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https://www.readbyqxmd.com/read/28336741/differences-between-determinants-of-in-hospital-mortality-and-hospitalisation-costs-for-patients-with-acute-heart-failure-a-nationwide-observational-study-from-japan
#1
Noriko Sasaki, Susumu Kunisawa, Hiroshi Ikai, Yuichi Imanaka
OBJECTIVES: Although current case-mix classifications in prospective payment systems were developed to estimate patient resource usage, whether these classifications reflect clinical outcomes remains unknown. The efficient management of acute heart failure (AHF) with high mortality is becoming more important in many countries as its prevalence and associated costs are rapidly increasing. Here, we investigate the determinants of in-hospital mortality and hospitalisation costs to clarify the impact of severity factors on these outcomes in patients with AHF, and examine the level of agreement between the predicted values of mortality and costs...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28334567/review-of-nonformulary-medication-approvals-in-an-academic-medical-center
#2
Qoua L Her, Mary G Amato, Diane L Seger, James F Gilmore, John Fanikos, Julie M Fiskio, David W Bates
BACKGROUND: The Joint Commission requires hospitals to formally review formulary medications at least annually based on new clinical information. Although review of nonformulary medication (NFM) use is not required, frequent and inappropriate use of NFMs has the potential to increase hospital costs, negatively affect quality of care, and increase medication errors. Limited resources may restrict an institution's ability to review NFM use in addition to the required annual formulary review...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28302292/short-term-effects-of-tolvaptan-in-patients%C3%A2-with-acute-heart-failure-and%C3%A2-volume-overload
#3
Marvin A Konstam, Michael Kiernan, Arthur Chandler, Ravi Dhingra, Freny Vaghaiwalla Mody, Howard Eisen, W Herbert Haught, Lynne Wagoner, Divya Gupta, Richard Patten, Paul Gordon, Kenneth Korr, Russell Fileccia, Susan J Pressler, Douglas Gregory, Patricia Wedge, Douglas Dowling, Matthew Romeling, Jeremy M Konstam, Joseph M Massaro, James E Udelson
BACKGROUND: In patients with acute heart failure (AHF), dyspnea relief is the most immediate goal. Renal dysfunction, diuretic resistance, and hyponatremia represent treatment impediments. OBJECTIVES: It was hypothesized that the addition of tolvaptan to a background diuretic improved dyspnea early in patients selected for an enhanced vasopressin antagonism response. METHODS: In a double-blind trial, patients were randomized to tolvaptan 30 mg/day or placebo...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28291623/bmi-is-inversely-correlated-to-the-risk-of-mortality-in-patients-with-type-2-diabetes-hospitalized-for-acute-heart-failure-findings-from-the-gulf-acute-heart-failure-gulf-care-registry
#4
Charbel Abi Khalil, Kadhim Sulaiman, Rajvir Singh, Amin Jayyousi, Nidal Asaad, Khalid F AlHabib, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael AlMahmeed, Soha Dargham, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam AlFaleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
BACKGROUND: A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute heart failure (AHF). We hypothesized that an obesity paradox also governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and AHF. METHODS: We studied 3-month and 12-month mortality in patients with T2D hospitalized for AHF according to 5 BMI categories: Underweight (<20kg/m(2)), normal weight (referent group, 20-24...
February 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28280889/end-points-in-heart-failure-are-we-doing-it-right
#5
REVIEW
Luxitaa Goenka, Melvin George, Sandhiya Selvarajan
PURPOSE: Heart Failure (HF) continues to be associated with high mortality and morbidity. We attempted to identify the most common end points used in phase 3 clinical trials of heart failure and discuss their merits and demerits. METHODS: Literature evaluation was done using the databases PubMed and Clinicaltrials.gov from January 2010 to December 2016 to identify randomised clinical trials (RCTs) evaluating the effect of therapeutic drugs on heart failure. Following the literature search, the data on the primary end points were extracted from each of the selected trials...
March 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28259597/circulating-microrna-150-5p-as-a-novel-biomarker-for-advanced-heart-failure-a-genome-wide-prospective-study
#6
Domenico Scrutinio, Francesca Conserva, Andrea Passantino, Massimo Iacoviello, Rocco Lagioia, Loreto Gesualdo
BACKGROUND: Circulating microRNAs (miRs) are promising biomarkers for heart failure (HF). Previous studies have provided inconsistent miR "signatures." The phenotypic and pathophysiologic heterogeneity of HF may have contributed to this inconsistency. In this study we assessed whether advanced HF (AHF) patients present a distinct miR signature compared with healthy subjects (HS) and mild to moderate HF (MHF) patients. METHODS: The study consisted of 2 phases: a screening phase and a validation phase...
