Gerotechnology for Older Adults With Cardiovascular Diseases

Krishnaswami, Ashok; Beavers, Craig J.; Dorsch, Michael P.; Dodson, John A.; Creber, Ruth Masterson; Kitsiou, Spyros; Goyal, Parag; Maurer, Mathew S.; Wenger, Nanette K.; Croy, Deborah S; Alexander, Karen P.; Batsis, John A.; Turakhia, Mintu P.; Forman, Daniel E.; Bernacki, Gwen M.; Kirkpatrick, James N.; Orr, Nicole M.; Peterson, Eric D.; Rich, Michael W.; Freeman, Andrew M.; Bhavnani, Sanjeev P.

doi:10.1016/j.jacc.2020.09.606

Cited by 88 publications

(59 citation statements)

References 107 publications

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“… 5 Collectively, data on the impact of various treatments on health status have become an integral part of evaluating therapies and improving care for this high-risk patient population. Only a few interventions have demonstrated benefits in terms of health status in patients with chronic HF with reduced ejection fraction: these include dapagliflozin, 21 empagliflozin, 22 sacubitril/valsartan, 23 exercise training, 24 self-management interventions with or without remote monitoring, 25 , 26 and IV FCM. 13–15 Importantly, the modest effects of these therapies (a net effect of +1.5–3.0 points of the KCCQ, at maximum) have been demonstrated in three- to four-fold larger studies and under more stable clinical conditions, which cannot be extrapolated to patients recovering from acute HF.…”

Section: Discussionmentioning

confidence: 99%

The effect of intravenous ferric carboxymaltose on health-related quality of life in iron-deficient patients with acute heart failure: the results of the AFFIRM-AHF study

Jankowska

Kirwan

Kosiborod

et al. 2021

European Heart Journal

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Aims Patients with heart failure (HF) and iron deficiency experience poor health-related quality of life (HRQoL). We evaluated the impact of intravenous (IV) ferric carboxymaltose (FCM) vs. placebo on HRQoL for the AFFIRM-AHF population. Methods and results The baseline 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12), which was completed for 1058 (535 and 523) patients in the FCM and placebo groups, respectively, was administered prior to randomization and at Weeks 2, 4, 6, 12, 24, 36, and 52. The baseline KCCQ-12 overall summary score (OSS) mean ± standard error was 38.7 ± 0.9 (FCM group) and 37.1 ± 0.8 (placebo group); corresponding values for the clinical summary score (CSS) were 40.9 ± 0.9 and 40.1 ± 0.9. At Week 2, changes in OSS and CSS were similar for FCM and placebo. From Week 4 to Week 24, patients assigned to FCM had significantly greater improvements in OSS and CSS scores vs. placebo [adjusted mean difference (95% confidence interval, CI) at Week 4: 2.9 (0.5–5.3, P = 0.018) for OSS and 2.8 (0.3–5.3, P = 0.029) for CSS; adjusted mean difference (95% CI) at Week 24: 3.0 (0.3–5.6, P = 0.028) for OSS and 2.9 (0.2–5.6, P = 0.035) for CSS]. At Week 52, the treatment effect had attenuated but remained in favour of FCM. Conclusion In iron-deficient patients with HF and left ventricular ejection fraction ≤50% who had stabilized after an episode of acute HF, treatment with IV FCM, compared with placebo, results in clinically meaningful beneficial effects on HRQoL as early as 4 weeks after treatment initiation, lasting up to Week 24.

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Section: Discussionmentioning

confidence: 99%

The effect of intravenous ferric carboxymaltose on health-related quality of life in iron-deficient patients with acute heart failure: the results of the AFFIRM-AHF study

Jankowska

Kirwan

Kosiborod

et al. 2021

European Heart Journal

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“…Overall COVID-19 infection has posed a tremendous burden to subjects with diabetes, especially for those with comorbidities and the elderly. This pandemic has also revolutionized the approach to our diabetic patients: telemedicine has facilitated the management of diabetes, although this approach needs a more widespread broadband internet and the capability to understand the use of not-easy-to-use programs [ 59 ]. Regarding the several diabetes treatment approaches, metformin appears the only one that stands for its ability to decrease death risk in those with the severe form of the disease.…”

Section: Discussionmentioning

confidence: 99%

Managing diabetes in diabetic patients with COVID: where do we start from?

2021

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Aims COVID-19 has and still is sweeping away the national health systems worldwide. In this review, we sought to determine the evidence base proofs on the antidiabetic treatment capable to reduce the risk of COVID-19-related mortality. Methods We have performed a systematic search of published articles using PubMed, and EMBASE from March 2020 to March 31st, 2021. We excluded editorials, commentary, letters to the editor, reviews, and studies that did not have mortality as an outcome. For metformin and insulin only, we performed a meta-analysis using Cochrane RevMan 5.2. Results Among antidiabetic drugs, metformin was the only drug associated with a reduced risk of mortality. Conversely, insulin appears associated with an increased risk. The other classes of drugs were neutral. Conclusions The totality of articles reports retrospective data strongly affected by “channeling bias” so that most of the existing results on each class of drugs are driven by the phenotype of patients likely to receive that specific drug by prescription.

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“…As discussed, digital health technologies are effective for delivering aerobic exercise interventions and are acceptable for use by midlife and older populations (47).…”

Section: Potential For Digital Health Technologies To Advance Imstmentioning

confidence: 99%