One year survival of ambulatory patients with the end-stage heart failure: the analysis of prognostic factors

Szyguła‐Jurkiewicz, Bożena; Szczurek, Wioletta; Skrzypek, Michał; Zakliczyński, Michał; Siedlecki, Łukasz; Przybyłowski, Piotr; Zembala, Marian; Gąsior, Mariusz

doi:10.20452/pamw.3975

Cited by 11 publications

(17 citation statements)

References 6 publications

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“…Recently, another score has been gaining popularity, namely, the Model for End -stage Liver Disease, which is used for the assessment of multisystem dysfunction (renal, cardiac, and hepatic) and coagulopathy. 5 It should be noted, however, that prognostic factors in patients with chronic HF are still being investigated, because their type and prognostic value change with time as a result of medical progress, as reflected by modifications in management standards for patients with HF. Furthermore, the most useful stratification tools in daily clinical practice should include noninvasive, simple, repeatable, and readily available tests.…”

Section: Discussionmentioning

confidence: 99%

Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes mellitus predict all-cause mortality in patients with advanced heart failure

Szyguła‐Jurkiewicz¹,

Siedlecki²,

Pyka³

et al. 2017

Polish Archives of Internal Medicine

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INTRODUCTION Early identification of patients with advanced heart failure (HF) who are at higher risk of poor outcome is an important element of patient management, both from the medical and economic standpoint. OBJECTIVES We sought to determine the association between hematologic parameters assessed on admission and within a 3‑year follow‑up in consecutive patients with advanced HF. We also investigated the association between baseline demographic and clinical data and mortality. PATIENTS AND METHODS We analyzed the data of consecutive patients with advanced HF from the single‑center registry COMMIT‑HF. Patients with hematologic and autoimmune disorders, acute or chronic inflammatory diseases, malignant diseases, incomplete clinical and laboratory data, and those receiving glucocorticoids were excluded from the study. RESULTS We analyzed 785 patients with advanced HF out of the total number of 1798 patients included in the COMMIT‑HF registry between 2009 and 2013. The mean (SD) age of the patients was 61.9 (12.4) years, and 76.8% of them were male. Diabetes (hazard ratio [HR], 1.46; 95% CI, 1.15-1.86; P = 0.002), elevated red blood cell distribution width (RDW; HR, 1.05; 95% CI, 1.04-1.07; P <0.0001), and a low relative lymphocyte count (RLC%; HR, 0.942; 95% CI, 0.928-0.956; P <0.0001) were shown to be independent predictors of death. CONCLUSIONS Our study showed that diabetes is a strong independent predictor of death in patients with advanced HF. RDW and RLC% are simple, accurate, and widely available markers predicting mortality at 3 years in patients with advanced HF.

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Section: Discussionmentioning

confidence: 99%

Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes mellitus predict all-cause mortality in patients with advanced heart failure

Szyguła‐Jurkiewicz¹,

Siedlecki²,

Pyka³

et al. 2017

Polish Archives of Internal Medicine

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“…Hyponatremia remains a common prob lem and a strong predictor of poor outcome in different populations of patients with HF. [31][32][33][34] It is included in many prognostic models used in these patients. [31][32][33][34] Our study has several limitations.…”

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confidence: 99%

Mortality risk factors in patients with advanced heart failure and diabetes mellitus

Siedlecki¹,

Szyguła‐Jurkiewicz²,

Szczurek³

et al. 2019

Kardiologia Polska

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BACKGROUND An accurate assessment of prognosis is an important element of the management of patients with advanced heart failure (HF) and diabetes mellitus, because the cooccurrence of these 2 diseases has a particularly unfavorable effect on their course and treatment efficacy. AIMS The aim of the study was to determine the prognostic factors affecting survival in patients with HF and diabetes. METHODS This was a retrospective analysis of clinical and laboratory data of 367 consecutive patients with advanced HF (New York Heart Association classes III-IV) and diabetes, hospitalized in a tertiary referral center for interventional cardiology between 2009 and 2013. Patients with hematologic disorders, those treated with steroids, and those with incomplete clinical data were excluded. The endpoint of the study was all-cause death. RESULTS The mean (SD) age of patients was 63.3 (10.8) years; men constituted 75.7% of the study group. During a mean (SD) follow-up of 4.4 (1.3) years, the overall mortality rate was 53.7%. In a multivariate analysis, independent risk factors of death included atrial fibrillation (AF) (hazard ratio [HR], 1.57; 95% CI, 1.14-2.17; P <0.01), red blood cell distribution width (RDW) (HR, 1.05; 95% CI, 1.02-1.07; P <0.0001), and platelet-to-lymphocyte ratio (PLR) (HR, 1.01; 95% CI, 1.01-1.01; P <0.0001). CONCLUSIONS Our study showed that permanent AF and 2 hematologic parameters, RDW and PLR, are associated with an increased risk of death in a long-term follow-up in patients with advanced HF and concomitant diabetes.