February 11, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28235980/galectin-3-as-a-marker-for-clinical-prognosis-and-cardiac-remodeling-in-acute-heart-failure
#7
R I Lala, D Lungeanu, D Darabantiu, L Pilat, M Puschita
BACKGROUND: Galectin-3 has been reported as a mediator of heart failure (HF) development and progression. Most studies, however, have been conducted on patients with chronic HF rather than acute HF (AHF). The aim of this study was to confirm galectin-3 as a prognostic marker in subjects with AHF and to investigate its possible relationship with left ventricular (LV) remodeling. METHODS: A total of 69 patients hospitalized with a primary diagnosis of AHF were followed up for 18 months...
February 24, 2017: Herz
https://www.readbyqxmd.com/read/28220142/absence-of-an-n-linked-glycosylation-motif-in-the-glycoprotein-of-the-live-attenuated-argentine-hemorrhagic-fever-vaccine-candid-1-results-in-its-improper-processing-and-reduced-surface-expression
#8
John T Manning, Alexey V Seregin, Nadezhda E Yun, Takaaki Koma, Cheng Huang, José Barral, Juan C de la Torre, Slobodan Paessler
Junin virus (JUNV), a highly pathogenic New World arenavirus, is the causative agent of Argentine hemorrhagic fever (AHF). The live-attenuated Candid #1 (Can) strain currently serves as a vaccine for at-risk populations. We have previously shown that the Can glycoprotein (GPC) gene is the primary gene responsible for attenuation in a guinea pig model of AHF. However, the mechanisms through which the GPC contributes to the attenuation of the Can strain remain unknown. A more complete understanding of the mechanisms underlying the attenuation and immunogenicity of the Can strain will potentially allow for the rational design of additional safe and novel vaccines...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28217307/worse-prognosis-of-real-world-patients-with-acute-heart-failure-from-the-czech-ahead-registry-in-comparison-to-patients-from-the-relax-ahf-trial
#9
Jindrich Spinar, Jiri Jarkovsky, Lenka Spinarova, Jiri Vitovec, Ales Linhart, Petr Widimsky, Roman Miklik, Kamil Zeman, Jan Belohlavek, Filip Malek, Cestmir Cihalik, Jiri Spac, Marian Felsoci, Petr Ostadal, Ladislav Dusek, Jiri Kettner, Jan Vaclavik, Simona Littnerova, Zdeněk Monhart, Josef Malek, Jiri Parenica
AIMS: The randomized clinical trial RELAX-AHF demonstrated a positive effect of vasodilator therapy with serelaxin in the treatment of AHF patients. The aim of our study was to compare clinical characteristics and outcomes of patients from the AHEAD registry who met criteria of the RELAX-AHF trial (relax-comparable group) with the same characteristics and outcomes of patients from the AHEAD registry who did not meet those criteria (relax-non-comparable group), and finally with characteristics and outcomes of patients from the RELAX-AHF trial...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28214846/circulating-mir-30d-predicts-survival-in-patients-with-acute-heart-failure
#10
Junjie Xiao, Rongrong Gao, Yihua Bei, Qiulian Zhou, Yanli Zhou, Haifeng Zhang, Mengchao Jin, Siqi Wei, Kai Wang, Xuejuan Xu, Wenming Yao, Dongjie Xu, Fang Zhou, Jingfa Jiang, Xinli Li, Saumya Das
BACKGROUND/AIMS: Identification of novel biomarkers to identify acute heart failure (AHF) patients at high risk of mortality is an area of unmet clinical need. Recently, we reported that the baseline level of circulating miR-30d was associated with left ventricular remodeling in response to cardiac resynchronization therapy in advanced chronic heart failure patients. However, the role of circulating miR-30d as a prognostic marker of survival in patients with AHF has not been explored...
February 16, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28193580/astaxanthin-inhibits-inflammation-and-fibrosis-in-the-liver-and-adipose-tissue-of-mouse-models-of-diet-induced-obesity-and-nonalcoholic-steatohepatitis
#11
Bohkyung Kim, Callie Farruggia, Chai Siah Ku, Tho X Pham, Yue Yang, Minkyung Bae, Casey J Wegner, Nicholas J Farrell, Ellen Harness, Young-Ki Park, Sung I Koo, Ji-Young Lee
The objective of this study was to determine if astaxanthin (ASTX), a xanthophyll carotenoid, can prevent obesity-associated metabolic abnormalities, inflammation and fibrosis in diet-induced obesity (DIO) and nonalcoholic steatohepatitis (NASH) mouse models. Male C57BL/6J mice were fed a low-fat (6% fat, w/w), a high-fat/high-sucrose control (HF/HS; 35% fat, 35% sucrose, w/w), or a HF/HS containing ASTX (AHF/HS; 0.03% ASTX, w/w) for 30 weeks. To induce NASH, another set of mice was fed a HF/HS diet containing 2% cholesterol (HF/HS/HC) a HF/HS/HC with 0...
