) data for 2008 to 2014 and ranked 1820 hospitals based on all readmissions, readmissions for CHF, short-stay CHF readmissions, and readmissions for severe CHF with evidence of cardiogenic shock...
November 7, 2018: Population Health Management
Tomo Ando, Oluwole Adegbala, Pedro Villablanca, Emmanuel Akintoye, Said Ashraf, Mohamed Shokr, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso, Theodore Schreiber
Candidates for transcatheter aortic valve implantation (TAVI) are generally older with multiple co-morbidities and are therefore susceptible to nonelective admissions before scheduled TAVI. Frequency, predictors, and outcomes of TAVI after nonelective admission are under-explored. We queried the Nationwide Inpatient Sample database, an administrative database, from January 2012 to September 2015 to identify hospitalization in those age ≥50 who had transarterial TAVI. A propensity-matched cohort was created to compare the outcomes between nonelective and elective admission who had TAVI...
September 26, 2018: American Journal of Cardiology
Prabhjot Singh, Fabio V Lima, Puja Parikh, Chencan Zhu, William Lawson, Anil Mani, Allen Jeremias, Jie Yang, Luis Gruberg
BACKGROUND: Patient presenting with ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) have extremely high mortality rates. OBJECTIVES: We sought to assess the impact of prior revascularization by either coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI) on the in-hospital and 12-month outcomes and compare them with revascularization-naïve patients. METHODS AND RESULTS: Between 1/2010 and 5/2017, a total of 241 consecutive patients were admitted to our institution with STEMI and CS as defined by New York State Percutaneous Coronary Interventions Reporting System (PCIRS) and underwent primary PCI...
October 15, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Rajkumar Doshi, Evan Shlofmitz, Krunalkumar Patel, Perwaiz Meraj
OBJECTIVES: The aim of this study was to investigate the safety and efficacy of atherectomy devices in obese patients with coronary artery calcification (CAC). BACKGROUND: Atherectomy is an important tool for lesion preparation in patients with CAC undergoing percutaneous coronary intervention (PCI). There have been no studies that compared the outcomes of orbital atherectomy (OA) and rotational atherectomy (RA) in obese patients. METHODS: A total of 35,590 patients from five tertiary-care hospitals who underwent PCI between January 2011 to April 2016 were identified...
October 15, 2018: Journal of Invasive Cardiology
Takeshi Mikami, Hitoshi Kamiunten
Peripartum cardiomyopathy (PPCM) is an idiopathic left ventricular dysfunction in women who are in late pregnancy or the postpartum period. PPCM is a rare but sometimes fatal disease, and mechanical circulatory support is required if heart failure is refractory to conventional therapy. A 28-year-old woman in late pregnancy was admitted to our hospital due to congestive heart failure with cardiogenic shock. Her heart rate was 200 beats per minute (sinus tachycardia), and left ventricular ejection fraction (LVEF) was 10%...
June 2018: Journal of Cardiology Cases
Kyle D Buchanan, Paul Kolm, Micaela Iantorno, Deepakraj Gajanana, Toby Rogers, Jiaxiang Gai, Rebecca Torguson, Itsik Ben-Dor, William O Suddath, Lowell F Satler, Ron Waksman
BACKGROUND/PURPOSE: Appropriate patient selection for mechanical circulatory support following percutaneous coronary intervention (PCI) remains a challenge. This study aims to evaluate the role of coronary perfusion pressure and other left ventricular hemodynamics to predict cardiovascular collapse following PCI. METHODS/MATERIALS: We retrospectively analyzed all patients who underwent PCI for acute coronary syndrome (ACS) from 2003 to 2016. Coronary perfusion pressure was calculated for each patient and defined as the difference in mean arterial pressure and left ventricular end diastolic pressure (LVEDP)...
September 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Holger Thiele, Ibrahim Akin, Marcus Sandri, Suzanne de Waha-Thiele, Roza Meyer-Saraei, Georg Fuernau, Ingo Eitel, Peter Nordbeck, Tobias Geisler, Ulf Landmesser, Carsten Skurk, Andreas Fach, Alexander Jobs, Harald Lapp, Jan J Piek, Marko Noc, Tomaž Goslar, Stephan B Felix, Lars S Maier, Janina Stepinska, Keith Oldroyd, Pranas Serpytis, Gilles Montalescot, Olivier Barthelemy, Kurt Huber, Stephan Windecker, Lukas Hunziker, Stefano Savonitto, Patrizia Torremante, Christiaan Vrints, Steffen Schneider, Uwe Zeymer, Steffen Desch
BACKGROUND: Among patients with acute myocardial infarction, cardiogenic shock, and multivessel coronary artery disease, the risk of a composite of death from any cause or severe renal failure leading to renal-replacement therapy at 30 days was found to be lower with percutaneous coronary intervention (PCI) of the culprit lesion only than with immediate multivessel PCI. We evaluated clinical outcomes at 1 year. METHODS: We randomly assigned 706 patients to either culprit-lesion-only PCI or immediate multivessel PCI...
