Comorbidity-adjusted relative survival in newly hospitalized heart failure patients: A population-based study

Baldi, Ileana; Azzolina, Danila; Berchialla, Paola; Gregori, Darío; Scotti, Lorenza; Corrao, Giovanni

doi:10.1016/j.ijcard.2017.05.080

Cited by 13 publications

(8 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our observations are consistent with the literature: OSA is a major risk for cardiovascular and metabolic diseases [12][13][14][15][16]18] and mortality [48]. Decreased renal function was associated with both obstructive and central sleep apnea; there is a 20-40% increased risk of OSA in patients with CKD [8,22].…”

Section: Discussionsupporting

confidence: 91%

“…OSA is the most common kind of sleep apnea characterized by upper airway collapse during sleep with repeated episodes of apneas and hypopneas leading to oxygen desaturations [5][6][7][8][9][10][11]. OSA is related to congestive heart failure, hypertension, stroke, arrhythmias, and worsens the prognosis of coronary artery disease [12][13][14][15][16][17]. The organ damage is related to intermittent hypoxia, inducing oxidative stress, inflammatory state, hemodynamic instability, and increased sympathetic activity; all of these factors contribute to tissue injury that can be mainly ascribed to endothelial dysfunction [18].…”

Section: Introductionmentioning

confidence: 99%

“…It was estimated that more than 17% of the general population suffers from OSA [12][13][14][15][16][17][18][19], but the prevalence of OSA in CKD patients has been reported to be even greater than 40% [5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

Pochetti

Azzolina

Ragnoli

et al. 2020

IJERPH

Self Cite

View full text Add to dashboard Cite

Previous studies showed a bidirectional relationship between renal function decline and obstructive sleep apnea (OSA) syndrome. Continuous Positive Airway Pressure (C-PAP) treatment was shown to preserve the kidney function in OSA patients. This study aims to investigate the progression of long-term renal function in OSA patients treated with different PAP strategies (patients were divided into two groups, fixed C-PAP or other PAP—automatic and bilevel pressure). Comorbidities and 10-years survival were also evaluated. We performed a retrospective, observational, single-center, cohort study, including the first 40 consecutive patients enrolled from 2009 in the Respiratory disease Unit at the Vercelli University Hospital database. The patient inclusion criteria were: age ≥ 18 years with OSA syndrome according to AASM (American Academy of Sleep Medicine) guidelines. Creatinine serum levels (mg/dL) and the estimated Glomerular Filtration Rate (eGFR, mL/min calculated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation)) were measured at 3 different time points: at baseline, 3 years and 8 years after PAP treatment. The Kaplan–Meier survival curves stratified according to PAP treatment and compliance have been reported together with log-rank test estimation. In our study, we found a significant creatinine serum level reduction after 3 years of fixed C-PAP treatment (p value = 0.006) when compared to baseline values. However, we observed that the long-term C-PAP benefit was not significant (p value = 0.060). Our data confirmed the progressive renal function decline in OSA patients, especially in those using other-PAP treatments; nevertheless, OSA treatment with a fixed C-PAP device has shown, in the short term, a significant improvement in renal function. By contrast, in our study, long-term benefits after 8 years are not been demonstrated probably because of the lack of compliance of the patients and the aging effect.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

Pochetti

Azzolina

Ragnoli

et al. 2020

IJERPH

Self Cite

View full text Add to dashboard Cite

show abstract

“…In patients with HF, 22–73% of subjects present with a preserved ejection fraction (HFpEF), which has a wide range of prevalence based on the varying definitions of the disease [ 1 ]. Such patients often suffer from multiple concomitant diseases, which also adversely affect their outcomes [ 2 , 3 , 4 , 5 ]. Anemia is one of the most frequent comorbidities in this patient population; however, its prevalence in HFpEF patients varies widely, occurring in 21–68% of hospitalized patients, 19–27% in randomized controlled trial participants, and 30–33% in outpatient cohorts [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Anemia in Patients with Preserved, Mildly Reduced and Recovered Ejection Fraction