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“…As an evidence of the opinion it has been allowed presenting data, which confi rm higher predictive value of elevated SUA in HF patients beyond etiology of disease, cardiac pump function, traditional risk factors and estimated glomerular fi ltration rate [24][25][26]. Interestingly, large numbers of clinical and observational studies have shown that elevated SUA levels are associated with reduced survival in in-patients and outpatients with several phenotypes of chronic HF, as well as in acute / actually decompensated HF [27][28][29].…”

Section: Short Communicationmentioning

confidence: 99%

Serum uric acid as a metabolic regulator of endothelial function in heart failure

Berezin¹

2017

Arch Clin Hypertens

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Citation: Berezin AE (2017) Serum uric acid as a metabolic regulator of endothelial function in heart failure. Arch Clin Hypertens 3(1): 027-029. DOI: http://dx.doi.org/10.17352/ach.000016 AbstractThe development of heart failure (HF) associated with elevated level of serum uric acid (SUA). Additionally, the majority of individuals with traditional cardiovascular risk factors contributing in HF risk exhibited increased levels of SUA. Although SUA lowering drugs are widely used in patients with symptomatic hyperuricemia and gout beyond their etiologies, there is no agreement of SUA below target level 6.0 mg/dL in asymptomatic individuals with kidney injury and CV disease and data of ones in heart failure (HF) are suffi ciently controversial. First SUA plays an important role in inducing oxidative stress, infl ammation, neurohumoral activation, and endothelial dysfunction. Secondary, SUA may act as antioxidant contributing in restoring of vascular function. Moreover, SUA is able to epigenetically regulate a survival of endothelial precursors, mediate their mobbing and differentiation, as well as coordinate a turn-over effect of metabolic memory phenomenon into repair capability of cell precursors. However, elevated SUA level was found a predictor of adverse clinical outcomes of HF. The short communication is depicted the importance of new clinical data to confi rm the emerging reparative ability of SUA in HF and its role as promising target for treatment in cardiac failure. Short Communication Serum uric acid as a metabolic regulator of endothelial function in heart failureAlexander E Berezin* Short CommunicationThere is a large body of evidence regarding the role of serum uric acid (SUA) in pathogenesis of cardiovascular diseases (CVD) including heart failure (HF). Although SUA levels above the current international reference limit equal 6.0 mg/dL are highly prevalent in chronic kidney disease (CKD), hyperuricemia strongly associates with in-hospital CV mortality independently from CKD etiology and renal function in individuals admitted to the hospital due to several causes, i.e. acute myocardial infarction, stroke, hypertensive emergencies, acute / chronic heart failure, arrhythmia, shock and sepsis.In contrast, hypouricemia did not associate with increased mortality rate in patient populations with established CVD [1]. In HF an elevated SUA level was found due to several mechanisms including an increased activity of xanthine oxidase (XO), which is a key enzyme in uric acid synthesis and is under control of infl ammatory cytokines / chemokines, some growth factors, and intermediates (blood glucose). Whether SUA could be an independent predictor of HF development is not fully clear. Recent clinical studies and some meta-analysis have shown that elevated SUA levels were associated with an increased risk of incident HF, observed in majority of patients with established chronic HF and relate to adverse clinical outcomes in HF [8][9][10][11]. However, the impact of uric acid on all-cause mortality and HF-related dea...

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One year survival of ambulatory patients with the end-stage heart failure: the analysis of prognostic factors

Cited by 11 publications

References 6 publications

Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes mellitus predict all-cause mortality in patients with advanced heart failure

Red blood cell distribution width, relative lymphocyte count, and type 2 diabetes mellitus predict all-cause mortality in patients with advanced heart failure

Mortality risk factors in patients with advanced heart failure and diabetes mellitus

Serum uric acid as a metabolic regulator of endothelial function in heart failure

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