November 1, 2018: New England Journal of Medicine
Abdulaziz U Joury, Ahmed S Hersi, Hussam Alfaleh, Khalid F Alhabib, Tarek Seifaw Kashour
Background and objectives: Limited data are available highlighting the different clinical aspects of acute coronary syndrome (ACS) patients, especially in Gulf countries. In this study, we aimed to compare patients who presented with acute myocardial infarction (AMI) as the first presentation of patients who have a history of ACS in terms of initial presentation, medical history, laboratory findings, and overall mortality. Methods: We used the Second Gulf Registry of Acute Coronary Events (Gulf RACE-II), which is a multinational observational study of 7930 ACS patients...
July 2018: Journal of the Saudi Heart Association
Rupak Desai, Sandeep Singh, Maryam Baikpour, Hemant Goyal, Abhijeet Dhoble, Abhishek Deshmukh, Gautam Kumar, Rajesh Sachdeva
BACKGROUND: Obesity can lead to increased oxidative stress which is one of the proposed mechanisms in the etiopathogenesis of takotsubo cardiomyopathy (TCM). HYPOTHESIS: The presence of obesity adversely impacts clinical outcomes in TCM patients. METHODS: We queried the Nationwide Inpatient Sample database (2010-2014) to identify adult patients admitted with a principal diagnosis of TCM with and without obesity. We compared the categorical and continuous variables by Pearson χ2 and Student t test, respectively, in propensity-score matched cohorts...
August 2018: Clinical Cardiology
Takeo Fujino, Shujiro Inoue, Shunsuke Katsuki, Taiki Higo, Tomomi Ide, Yoshinao Oda, Hiroyuki Tsutsui
A 31-year-old man was admitted to our hospital with atrial tachycardia and cardiogenic shock. He had been diagnosed with hereditary spherocytosis (HS) during childhood, but he never received any red blood cell transfusions. Right ventricular endomyocardial biopsy revealed multiple myocardial hemosiderin deposits, and he was diagnosed with cardiac hemochromatosis. In addition to the iron deposition in the heart, the loss of myocyte and severe interstitial fibrosis were present. His cardiac function did not improve even after the cardioversion for atrial tachycardia, and he suffered from recurrent heart failure...
March 30, 2018: International Heart Journal
Yukio Mizuguchi, Hiroki Shibutani, Sho Hashimoto, Takeshi Yamada, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata, Akihiko Takahashi
BACKGROUND: The various guidelines clearly mention the treatment strategies for in patient of acute myocardial infarction (MI) presenting more than 24h from symptom onset (recent myocardial infarction, RMI). However, the appropriate timing of reperfusion for RMI is unclear. METHODS: We retrospectively evaluated 525 consecutive MI patients who underwent percutaneous coronary intervention (PCI) in our hospital between January 2008 and December 2012. RESULTS: Sixty RMI patients were more frequently associated with cardiac complications such as myocardial rupture (3...
January 2018: Indian Heart Journal
Caíque Bueno Terhoch, Henry Fukuda Moreira, Silvia Moreira Ayub-Ferreira, Germano Emilio Conceição-Souza, Vera Maria Cury Salemi, Paulo Roberto Chizzola, Mucio Tavares Oliveira, Silvia Helena Gelas Lage, Edimar Alcides Bocchi, Victor Sarli Issa
AIMS: Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. METHODS AND RESULTS: Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47-66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27...
February 2018: PLoS Neglected Tropical Diseases
Amit Iyengar, Oh Jin Kwon, Katherine L Bailey, Adeel Ashfaq, Ayman Abdelkarim, Richard J Shemin, Peyman Benharash
BACKGROUND: Cardiogenic shock after cardiac surgery leads to severely increased mortality. Intra-aortic balloon pumps may be used during the preoperative period to increase coronary perfusion. The purpose of this study was to characterize predictors of postoperative cardiogenic shock in cardiac surgery patients with and without intra-aortic balloon pumps support. METHODS: We performed a retrospective analysis of our institutional database of the Society of Thoracic Surgeons for patients operated between January 2008 to July 2015...
June 2018: Surgery
Yinggan Zheng, Kevin R Bainey, Benjamin D Tyrrell, Neil Brass, Paul W Armstrong, Robert C Welsh
BACKGROUND: Using a comprehensive ST-segment-elevation myocardial infarction registry, we evaluated the relationships of baseline Q waves, time from symptom onset, and reperfusion strategy with in-hospital clinical outcomes. METHODS AND RESULTS: Consecutive ST-segment-elevation myocardial infarction patients from a defined health region were classified by the presence of baseline Q waves and additionally into primary percutaneous coronary intervention, fibrinolysis, or no reperfusion...