et al. 2022

View full text Add to dashboard Cite

Data on the relevance of anemia in heart failure (HF) patients with an ejection fraction (EF) > 40% by subgroup—preserved (HFpEF), mildly reduced (HFmrEF) and the newly defined recovered EF (HFrecEF)—are scarce. Patients with HF symptoms, elevated NT-proBNP, EF ≥ 40% and structural abnormalities were registered in the HFpEF-HFmrEF database. We described the outcome of our HFpEF-HFmrEF cohort by the presence of anemia. Additionally, HFrecEF patients were also selected from HFrEF patients who underwent resynchronization and, as responders, reached 40% EF. Using propensity score matching (PSM), 75 pairs from the HFpEF-HFmrEF and HFrecEF groups were matched by their clinical features. After PMS, we compared the survival of the HFpEF-HFmrEF and HFrecEF groups. Log-rank, uni-and multivariate regression analyses were performed. From 375 HFpEF-HFmrEF patients, 42 (11%) died during the median follow-up time of 1.4 years. Anemia (HR 2.77; 95%CI 1.47–5.23; p < 0.01) was one of the strongest mortality predictors, which was also confirmed by the multivariate analysis (aHR 2.33; 95%CI 1.21–4.52; p = 0.01). Through PSM, the outcomes for HFpEF-HFmrEF and HFrecEF patients with anemia were poor, exhibiting no significant difference. In HFpEF-HFmrEF, anemia was an independent mortality predictor. Its presence multiplied the mortality risk in those with EF ≥ 40%, regardless of HF etiology.

show abstract

“…The adequacy of the circadian rhythm of BP was assessed by the degree of nocturnal decrease in systolic BP (SBP) and diastolic BP (DBP) -by the daily index (DI) for each of them: DI= ( daytime BPmean -nighttime BPmean )×100% daytime BPmean Depending on the BP profile, the subjects with 10-20% nocturnal SBP mean decrease (physiological) were defined as "dippers". The subjects who did not reach the level of 10% decrease were called "non-dippers", the persons who showed a decrease of ≥20% -"over-dippers", the subjects who had a nighttime increase in BP were called "night-peakers" (Baldi et al, 2017).…”

mentioning

confidence: 99%

Evaluation of Cardiovascular Dysregulation in Patients After Hemorrhagic Stroke as a Complication of Essential Hypertension

Tkachyshyn

2021

USMYJ

View full text Add to dashboard Cite

The aim of the study was to compare blood pressure and electrocardiogram indices, assessed by their daily monitoring, and anamnestic data on mild traumatic brain injury between a group of patients with essential hypertension ≥6 months after a hemorrhagic stroke and a group of patients with essential hypertension without complications. Materials and methods. The total number of examined patients was 198 people, who were divided into 2 groups: the main (n = 94; age – 54,4±8,8 years, M±σ years) and the control (n = 104; age – 53,7±8,9 years) one. Patients in the main group suffered a hemorrhagic stroke as a complication of essential hypertension ≥6 months ago. The control group included patients with essential hypertension, stage II. In both groups of patients, the parameters of 24-hour ambulatory blood pressure monitoring and electrocardiogram were determined. Results. The indices of 24-hour ambulatory blood pressure monitoring in the main group and the control group were the following ones, respectively: the mean daytime systolic blood pressure was 109,6±1,6 and 121,1±1,1 mm Hg, the minimal one was 74,4±2,0 mm Hg and 82,3±12,5 mm Hg, and the maximal one was 168,2±1,9 and 161,9±1,7 mm Hg, p<0,05. The daytime sigma systolic blood pressure (17,9±0,6) and its average real variability of (11,31±2,52 mm Hg) were bigger in the main group (p<0,05). The daytime index of the hyperbaric load of systolic blood pressure was bigger in the main group: it was 403,6±25,9 against 231,7±12,1 mm Hg×h in the comparison group (p<0,05). The mean, minimum and maximum heart rate at night were significantly lower in the main group (p<0,05). The QTcmin index was significantly lower in the main group in contrast to the control one – 286,28±43,34 and 336,69±22,55, and the QT variance was greater – 232,56±44,55 – in comparison to the control group (188,31±33,67) (p<0,05). From the anamnestic data of patients, a significantly higher prevalence of mild traumatic brain injury was found in 37,4% (35 patients out of 94) in the main group relative to the control one – 13,5% (14 out of 104), p<0,05. Conclusions: The results of the study indicate the larger ranges of blood pressure variability in patients with essential hypertension complicated with hemorrhagic stroke, which can be caused by impaired autoregulation according to the QTc interval data. In combination with the disturbances of cerebral circulation, caused by the injury of the brain due to the hemorrhagic stroke alone or in combination with mild traumatic brain injury episode, such a situation may lead to the development of recurrent stroke.

show abstract

Comorbidity-adjusted relative survival in newly hospitalized heart failure patients: A population-based study

Cited by 13 publications

References 19 publications

Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

The Prognostic Value of Anemia in Patients with Preserved, Mildly Reduced and Recovered Ejection Fraction

Evaluation of Cardiovascular Dysregulation in Patients After Hemorrhagic Stroke as a Complication of Essential Hypertension

Contact Info

Product

Resources

About