March 2, 2016: Journal of Nutritional Biochemistry
https://www.readbyqxmd.com/read/28188268/design-and-rationale-of-a-randomized-trial-of-a-care-transition-strategy-in-patients-with-acute-heart-failure-discharged-from-the-emergency-department-guided-hf-get-with-the-guidelines-in-emergency-department-patients-with-heart-failure
#12
Gregory J Fermann, Phillip D Levy, Peter Pang, Javed Butler, S Imran Ayaz, Douglas Char, Patrick Dunn, Cathy A Jenkins, Christy Kampe, Yosef Khan, Vijaya A Kumar, JoAnn Lindenfeld, Dandan Liu, Karen Miller, W Frank Peacock, Samaa Rizk, Chad Robichaux, Russell L Rothman, Jon Schrock, Adam Singer, Sarah A Sterling, Alan B Storrow, Cheryl Walsh, John Wilburn, Sean P Collins
GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure) is a multicenter randomized trial of a patient-centered transitional care intervention in patients with acute heart failure (AHF) who are discharged either directly from the emergency department (ED) or after a brief period of ED-based observation. To optimize care and reduce ED and hospital revisits, there has been significant emphasis on improving transitions at the time of hospital discharge for patients with HF. Such efforts have been almost exclusively directed at hospitalized patients; individuals with AHF who are discharged from the ED or ED-based observation are not included in these transitional care initiatives...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28181125/different-trajectories-and-significance-of-b-type-natriuretic-peptide-congestion-and-acute-kidney-injury-in-patients-with-heart-failure
#13
Matteo Beltrami, Gaetano Ruocco, Aladino Ibrahim, Barbara Lucani, Beatrice Franci, Ranuccio Nuti, Alberto Palazzuoli
The exact relationship existing among congestion status, brain natriuretic peptide (BNP) changes and acute kidney injury (AKI) has not been elucidated in patients with acute heart failure (AHF). The aims of this study are: to investigate the relation and prognostic role of BNP, AKI and clinical congestion after discharge; to define the exact BNP cut off value or a BNP in-hospital reduction to identify patients with higher risk during vulnerable post-discharge phase. We consecutively enrolled 157 patients with a diagnosis of AHF...
February 8, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28178959/il-8-predicts-early-mortality-in-patients-with-acute-hypercapnic-respiratory-failure-treated-with-noninvasive-positive-pressure-ventilation
#14
Brynja Jónsdóttir, Åsa Jaworowski, Carmen San Miguel, Olle Melander
BACKGROUND: Patients with Acute Hypercapnic Respiratory Failure (AHRF) who are unresponsive to appropriate medical treatment, are often treated with Noninvasive Positive Pressure Ventilation (NPPV). Clinical predictors of the outcome of this treatment are scarce. Therefore, we evaluated the role of the biomarkers IL-8 and GDF-15 in predicting 28-day mortality in patients with AHRF who receive treatment with NPPV. METHODS: The study population were 46 patients treated with NPPV for AHRF...
February 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28161130/pharmacological-reasons-that-may-explain-why-randomized-clinical-trials-have-failed-in-acute-heart-failure-syndromes
#15
REVIEW
Juan Tamargo, Giuseppe M C Rosano, Eva Delpón, Luis Ruilope, Jose López-Sendón
Acute heart failure (AHF) represents a clinical challenge as it encloses a heterogeneous group of syndromes (AHFS) with different pathophysiology, clinical presentations, prognosis and response to therapy. In the last 25years multiple therapeutic targets have been identified and numerous new drugs were evaluated but, up to now, all failed to demonstrate a consistent benefit on clinical outcomes. Moreover, a repeated finding has been the poor correlation between the encouraging results of preclinical and early clinical trials and the lack of effect on outcomes observed in phase III trials...
