A Retrospective Study of the Treatment Outcome of Drug Therapies used in Heart Failure Patients with Associated Co-morbidities in a Tertiary Care Hospital

Thanusubramanian, Harish; K, Meena Kumari; Shetty, Ranjan; Amberkar, Mohan Babu

doi:10.7860/jcdr/2016/18636.7989

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…Of the total 451 study patients, male predominance of 63.6% with a mean age of 59.76 ± 14.11 and a median hospital stay of 6 ± 4 days corroborating a similar previously reported finding. 5,6 The mean number of days for which the patients were experiencing symptoms before hospital admission was 10.77 ± 17.6. Jia rong wu et al reported patients who waited due to severe dyspneic symptoms before seeking consultation resulted in prolonged admission and exacerbation of HF 7 suggesting greater the wait in number of days to consult the physician, higher the risk of readmission and worsened clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Readmissions and clinical outcomes in heart failure patients: A retrospective study

Akkineni

Mohammed

Pathiraj

et al. 2020

Clinical Epidemiology and Global Health

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Background: Heart failure is a syndrome, due to structural and/or functional abnormalities of the heart associated with high mortality and readmissions. Causes of readmissions are poorly understood and identifying the factors associated with readmissions are crucial to reduce poor clinical outcomes in these patients. Objectives: The main objective of this study was to identify the factors associated with readmissions and clinical improvement in heart failure patients. Materials and methods: A case-control study was conducted in South Indian tertiary care teaching hospital from August 2017 to February 2018. Heart failure patients with readmissions (cases) and without readmissions (control) were identified from medical records department patient files using International Classification of Diseases 10 code 150. Patient's demographics, medical history, laboratory parameters, treatment pattern, readmissions and clinical outcome were collected. Factors associated with readmissions and improved clinical outcome were identified by logistic regression. Results: Out of the total 451 heart failure patients 63.6% were male. The mean age of the study population was 59.7 ± 14.1. Hypothyroidism (OR: 2.64; p = 0.041), diabetes mellitus (OR: 1.59; p = 0.019) and hypertension (OR: 1.53; p < 0.034) were identified as statistically significant factors associated with readmissions. Conversion of intravenous to per oral diuretics (OR: 1.98; p = 0.019) and ejection fraction at readmission (OR: 1.04; p = 0.020) were associated with clinical improvement. Conclusions: Comorbidities like hypothyroidism, diabetes mellitus and hypertension were associated with increased readmissions in patients with heart failure in this study.

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Section: Discussionmentioning

confidence: 99%

Readmissions and clinical outcomes in heart failure patients: A retrospective study

Akkineni

Mohammed

Pathiraj

et al. 2020

Clinical Epidemiology and Global Health

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“…10. A retrospective study conducted by us demonstrated that while patient admission, the extent of prescription of loop diuretics was high for left ventricular systolic dysfunction cases than preserved systolic function ones [16].…”

Section: Vittalrao Et Almentioning

confidence: 97%

“…Nitrates, inotropic drugs, and ACE inhibitors usage were more in cases of left ventricular systolic dysfunction than preserved systolic function [16].…”

Section: Vasodilatorsmentioning

confidence: 99%

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Pharmacotherapy of Heart Failure

Vittalrao

Thanusubramanian

et al. 2018

Asian J Pharm Clin Res

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Heart failure (HF) is one of the major problems related to heart diseases in the modern era. Multiple comorbidities such as coronary artery disease, hypertension, diabetes mellitus, and anemia have a great contribution in the development of HF. It is primarily two types systolic and diastolic HF. Insufficient or decreased pumping of the heart is systolic HF, whereas diastolic HF is because of lack of ability of the heart to relax or increased muscle inflexibility. The pathophysiology of HF is due to enhanced activity of sympathetic system, renin angiotensin system, and structural changes in the wall of ventricle. The two definite targets of medical treatment in HF are as follows: (1) Alleviation of obstructive (or) decreased output manifestations and replenishment of cardiac function. The drugs used are frusemide, thiazides, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), amrinone/milrinone, dopamine/dobutamine, levosimendan, digoxin, hydralazine, nitroprusside, nitrate, bisoprolol, metoprolol, nebivolol, and carvedilol.(2) Prevention of advancement of HF and extension of patient survival -drugs used are β blockers, ACE inhibitors/ARBs, spironolactone, and eplerenone.

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Simvastatin Inhibits IL-1β-Induced Apoptosis and Extracellular Matrix Degradation by Suppressing the NF-kB and MAPK Pathways in Nucleus Pulposus Cells

Zhang

et al. 2017

Inflammation

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Statins are widely used hypocholesterolemic drugs that block the mevalonate pathway. Some studies have shown that statins may have the potential to inhibit intervertebral disk (IVD) degeneration (IDD). Interleukin (IL)-1β, a catabolic cytokine, is a key regulator of IDD. This study aimed to investigate the mechanism underlying the effect of simvastatin on IDD. The viability of nucleus pulposus (NP) cells was determined by the methyl-thiazolyl-tetrazolium (MTT) assay. The apoptosis of NP cells was measured by flow cytometric analysis, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and western blotting of relevant apoptotic proteins. The protein levels of catabolic factors and anabolic factors were determined by western blotting. The cells were stimulated with IL-1β in the absence or presence of simvastatin to investigate the effects on matrix metalloproteinase (MMP)-3, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, ADAMTS-5, type II collagen, and aggrecan expression. Our findings indicate that simvastatin considerably inhibited IL-1β-induced apoptosis in NP cells. We also found that simvastatin attenuated IL-1β-induced expression and MMP-3, MMP-13, ADAMTS-4, and ADAMTS-5 activities and also reduced the decrease in type II collagen and aggrecan expression. In addition, simvastatin considerably suppressed the nuclear translocation and activation of nuclear factor-kappa B (NF-KB) by inhibiting p65 phosphorylation and translocation and blocking inhibitor kB-α degradation. It also inhibited MAPK pathway activation by blocking c-Jun N-terminal kinase (JNK), p38, and ERK phosphorylation. The results of our study revealed that simvastatin is a potential agent for IDD prevention and treatment.

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A Retrospective Study of the Treatment Outcome of Drug Therapies used in Heart Failure Patients with Associated Co-morbidities in a Tertiary Care Hospital

Cited by 3 publications

References 13 publications

Readmissions and clinical outcomes in heart failure patients: A retrospective study

Readmissions and clinical outcomes in heart failure patients: A retrospective study

Pharmacotherapy of Heart Failure

Simvastatin Inhibits IL-1β-Induced Apoptosis and Extracellular Matrix Degradation by Suppressing the NF-kB and MAPK Pathways in Nucleus Pulposus Cells

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