November 2017: Circulation. Cardiovascular Interventions
Wes Brundridge, Jack Perkins
BACKGROUND: Thyroid storm (also known as thyroid or thyrotoxic crisis) is part of the spectrum of thyrotoxicosis and represents the extreme end of that spectrum. The condition is quite rare, yet mortality rates are high and may approach 10-30%. CASE REPORT: A 34-year-old-man who had a history of Graves disease presented in atrial fibrillation with rapid ventricular response and mild congestive heart failure. During the course of his Emergency Department (ED) stay he deteriorated into cardiogenic shock...
December 2017: Journal of Emergency Medicine
Thomas J Povsic
The treatment of atherosclerotic heart disease has improved remarkably over the last several decades; however, the outlook for patients with symptomatic congestive heart failure with reduced ejection fraction remains bleak. Current drug therapies target the neurohormonal activation that accompanies congestive heart failure, but do not address the fundamental pathology inherent in this condition-the loss of contractile capacity. Stem cell therapies offer the possibility of rectifying this deficiency and normalizing left ventricular dimensions and cardiac performance by regenerating novel contractile tissue, thereby reversing the negative remodeling that portends progressive left ventricular dysfunction, worsening symptoms, and ultimately cardiogenic shock...
January 2018: Clinical Pharmacology and Therapeutics
Divyanshu Mohananey, Nathaniel Smilowitz, Pedro A Villablanca, Nirmanmoh Bhatia, Sahil Agrawal, Anushka Baruah, Muhammad S Ali, Sripal Bangalore, Harish Ramakrishna
BACKGROUND: Thyroid storm (TS) constitutes an endocrine emergency with an incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock (CS) is a rare complication of TS and very limited data exists on its incidence and outcomes. We aimed to estimate the national trends in incidence and outcomes of CS among patients admitted to US hospitals with TS. MATERIALS AND METHODS: We queried the nationwide inpatient sample for patients with the discharge diagnosis of TS between the years of 2003 and 2011...
August 2017: American Journal of the Medical Sciences
Nikolaos Miaris, Stefanos Zezas, Joseph Sgouros, Dimitra-Christina Zirou, Stefania Gkoura, George Stamoulis, Helen Angelopoulou, George Avgeropoulos, Epaminondas Samantas
BACKGROUND: Anthracycline-induced cardiomyopathy is a serious side effect that ranges from mild left ventricular systolic impairment to congestive heart failure and cardiogenic shock. Currently, there is no evidence indicating the effective use of levosimendan in these cases. OBJECTIVE: We aim to present a case of life-threatening doxorubicin-induced cardiomyopathy that was successfully managed with levosimendan. CASE: A 48-year-old female with formerly normal heart function, who had been treated with doxorubicin-based regimens for dedifferentiated chondrosarcoma, presented with cardiomyopathy with low left ventricular ejection fraction eight months after the last infusion...
September 2017: Heart & Lung: the Journal of Critical Care
Veli-Pekka Harjola, Wilfried Mullens, Marek Banaszewski, Johann Bauersachs, Hans-Peter Brunner-La Rocca, Ovidiu Chioncel, Sean P Collins, Wolfram Doehner, Gerasimos S Filippatos, Andreas J Flammer, Valentin Fuhrmann, Mitja Lainscak, Johan Lassus, Matthieu Legrand, Josep Masip, Christian Mueller, Zoltán Papp, John Parissis, Elke Platz, Alain Rudiger, Frank Ruschitzka, Andreas Schäfer, Petar M Seferovic, Hadi Skouri, Mehmet Birhan Yilmaz, Alexandre Mebazaa
Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality...
July 2017: European Journal of Heart Failure
Mateusz Ostręga, Marek J Gierlotka, Grzegorz Słonka, Paweł Nadziakiewicz, Mariusz Gąsior
INTRODUCTION There are limited data on the impact of ischemic etiology on the clinical status and long‑term prognosis of patients with acute severe heart failure (HF) not associated with acute coronary syndrome (ACS). OBJECTIVES The aim of this study was to assess the clinical characteristics, treatment, and 12‑month mortality of patients with acute severe HF not associated with ACS, according to the etiology of HF.  PATIENTS AND METHODS Data from 112 patients with acute severe HF not associated with ACS were analyzed: 61 patients with ischemic HF and 51 patients with nonischemic HF...
May 31, 2017: Polish Archives of Internal Medicine
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