April 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28150186/serelaxin-in-acute-heart-failure-patients-with-and-without-atrial-fibrillation-a-secondary-analysis-of-the-relax-ahf-trial
#16
Gerasimos Filippatos, Dimitrios Farmakis, Marco Metra, Gad Cotter, Beth A Davison, G Michael Felker, Barry H Greenberg, Tsushung A Hua, Peter S Pang, Piotr Ponikowski, Min Qian, Thomas A Severin, Adriaan A Voors, John R Teerlink
BACKGROUND: Atrial fibrillation (AFib) is a common comorbidity in HF and affects patients' outcome. We sought to assess the effects of serelaxin in patients with and without AFib. METHODS: In a post hoc analysis of the RELAX-AHF trial, we compared the effects of serelaxin on efficacy end points, safety end points and biomarkers in 1161 patients with and without AFib on admission electrocardiogram. RESULTS: AFib was present in 41.3% of patients...
February 1, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28148262/demographic-factors-associated-with-dietary-supplement-prescriptions-filled-by-united-states-military-service-members-2005-2013
#17
Joseph J Knapik, Rosenie T Jean, Krista G Austin, Ryan A Steelman, Emily K Farina, Harris R Lieberman
BACKGROUND: Dietary supplements (DSs) can be purchased over-the-counter but may also be prescribed by medical personnel for specific therapeutic reasons. Few studies have examined this latter source of DSs despite the fact that 79% of physicians and 82% of nurses have recommended DSs to their patients. This investigation examined demographic factors associated with temporal trends in oral DS prescriptions filled by all United States (US) service members (SMs) from 2005 to 2013 (n = 1,427,080 ± 22,139, mean ± standard deviation per year)...
January 31, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28133908/a-multimarker-multi-time-point-based-risk-stratification-strategy-in-acute-heart-failure-results-from-the-relax-ahf-trial
#18
Biniyam G Demissei, Gad Cotter, Margaret F Prescott, G Michael Felker, Gerasimos Filippatos, Barry H Greenberg, Peter S Pang, Piotr Ponikowski, Thomas M Severin, Yi Wang, Min Qian, John R Teerlink, Marco Metra, Beth A Davison, Adriaan A Voors
AIMS: We evaluated the added prognostic value of a multi-time point-based multimarker panel of biomarkers in patients with acute heart failure (AHF). METHODS AND RESULTS: Seven circulating biomarkers [NT-proBNP, high sensitivity cardiac troponin T (hs-cTnT), soluble ST2 (sST2), growth differentiation factor 15 (GDF-15), cystatin-C, galectin-3, and high sensitivity C-reactive protein (hs-CRP)] were measured at baseline and on days 2, 5, 14, and 60 in 1161 patients enrolled in the RELAX-AHF trial...
January 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28133864/urinary-levels-of-novel-kidney-biomarkers-and-risk-of-true-worsening-renal-function-and-mortality-in-patients-with-acute-heart-failure
#19
Mateusz Sokolski, Robert Zymliński, Jan Biegus, Paweł Siwołowski, Sylwia Nawrocka-Millward, John Todd, Malli Rama Yerramilli, Joel Estis, Ewa Anita Jankowska, Waldemar Banasiak, Piotr Ponikowski
AIMS: Recent studies indicate the need to redefine worsening renal function (WRF) in acute heart failure (AHF), linking a rise in creatinine with clinical status to identify patients who develop 'true WRF'. We evaluated the usefulness of serial assessment of urinary levels of neutrophil gelatinase-associated lipocalin (uNGAL), kidney injury molecule-1 (uKIM-1), and cystatin C (uCysC) for prediction of 'true WRF'. METHODS AND RESULTS: In 132 patients with AHF, uNGAL, uKIM-1, and uCysC were measured using a highly sensitive immunoassay based on a single-molecule counting technology (Singulex, Alameda, CA, USA) at baseline, day 2, and day 3...
January 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28128065/neutrophil-to-lymphocyte-n-l-and-platelet-to-lymphocyte-p-l-ratios-in-differentiating-acute-heart-failure-from-respiratory-infection
#20
Eftychios E Siniorakis, Konstantinos Tsarouhas, Christina Tsitsimpikou, Theodora Ch Batila, Stamatia Panta, Konstantinos G Zampelis, Elias Rentoukas, Filippos Triposkiadis, Sotiria J Limberi
BACKGROUND: The clinical manifestations of acute heart failure (AHF) and respiratory infection (RI) frequently overlap in patients presenting with dyspnoea at the emergency department (ED). The neutrophil to lymphocyte (N/L) and platelet to lymphocyte (P/L) ratios have been proposed as diagnostic and prognostic indices in this setting. OBJECTIVE: To evaluate the ability of N/L and P/L ratios to discriminate the cause of dyspnoea in patients admitted with an initial diagnosis of AHF-RI...
January 26, 2017: Current Vascular Pharmacology
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